Musungu!

It’s a familiar scene now. I walk through the village to the market to get some bread or whatever. As I walk past villagers’ houses, hordes of kids run out, point at me and scream “Musungu! Musungu! Musungu!” while adults either stare and give the gesture of greeting by clasping their hands together or stare and say “Chungulo (good afternoon)” or just stare. Being the only foreigner in a thirty-kilometer radius, this kind of attention is pretty much unavoidable.

I learned that “musungu” is the local language for “white man.” I was hoping that it may translate to “evil foreigner that breathes fire” or something more dramatic. But no, it just means “white man.”

Man, these people are calling me white? I really should start working on my tan!

A Break from Lubwe

It was two weeks ago when I last went to Mansa, the administrative center of Luapula Province. As my food supply is getting low, I jump at the opportunity when Ms. K., the hospital’s medical licentiate, invited me to go along with her to Mansa.

Two hours and one hundred kilometers later, we arrive at Mansa’s town center. I head to the Barclay Bank ATM to take out money. After half a minute, out comes the cash I wanted. Compared to the ordeal last time when I tried to cash my traveler’s checks, this is as painless as it gets. I really have to remember never to touch traveler’s checks again!

I desperately want to check my emails. Unfortunately, power is out in the whole town. So we decide to head out of town to see Mumbuluma Falls, one of numerous waterfalls in this part of the country.

Less than an hour out of Mansa towards the border with Congo (D.R. Congo, that is, the country formerly known as Zaire, not to be confused with Congo-Brazzaville farther north in the continent), the Landcruiser stops at the end of a well-maintained gravel road. The roar of the falls can be heard as we step out of the car. A few people are washing their clothes at the river bank at the other side of the river just above the first falls. Ms. K. tells me that these are Congolese villagers who depend on this river for their water supply. We must be really close to the border now. The tribes living along the arbitrarily drawn border between Zambia and Congo regularly cross it as they had for thousands of years. To them, the central governments of their respective countries are so far away, their lives are hardly affected by the countries’ policies. There is no citizenship, no immigration formalities, no border checks – those are for foreigners like me and urbanites from Lusaka.

We arrive at the end of the gravel road to Mumbuluma Falls

Villagers doing their washing just above the upper falls

Upper falls

Lower Falls. Water levels are very high at this time of the year

At the edge of lower falls

After a picnic by the falls, we head back to Mansa to do some shopping. Compared to ShopRite, in which most produce is trucked in from South Africa, the open-air market in town has the better and cheaper locally-produced fruits and vegetables. As we walk from stall to stall, Ms. K. has to explain to people that, no, I am not part of the group of Chinese here to build the bridge across the river that forms the border between Zambia and Congo.

The main street of Mansa

All the cabs are required to be painted sky blue

The market for all your fruits and vegetables needs

Different types of caterpillars are on offer at this stall

These women just realize I am pointing my camera at them

All stocked up on provisions, we make our way back to Lubwe as the sun starts to set.

Fever = Malaria

Malaria is endemic in Zambia. To give you an idea how common it is here, whenever people have fever, they just say they have malaria; the two words are almost interchangeable. It’s so common, people get malaria like we get colds. Everyone knows the symptoms; self diagnosis is common, so are anti-malarial medications. Almost everyone here has had malaria at one point in their lives; it’s kind of like a rite of passage. The pharmacy at the hospital has a huge section reserved for different anti-malarials. I really didn’t have to spend the money and bring my own malaria treatment. The pharmacy here has better, and far cheaper, malaria treatment medication than hospitals in Brisbane. The latest malaria treatment, artemether plus lumefantrine, is difficult to get in Brisbane and not even available in the United States, is a dime a dozen here.

Malaria in this part of Africa is of the falciparum species, which, while causing the most number of malaria-related fatalities worldwide, is highly curable when treated early and aggressively. It doesn’t cause relapses like the other more benign varieties like ovale, malariae, and vivax. Whichever it is, I am trying my best not to get it. Between taking my malaria prophylaxis religiously, wearing long-sleeves in the evening, sleeping under a mosquito net, and spraying insect spray around my room regularly, I am hoping I can avoid joining the club.

In the hospital, treating patients for malaria is a daily chore. They may come with some other problems, but almost everyone gets a blood slide done for malaria. Quinine flows like the keg at a fraternity party and, because hypoglycemia is a common side effect, everyone on quinine eats sugar by the cupful. Good thing diabetes is not common here. I am sure that, by the end of these eight weeks, I will have seen more malaria cases than I will for the rest of my medical career, barring any future medical trips to malaria-endemic regions.

HIV In A Bottle?

There has been a pretty big controversy in Zambia since last week. The Minister of Health announced that HIV virus has been found in bottles of the contraceptive injection Depo Provera made by an American company. He said the product has been pulled from the market until further notice.

This news really delivered a blow to a country with the world’s sixth highest rate of HIV infection and among the highest birth rates. Among the women in rural areas, many of whom have minimal education, it seems that they are destined to live a life of bearing one child after another, regardless of their ability to raise them. They are thus trapped in a life of crushing poverty. Contraception is at least one way to help them break out of this life; and Depo Provera is the only contraception that can be administered by health workers with minimal medical skills to a scattered rural population. It doesn’t require the women to remember to take a pill every day; it doesn’t require cooperation from the men; and it only needs to be given every three months.

With this hasty announcement from the Minister of Health, I am sure the drive for birth control will suffer a severe setback. The sensationalism surrounding it alone is enough to make people wary of receiving injections of any kind. Why were they looking for the virus in Depo anyway? How did the suspicion come about? How likely is the HIV virus to be able to survive in a contraceptive solution? Was it really the virus itself that has been found? Has it been confirmed? None of these questions were answered, just an announcement without any explanation. So, you can just feel the knee-jerk reactions going around the country.

During the morning handover, one nurse’s knee-jerk reaction was particularly high. She proclaimed that “we should all just use the natural methods for contraception!” Upon prodding for elaboration, she offered, “the withdrawal method, the calendar method, and lactational contraception.” Her earnest and emotional reaction, along with her advice, was met with stifled chuckles from the rest of the staff. If an educated person has this kind of reaction to the news, just imagine what the uneducated villagers would think.

I will keep my eyes peeled to see how this controversy develops.

Kung Fu Hustle

After ward rounds, I sit by the desk to write some notes. Out of nowhere, the nurse asks:

Nurse:
Do you know kung fu?

Me:
That’s random. No, I don’t.

Nurse:
I think you do. Every Chinese does.

Me:
Where’d you get that idea from?

Nurse:
On TV, we see that people in China are trained in kung fu from the time when they’re little.

Me:
No, actually, we’re born already knowing kung fu. It’s in the blood. My mom told me that I’d kicked my way out of her womb, and then cut the cord with a kung fu chop.

Nurse:
Really?

Me:
No, of course not! I don’t know kung fu.

Nurse:
(Eyes me suspicious, unconvinced)

That was not the first time someone in Zambia has asked me if I know kung fu. Just the other day when I went jogging past the village market, some kid was mimicking kung fu moves at me and challenging me to a fight. I laughed and jogged passed him, thus perpetuating the stereotype by showing my incredible restraint and tolerance.

Should I feel flattered or offended?

Lower Expectations

Being the only day off, Sunday is the day I take care of chores like doing laundry. Here, doing laundry means actually washing every piece of my clothes by hand. When I have to put in the hard labor, what goes in the laundry is determined by the smell test: if I hold it near my nose, do I feel like my breakfast is making its way up? Yes – it goes to the laundry; yes, but just a little – it can probably be worn at home for another day; no – it’s as good as fresh. I know, it’s a bit like back in college again.

As I sit by the faucet in the court yard washing my laundry, Alice the cook expresses her surprise that I know how to wash clothes by hand. “If I don’t know how to wash my clothes by now, I’m in real big trouble,” I tell her.

People here seem to be surprised by what I can and would do. Besides my laundry skills, people also seem to be surprised that I would eat on a daily basis nshima, the local staple food, and all the various leaves and other foods the locals eat, and that I can take cold showers in the morning. What kind of spoiled foreigners had come to stay here before? What do the locals expect of foreigners? Whatever it is, the expectations seem to be pretty low. I am glad to see it doesn’t take much to impress them. Thank you, my predecessors who had come before me and set the bar so low.

Village Night Life

After dinner, I want to check out the night life in the village. So I head out with Alick and Christian, who are both from around this area and are also staying at the guesthouse.

We step into the first of two bars in the village. Ten or so tables are arranged haphazardly around the room, which is illuminated by a single bare light bulb and a spotlight aimed at a bare wall. A boombox sits at the bar, playing music by a Zambian band at top volume. A couple of women are sitting at the bar drinking and a small group of men are sitting and drinking around a table next to the dart board at the other side of the room. We are the third group.

The bar consists of a few dusty bottles sitting on a couple of wooden shelves on the wall, accompanied by a few bottles of hard liquor. The only beers available are the local brews Castle and Mosi. Each grabbing a Castle, we sit down at a table halfway between the dart board and the bar. Alick recognizes that one of the men sitting at the table is the local priest at the Catholic church. I may be mistaken, but I thought Catholic priests are supposed to refrain from patronizing drinking establishments; and here he is, taking a swig of his beer in between throwing darts. Has the church relaxed the rules to attract and retain priests to rural areas? Is the priest openly flouting the rules knowing that he can get away with it? Are the people so devoted to the priest and the church that they don’t question his conducts? Of course, a priest drinking and having entertainment is really no big deal in comparison to the big scandals the Catholic Church has been involved in recently. But isn’t making this comparison akin to indulging in the kind of moral relativism the Church has been warning us about? Slippery slope, anyone?

We next visit the bar at the other side of the market. On our arrival, we just double the number of patrons at the bar. This place has a pool table. We play pool until the barkeep tells us that she wants to go home. I look at my watch – eleven o’clock. I guess that’s late enough for a Saturday night out in a village in the middle of Zambia. The night life on the weekend here is pretty dead. But for the villagers, most of whom do not have formal employment, a Saturday night means nothing to them – it’s not any different than a Monday night, or a Wednesday night, or any other night of the week.

As the bar shuts, we retrace our way back to the guesthouse on the dirt road as a light shower comes down.