Life and AIDS Work in NorthWest Cameroon

Why am I here? What am I doing? Who do I want to be?

Being abroad for 6 months, away from friends and family, living on a tight budget, with little access to the normal distractions and amusements gives one a lot of time to think about existential issues.  Usually, I just spin round and round in my head, and once I am fatigued I simply decide to enjoy what is around: the view, the jokes, the ironies and oddities of everyday life.  But every once in a while, I get a glimpse of insight into the bigger questions and issues invoked by this extra-ordinary adventure.   

My latest batch of thoughts were inspired by Robert Strauss, the Peace Corps Director of Cameroon.  The following are some excerpts from his monthly mailing, edited to focus on what I thought were the most interesting points.

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Along with all the various hardships one faces in Cameroon, we are also confronted with the same questions that many Peace Corps Volunteers - here and around the world - continue to confront. "What am I doing?" Did I make the right choice?" "Why am I here?" "Why are we in Cameroon?" "People here aren't starving. Shouldn't I be working where people are starving?" Or "Why am I not working at home to alleviate poverty? There are more pressing needs just miles from where I used to live than there are here."

Since arriving in Cameroon I have conducted many interviews, met several dozen of you in the office and more in the field. Every interview has been interesting. Some have been challenging, other intriguing. None, unfortunately, has provided me with philosophical tautologies to answer any of these questions. What they have done is clarified some thoughts I have about how one can think about the fundamental questions of development and how we decide what to do now that we are here.

Development itself is a peculiar field. How do we define development? From whose point of view? The United States, in terms of material acquisition and infrastructure, is by most standards "developed." Yet judged on the basis of American rates of murder and family cohesiveness we are perhaps not so developed. In the face of such conflicting information, how do we think about what we are doing here in Cameroon?

Not long ago I took a seminar in which the facilitator asserted that seeking answers to "why" questions was a waste of time. Find out "why" you do something and so what? Where does that leave one? Every why question generates a reason as an answer which can provoke another "why." At the seminar the facilitator had us go through endless cycles of "why" and behind each answer, behind each reason, there was always another question and another reason. And the reasons, though self-satisfying and self-justifying, ultimately got us all nowhere. Likewise with "What am I doing?" and "Did I make the right choice?" kind of questions. These are questions, as my facilitator pointed out, that don't get us anywhere. They serve mainly as some type of psychological justification for what we have already done. They do little to get us where we want to be.

The questions to ask, the facilitator suggested, are, "Who do I want to be?" or "What am I personally committed to?" The answers to these types of question draw us into the future. In the face of adversity and challenge (as we are all likely to face in Peace Corps), the answers to these questions pull us toward a future that inspires us, toward a personal possibility and commitment. The answers to "Why am I here?" or "What (the hell) am I doing?" don't do this and more often than not come from something that is pushing us from behind - such saving face, or parental judgment, or finishing up something no matter what or how distasteful. How much more powerful it is to be drawn forward by a personal aspiration or commitment.

In any given situation in life, no matter the hardship, we can choose to commit ourselves to something that inspires and motivates us by answering the question, "Who do I want to be?" In a Peace Corps context, this could be being the best teacher one can be, being an inspiring and supportive manager, being a compassionate and irrepressible health educator, or maybe simply being a good listener. The character of commitment is often built around an adjective; compassionate, dedicated, adventurous, supportive, innovative. You can try a different one on each day - "Today I'm going to be adventurous" - until you find the one that works for and inspires you. The beauty of this approach is that we don't have to like what we are doing moment by moment because what we are doing moment by moment is motivated by the person we are committed to being rather than the actions we are taking. The actions are taken only in service to the commitment, not in and of themselves. So when teaching or managing is a drag, or when all the crops have withered, or when the funds have been diverted, or when people didn't show up when they said they would, yes, it's distressing, it's troubling, it's unfortunate, it's a pain. But ultimately - unless there is arterial bleeding going on - it doesn't matter because circumstances and emotions do not need to affect the person you have chosen to be. You can continue to choose to be that person. And your commitment can sustain and inspire you in the face of bad weather, broken promises, failed communication, and all the many other annoyances that can plague and get us down.

So decide who you want to be: bold, courageous, compassionate, loving, adventurous, and try it on. Walk in that character for a day or a week or a month and see how it feels. And how the world around you looks when you see if from the point of view of a personal commitment you have selected. And then let me know how it works and how if feels.

Trek to Lake Oku

On Sunday, we rented a 4-wheel drive truck to take us to the mystical and mythical Lake Oku in the nearby Ijim forest preserve.  This is an important site for studying biodiversity, and it has some rare species of birds, frogs, and vegetation that are not found anywhere else in the world.  For more information about the interesting ecology of this area, see the following links

• http://www.birdlife.org/action/ground/bamenda/bamenda3.html 
• http://www.projectexploration.org/projectfrog/fu-082106.htm

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Piling into the truck:  F Paul and Shannon in front, my father and mother in back.  ==============================================================================

The road was so steep and slippery, sometimes the drivers' assistant needed to get out to put stones under the wheels and push the truck out of the muddy ruts in the road.

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When the road got too steep and our bones ached from bumping along the rugged track, we got out of the truck and hiked up the rest of the way.

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F.Paul leads the way.  He has a masters degree in ethnobotany and studied the medicinal uses of the plants in this forest preserve, so he was definitely in his element.

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An Alchemilla glistening with dew.  This forest preserve is one of the few remaining cloud forests in West Africa, and the plants gather most of their moisture from the mists that are continuously drifting through.

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Prunus Africanus.  The bark of this tree has been stripped and sold to a pharmaceutical company which uses it to create a drug to treat prostatitis.

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The clouds drift by the summit and when they lift, they reveal the mystical Lake Oku.

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After visiting the Lake Oku, we stopped by to greet the second class chief.  We gave him 5 liters of wine as a tribute for visiting the forest.   We marveled at the traditional carvings on his house.  Only three people in the entire Kom kingdom are allowed to decorate their dwellings in this manner.

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The women's group of Anyajua were excited to meet my parents.  They sang a traditional welcome song and danced around with peace plants in a gourd.

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While in Anyajua, we also stopped by to say hi to FPaul's mother.   Here we are posing in front of the house where he was born.

Three Burials and No Wedding

There has a rash of deaths in the last 24 hours.  Today, my parents and I ran into three burials by accident.   

Walking out of the house this morning, my parents and I witnessed the wailing and flailing of a woman mourning the death of a child.  A crowd had gathered in front of the house of the family, talking quietly and trying to console the family who were sobbing and singing sad songs inside.

Then we past Shannon's house where a huge crowd had gathered on her road.  Her neighbor had been found dead that morning in a stream in a remote area about halfway between his home and the elementary school where he was the headmaster.   It was a shocking and disturbing death because very few people die by drowning, because he is a very quiet family man with seven children, and because his head was covered in bruises, which made it look like he was beaten.  I went to give my condolences to the family, not realizing it was open casket without any makeup.  An older lady in a fancy dress was barking order at his seven kids so they would pose for a photo gathered around their father's corpse.  Meanwhile his wife was leaning into the coffin, and his mother came up to put her hands on his battered head.   It was very grim.

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Here are schoolkids holding a photo of their deceased headmaster and beating drums at his wake.

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Then when we returned from the market with our weekly load of tomatos, onions, and condiments, we ran into a third burial.  This one had a festive tone, with drums, jujus, and dancing, so the deceased must have been an older person.

Death is happening all around, with little or no warning or explanation.

Cry Die

Yesterday, we went to the death celebration, or "Cry Die," of a man who was born in 1894.   Since elderly people are revered here, all the "jujus" or masked dancers came to the memorial service, including some that made the long trek from the Fon's palace in Fundong.  The Fon is the ruler of all the Kom people, so this was the highest honor that can be bestowed on a community member.

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Heidi and Peter trekking through the mud.  It rained on and off, all day long, and the location of the funeral was about an hour walk from town.

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When we arrived, we had to jump in the bushes because the jujus were on the loose and there are some you should not look at.  I snuck a photo of them from where I was hiding.  These are called "Nantang."

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Here is Peter posing with "Nikang," the Joker jugu, who prances around in what looks like a pair of droopy diapers.

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There was a huge crowd that gathered to celebrate despite the the persistent rain and remote location.

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Here is "Mabu," a powerful jugu that comes from the Fon's palace only for very special occasions.  Everyone is bent over as a sign of respect.  Also, if you don't bend down, it may come over and hit you with the spear.

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Here is the nephew that inherited the old man's land and six surviving wives.  Inheritance is matrilineal: the "successor" is the first son of the deceased's oldest sister.

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African Modernism

I have spent the last couple of days in Yaounde with my parents who just arrived this weekend.  While overall it is a pretty dirty city, there is some really cool modernist achitecture.  Here are some photos.

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The pool at the fabulous Mount Febe hotel

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Fake African dance at the hotel.  In the village, a woman would not be caught dead in a bikini top and grass skirt, which is to say she would not be caught alive in such skimpy attire.

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Building  with odd tumor, conference room  appendage.

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Facade of a bank

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Palm tree

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Mask in a museum established by a Swiss Benedictine monk in the 1960s.

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My mother (Heidi) taking pictures in the museum

Reverse Tourism

I went to a fully stocked supermarket today and stood in awe of the shiny linoleum floors and stacks of packaged items, priced to be desirable and just out of reach.   It glistened like a museum to Western culture.

• Tin of Danish butter cookies ($7)
• Bottle of peach flavored ice tea ($4)
• Ten different types of cheeses (one slice of Gruyere $6)
• Nivea body lotion ($10--- the cost of a 6 hour bus trip)   
• Towels and plastic sieves in all the colors of the rainbow   

Chocolate croissants, breakfast cereals, gold jewelry, counterfeit clothes from the Gap and Banana Republic, the store had it all.  But even though I craved variety in my post, once I saw all the options, I was overwhelmed and lost my appetite.  So I left the store with a tiny packet of M&Ms and had a chilled piece of pineapple from a street vendor.  Later that afternoon, when I recovered my cool, I went out for a chocolate ice cream cone and a chicken sandwich.  This may be an ordinary everyday occurance in the US, but here it is a rare treat.

Amoebas, E. Coli, and Other Intestinal Adventures

I am in the Peace Corps house in Yaounde, waiting to pick up my parents who are arriving for a two week visit.  Hanging out with other Peace Corps volunteers for the day makes me realize how our culture and conversations change to adapt to our environment.  One of the the first topics of conversation: unusual bowel movements and other mysterious ailments.

One guy I met got antibiotic resistant E.Coli and had to be put on intravenous treatment.  A woman posted in the extreme north has recurrent amoebas.  Another kept passing out due to what was eventually diagnosed as an infection of the inner ear.  Not to be left out, I tested positive for micro-organisms which I think I got from eating guavas.   

I am relieved that the discomfort is not a psycho-somatic side effect of doing too many trainings on common childhood illnesses.   I also like the ironic reciprocity of being a visitor in a foreign land while being a host to unknown organisms.

A Reprieve to Refocus

September has been a time of tentative new beginnings.  Project Hope is always involved in a broad spectrum of spontaneous activities that are tangentially related to HIV/AIDS.  So I have been working on a creating a communication strategy to tackle diarrhea among children under 5 and on management training with the three paid staff to develop a strategic plan for revitalizing this organization and moving it forward.

One key issue is to decide how integrated Project Hope's approach should be.  As a spontaneously evolving community-based organization, it addresses some of the causes and consequences of HIV/AIDS like poverty and preventable illnesses.  Project Hope has already established income generating projects for people living with HIV/AIDS so they have a viable alternative to farming.  This makes sense because one of the reasons people do not get tested and treated for HIV/AIDS is lack of income.  Project Hope also works on integrated management of childhood illnesses: diarrhea, respiratory tract infections, and malaria, because they affect the orphans and vulnerable children in our program.

But the disadvantage to an integrated approach like this is that organizations needs staff with a broad range of skills.  The bookkeeping skills that help you run a successful small business are not the same skills that allow you to train community based organizations in digging wells and protecting water sources.   Of course, counseling on HIV/AIDS requires a whole other set of medical knowledge and psycho-social skills.

Sometimes an integrated program feels like it is not focused enough to be effective.  But on the other hand a narrow program that only provides HIV/AIDS treatment and promotes abstinence and fidelity does not meet all our clients needs.  In addition, being involved in activities that are not HIV/AIDS related helps Project Hope reach people who are still afraid to be associated with us for fear of being stigmatized as being HIV positive.

Is Project Hope's integrated approach open-minded and enlightened?  Or is it diffusing its limited resources in tangential issues?  It is too early to tell for sure, and in the end, it may be both.

Wa-BONG-nah!

Unlike the village where I worked in Mali, here in Njinikom there are many other Europeans and Americans working at the hospital and in the surrounding communities.  Here are some pictures of some of the other "Wobongna" as white people are known here.

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Eating fish with Rebecca, the Peace Corps Volunteer in the nearest town.  Prior to the Peace Corps, Rebecca served in the Army for many years. She even worked in the Army facility where biological weapons are studied and developed.

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Ingrid is a nurse who volunteered at the hospital during the summer.  There have been many other medical and nursing students from Germany who spend 3 weeks to 4 months at the hospital as part of their practicum.

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T. Paul posing with Tim, an American medical student who was here for 6 weeks this summer to evaluate and collaborate on a project that delivers drugs for HIV and common childhood illnesses at 50% off.

To Give or Not to Give...

One of the decisions I face here on a daily basis is the question of how to respond to requests.  Walking down the street is not uncommon for kids to call out, "Give me something" or "I beg for sweet."  At work, colleagues ask for help getting financial aid to study in Europe or the US.  Several people have asked me to pay their school fees, or the fees of their children.  Old men ask for kola nuts, deaf people moan and point at their stomach, and casual acquaintances, like the tailor and motorcycle taxi driver, ask me to buy them shoes.  Almost everyone wants help getting a visa to the US.

It is hard to know how to respond.  People here are comfortable asking just about anyone, especially any wealthy or white person, for things.  Successful Cameroonians are expected to help their less fortunate family members.  So most locals who are gainfully employed are supporting about three or four nieces and nephews in addition to their parents and children.  They send school fees, pay for death celebrations, and host anyone who shows up at their door for weeks at a time.  There is no stigma attached to relying on family members in perpetuity.  In fact, it is the reverse, refusing to help friends and family members is unacceptable.

One of the last Peace Corps volunteers in Njinikom was exceedingly generous.  She let three children move into her courtyard, and she paid the school fees of about 5 children.  Rumor has it that she would walk down the street handing out bread and candies to small children and that she gave a very generous to a teenage boy.

On the other hand, it can be very annoying to be constantly asked to give, give, give.   You begin to dread certain conversations because you wonder when are they going to ask you for something.  If you decline, there is always the inclination to explain why, since more often than not, you have more than they do, even though you are just a poor Peace Corps Volunteer.  Most Cameroonians work much harder than Americans but earn a lot less.  Still you are tempted to give a lecture about how in the US, it is better to work and save your money than to just ask for a hand-out.   

You want to be able to give freely and be generous, but their pre-emptive requests often catch you off-guard and leave you feeling uncertain.   When it comes to giving, is there always a string attached?

Back to School Spirit

Labor Day is celebrated on May 1 in Cameroon, as it is in the rest of the world.   So tomorrow is not a holiday,  but the first day of school. 

Already the village is in back-to-school spirit, bubbling over with teenagers back from their holidays in the big city.  There are sophisticated strangers parading down the road, calling out to each other in exaggerated nonchalance.  Teenage girls saunter seductively in skintight pants, and boys strut in baggy jeans and slouchy hats.  I even saw a few couples walking down the road hand in hand, something you hardly ever see around here. 

This afternoon everybody is down at the soccer field watching yet another championship soccer game.  Meanwhile, at the tailor shops, seamstresses are working overtime to finish school uniforms: royal blue polyester pinafore dresses for girls, and white shirts and navy slacks for boys.

Njinikom has no less than 3 secondary schools: VOTEC where you can learn to run small businesses like a family restaurant, hairdressing salon, or tailor workshop; Jua Memorial College, where you can study liberal arts and social sciences; and the Georgian Academy where you can learn construction, carpentry, computers, and other practical skills.  In this area, starting private schools seems to be a cottage industry, there are at least three other secondary schools within an hour's drive.

I am hoping that the optimism and enthusiasm of the returning students will rub off on me.  I had a rough August with two projects dissolving.  At the tailoring workshop for people living with HIV/AIDS, the tailor in charge has continued to drink on the job despite repeated warnings.   Even worse, he stole money from sales, but since he is the brother of one of the nuns it seems impossible to get rid of him. 

The market program in Belo has also been floundering.   Eric, the charismatic outreach worker who showed up reliably week after week, got married and is under pressure from his in-laws to go to the capitol to earn money at the Guinness factory.  In addition, he feels like he has been marginalized fro Project Hope because he received training from an organization that incude condom education as part of this HIV/AIDS prevention approach.  Efforts to find and train a replacement in the village of Belo to have been unsuccessful.  We recruited people for 4 weeks and in the end trained 13 peer educators, but after the training no one showed up to take over.

People have been trying to console me by saying that such problems are common in Cameroon and that you can learn a lot from failure.  Unfortunately, I have not had any brilliant insights yet.

So here's hoping this September I can make a fresh start and get past this entropy and apathy.