Panel on Safe Male Circumcision

For the most part, Peace Corps volunteers understand that we will rarely see the impact of our hard work.  I do feel appreciated by some people in my community, but they usually say, “You are so important” or “You are doing so much.”  They rarely single out specific interventions or projects as particularly noteworthy.  Peace Corps Botswana has mechanisms to recognize volunteer work.  We can submit success stories to the monthly newsletter.  We get positive feedback from our program managers.  And recently PC has started “Realities from the Field” panels.  PC staff invites volunteers working on specific interventions to come give a presentation to our governmental and non-governmental partners in Gaborone.

On November 20^th, the “Realities from the Field” panel was on safe male circumcision (SMC).  I presented on my work, along with four other volunteers.  The idea behind these panels is to give feedback to policymakers.  We tell them what is going on at the ground level, our successes and challenges in the safe male circumcision campaign.  We presented to a group of over 20 people with representatives from the Center for Disease Control, President’s Plan for Emergency AIDS Relief, Department of Defense, Botswana Ministry of Health, Population Services International, JHPIEGO and ACHAP (organizations working on SMC in Botswana).  It was definitely a room of heavy hitters.  We told them how men and women were receiving SMC in our villages, myths and questions we encountered, etc.  They can then shift their programs as needed.

The panels are great for Peace Corps volunteers because they are an appreciation of our work that we rarely experience otherwise.  I worked with Bright Mosimegi, a nurse at Shoshong Clinic, to develop a Setswana SMC/pap smear informational pamphlet for our April Month of Youth Against HIV/AIDS event. We designed it in Setswana because all of the pamphlets on SMC from the Ministry of Health were in English.  Some people speak English in Shoshong, but plenty do not.  Since we wanted everyone to be able to understand the message, they needed to be in Setswana.  The Ministry and its related partners in the SMC are starting to translate their materials into Setswana, but that is still a problem.

At the panel, I presented on my pamphlet and related health talks at the clinic.  I roughly translated the pamphlet, explaining to everyone the headings and information contained therein.  Many people asked me questions.  Then at the end, one man said that he was so happy to see this pamphlet.  He said that the Setswana was simple, which one rarely sees in pamphlets designed by public health specialists.  He was happy that the pamphlet was accessible, urging the groups there to involve people on the ground to make more pamphlets like this one.  And then everyone clapped.  It was such a great moment.

Before the panel, I sent the pamphlets out in an email to all volunteers in Botswana.  At this point, I think that about 5 other volunteers are using it.  Knowing that I have created something that is making health information accessible to people is a great feeling.

In the last post, I wrote about becoming comfortable in my role as a Peace Corps volunteer.  I learned early on that there is no reason to reinvent the wheel.  Using already existing programs and materials is the way to go.  It is really nice knowing that a product of mine will help volunteers and other service providers in Botswana better explain the importance of safe male circumcision and pap smears.

Left hand side is SMC; right is pap smear info

General translation of the pamphlets:

PAP PAMPHLET

What is pap smear (direct translation: testing for cervical cancer)?

•  It is done every year
• Checks the cervix

What does pap smear test for?

• Non-sexually transmitted infections like yeast and bacterial infections
• Sexually transmitted infections like gonorrhea, syphilis and others
• Sexually transmitted infections that can be treated, but that without treatment can give you pelvic inflammatory disease and cervical cancer
• Sexually transmitted diseases that cannot be cured like genital herpes

Consequences of not testing:

• Many of these diseases show no symptoms, so you can have them and not know it
•  If you do not seek treatment, some can become cancer
•  Cervical cancer can lead to fertility and even death

SMC PAMPHLET

What is SMC (direct translation: cutting the foreskin of the penis safely)?

• SMC is the surgical removal of the foreskin of the penis by health professionals in a health facility

SMC reduces the chances of the following:

•  Contracting sexually transmitted infections like syphilis
• Contracting HIV by 60 percent
• Getting penile cancer
•  Getting urinary tract infections
• Transmitting HPV to female partners

Why does SMC work?

•  The foreskin is easy to tear during sex
• The foreskin holds CD4 cells, which HIV targets
• It is difficult to clean foreskin, resulting in diseases if not cleaned properly

Other things you should know:

• SMC does not prevent HIV
•  Men must wait 6 weeks before having sex after doing SMC

Year Two Adjustments

I have felt a dip in workload lately.  This oftentimes coincides with the closing of the schools.  So many of us work in schools in some aspect or another, so the holidays bring a slowdown of projects.  Being six months away from close of service is a strange time.  We are still involved with projects in a real way, ideally beginning to see what our counterparts can continue without us.  We want to continue to grow our work within the community, but starting a new long-term project now seems foolish.  We are probably as comfortable as we will ever be in our villages.  We are thinking about plans after Peace Corps, but still have six months staring us in the face.

I have sensed a change in myself these past few months.  There are still difficult moments, ones in which I want to shut myself up in my house with a glass of wine in one hand and a bar of chocolate in the other.  But the difficulties don't have so much to do with the fact that I am a Peace Corps volunteer. They have to do with the fact that I am human.  If I were living anywhere else, those moments would still happen.

It is interesting to talk with volunteers who have been in service less time than I have.  It reminds me of my past phases of adjustment.  One volunteer wrote an article in our monthly newsletter about becoming unhappy as the doubts of Peace Corps service grab hold.  She was telling us not to give up on personal development, reminding us how to be responsible for finding the joy again.  The basic gist was that we can choose to be happy.  It made me smile because I realized that I no longer think about my service in that way.  I am just content.  I do not need to search for things to make me feel this way.  There was a time when Peace Corps service felt like something to have to "get through."  But I do not feel that way about the next 6 months.  I am not counting down.  I don't look at my time in Shoshong as  "service" anymore.  I am living in Botswana.  It is not something insular, different from my other experiences in my life.  It just IS my life.

A large part of the unique frustrations of Peace Corps service is the constant feeling of failure----or if not failure, then at least questioning whether or not you are making any kind of difference.  Wondering about actual legacy and impact is a big topic, for another post for sure.  But part of becoming content is realizing that I absolutely have succeeded in making a difference.  The key is in redefining success.  The best definition I have ever seen was hanging in the computer lab of Shoshong Junior Secondary School:

"Success is going from failure to failure without losing your enthusiasm."

Reminds me of golf.  Every shot is a new chance.  Every shot has the potential to be amazing.  And if anything, that has been my success...that regardless of how many projects never started or how many people said they would work with me and never followed through, I have continued to be enthusiastic if someone wants to start a project with me.  I have not been discouraged because of failure.  It's not really determination or perseverance, but rather a pleasant acceptance of the way things are.

Mosinyi's Coronation

Late August, we had a really exciting event take place in Shoshong.  My brother, Mosinyi Mosinyi, was coronated as chief of our ward, Bokaa!  Shoshong has three wards: Phaleng, Bokaa and Kgamane.  Phaleng and Bokaa are the largest, each having roughly 35 sub-wards.

Mosinyi now presides over the customary court of Bokaa, deciding on matters that are brought there.  He also gives people advice independent of court proceedings.  He can try cases of land disputes, marriage disputes, etc.  He is also seen as a leader in the community now that he is a chief.

Here are some photos from the event and the week leading up to it:

A lot of people came the week before to help clean, cook and prepare for the coronation.  Here, they are preparing the mud mixture that they will put around the tree.

 

Collecting straw to cover the small house in the back of the compound

Both my house and the main house were re-painted.  This is Mushi, one of Mosinyi's friends, painting the main house.

At any gathering, there is a metal fence put up where people are cooking.  The women always cook the starches, greens and other salads.  The men take care of the meat.  I think 11 cows were slaughtered to feed people at the coronation.  You can see some of them behind the metal wall here.

One of my favorite dishes is bogobe jwa lerotsi.  It is a starch made from sorghum.  Then you put little pieces of melon in it.  Yum!  Here the women are peeling the melons.

Program for the event (I have a shirt with the top part on it...its PRETTY GREAT)

People waiting for the event to start

The seat of honor with all the male village elders sitting behind it

Here comes Mosinyi flanked by chiefs of Shoshong and nearby villages

A group of young men doing some sort of drama (you can see me on the left videotaping)

Me videotaping

The next to perform was a chorus from Shoshong

Then a traditional dance group from Shoshong Junior Secondary School

How it looked at the kgotla - lots of people!

I wrote a poem for the occasion.  It was mostly in English but I think people liked it.

There were many speeches by old men I didn't know, but I didn't put those photos up here.  This is the part when Mosinyi was actually being coronated.  I thought it would be more ceremonial, but they mostly read the history of the Bakaa tribe, said some words of advice and then we went on our way.  Here, Mosinyi is sitting down.  Standing behind him (l to r) are Chief Mosinyi from Kalamare, another chief from somewhere I don't know, and Chief Mosinyi from Shoshong (one of the chiefs at the main kgotla).

Mma Mosinyi sitting at the table of honor

The best part: when we get to eat!  Here is Susan helping out with the serving

It was a lot of fun being part of the celebrations.  I was honored to read a poem and be included as a real community member.  It was special for me (and much easier to sit through) because it was my brother becoming chief.  These ceremonies take hours and hours, so it is really nice when you actually know the subject of the proceedings.  I don't think I have ever seen that many people at an event in Shoshong.  It was truly a great day!

General Updates

Apologies for not writing for so long.  Some people lessen their blog posts because they find they run out of things to say.  That's not the case with me.  I have so much to update!  I have just been so busy.

In October, I had two visitors.  The first was a trainee named Paige.  The other was my mom!  I had a great time with both of them.  It is so nice to share your village and your experience with other people.  My mom only planned on being here for 9 days but because of Hurricane Sandy was stuck in Gaborone for an extra three days.  That was three more days of laying by the pool at the hotel, three more days of good meals and shopping.  I wasn't complaining!

But it is so nice to be back in Shoshong working everyday...no visitors, no need to leave for any reason...just doing my thing.  Traveling all around so much gets tiring.  It is funny how things change.  There were days in which I wanted to be ANYWHERE ELSE but Shoshong.  But these days, I feel like I never want to leave.

There is a new group of community mobilizers in Shoshong.  They will be working to motivate men to get circumcised.  I am sure I will be partnering with them in some way.  I am continuing to try to work in the schools.  The one Life Skills class I was teaching has ended and the kids are finishing up their exams.  But I still have some time for some programs this month if I can kick it in gear.  New projects continue to come up.  I always like to leave my schedule flexible for these things.  It's really nice.

I will write more specific blog posts on Paige and mom's visits, as well as other things that have been happening.  Hopefully my internet works well enough to upload photos.