Choices

In Peace Corps philosophy, every project should have a local counterpart—a community member who is (hopefully) as passionate as you are.  You learn from each other while doing that project.  This is called “capacity building.”  Ideally, volunteers never do anything alone.  The point is to empower community members to do things themselves, to connect them with the right people/contacts/funding…whatever it may be.  Then, in the future, after you are gone, they may continue the work without you.

That is the pie in the sky view of things.  When you are on the ground, things begin to look a lot different.  How do you organize the community to host an event?  Which people do you choose as counterparts?  When do you pull back and let others take over?  If people seem excited but don’t do their end of the work, do you catalyze them to do more?  Or do you realize that the community buy-in for the project is low and abandon it?

Over the course of my service, I have allowed my projects to be dictated by community members’ interests.  I haven’t felt lazy or bored, for the most part.  Every week, my schedule fills of its own accord.  There have been specific instances in which I have taken initiative, like teaching life skills in the schools and giving health talks at the clinic.

November and December can be slower months.  Schools are closing and people are leaving for the holidays.  Lately, some volunteers have done events relating to the 16 Days of Activism Against Gender Violence Campaign.  I think it would be a great thing for us to do in Shoshong.  Perhaps a march, poetry contest when schools open back up…something.  Gender-based violence is rarely talked about and I think we should open up the dialogue.  Peace Corps volunteers can be really useful in this regard.  Culturally, it can be difficult to talk about sensitive issues.  Because we are foreigners, it is easier for us to initiate community dialogues about things like gender-based violence, HIV, sexual practices, etc.

I am breaking my mold a bit in spearheading an event myself.  My plan is to have the community come up with the whole event, if they think it is a good idea in the first place.  And then we will go from there.

Slow moving is okay.  In fact, it is wonderful.  It is how I have lived for the past year and a half.  But there is such a thing as allowing yourself to become idle and complacent.  And I don’t want to feel like my service is over.  I have six months and I intend to utilize them…or I intend to try, anyway.

We all make choices about how we want to conduct our Peace Corps service…how we want to enjoy our lives.  And at this point, my choice is to continue to be active.  That is not to say that any of my projects will succeed.  But at least I will have attempted to do something.

Cervical Cancer in Botswana

Many women in Botswana are dying of cervical cancer.  Cervical cancer is caused by HPV, the Human Papilloma Virus.  Although there is widespread knowledge about HIV in Botswana, other sexually transmitted infections (STIs) are not well-known.  More women die from cervical cancer in Botswana than from any other kind of cancer.  The tragic part about the situation is that cervical cancer is preventable.  Women must simply go their local clinic or hospital for yearly pap smears.  If abnormal cells are found on the cervix, a series of measures can be taken so that the abnormal cells do not turn into cancer.

HPV is not only a problem in Botswana.  According to the Center for Disease Control, at least 50% of sexually active Americans will contract HPV during their lifetime.  There are more than 40 different strands of HPV.  Some of them cause genital warts, others cervical changes.  There is no HPV test for men, which is one of the reasons why it is so easily spread.  You could have been infected with HPV years ago and not know it.  HPV rarely has any symptoms (other than warts) before it causes cervical cancer.

Luckily, foreign donors and the Botswana Ministry of Health are recognizing this as a problem that can be solved simply.  Get more women to do pap smears.  Get the results in a timely fashion.  Follow up with the women who have abnormal cells on their cervix.  Piece of cake, right?  Unfortunately, no.  Some women (especially younger, sexually active women) are afraid to do pap smears because they believe they are painful.  Results are not received in a timely manner.  Occasionally they are lost altogether.  And tracking women down in a large village with no transport, and where many people don't have cell phones...well, you get the picture.

Positive steps are being taken to remedy this serious health issue in Botswana.  In the past, HIV has been the message of the day.  But the Ministry of Health is realizing that it needs to integrate other messages about sexual reproductive health into HIV awareness.  Raising awareness about cervical cancer is a large part of that.

Former President George W. Bush came to Botswana a few months ago.  He announced a new multi-million dollar initiative to  step up cervical cancer screenings.  For more information, check this out.

What makes me most excited is the "See and Treat" program that the Ministry of Health is rolling out next year.  To ameliorate the issue of lack of timely results, the Ministry is trying a new tactic.  Doctors and trained professionals in a handful of hospitals across the country will be screening women for cervical cancer using vinegar.  When vinegar reacts with the cells on the cervix, one can identify the cervical changes and treat on the spot.  This eliminates the difficulty in finding women for follow-ups.  Here is a great NPR article about this new initiative.

When so much of our work is centered around behavior change and HIV, it is refreshing to hear about something exciting and different.  The "See and Treat" program could really make a difference in Botswana.  I hope other countries are using the same model.

As PCVs, we can refer women to places where they do the "See and Treat."  We can spread awareness about cervical cancer in a more comprehensive way.  Working to increase the number of women screened for cervical cancer in Botswana is something achievable that can make us feel fulfilled.  It is a great time to be working in international public health.

One of the More Enlightened Days

I have had some thoughts about the Peace Corps experience in general lately, but haven't figured out how to put them down on paper until now.  So...here ya go:

Peace Corps service shows you that there is a lot more to life than work and a paycheck, if you didn't know it already.  Many other experiences can also do this, but Peace Corps is one of the most effective.  You are forced to find fulfillment out of smaller things in life: the beauty in the sunrise, the relief that comes with approaching rain clouds, the carefree nature of children's laughter.  You can no longer define yourself by what you do.  Instead, what becomes more important is how you do it.  You realize how much you enjoy writing by candle light.  You actually meditate.  You read books you always meant to read, but never seemed to get around to before.  Peace Corps challenges your understanding of the world.  Through that, you emerge---the same as before, but oh so different.  You listen more.  You approach problems in a more nuanced way.  You observe without judgment and experience without reservation.  Who you are deepens and broadens.  You begin to see your well-being inextricably linked with the well-being of those around you.  On the worst days, you feel lost...pull-your-hair-out-, punch-a-pillow-, cry-at-a-sad-movie-just-to-feel-something-LOST.  On the best days, you think, "Wow...I may just actually be considered a member of this community.  How about that."  Every day, there are small fulfillments.  Maybe you learned a new Setswana word or mailed in your absentee ballot.  Occasionally you think someone may have learned something from you.  But being a Peace Corps volunteer means being humbled everyday with the knowledge that you may never see the fruits of your labor.  Because the destination is unknown and indefinable, you must be satisfied with the journey.  If you don't laugh at the absurdity of how long it takes to do ANYTHING, you'd go crazy.  You could come out of Peace Corps tired, frustrated, and happy to be ANYWHERE else.  Hell, you will probably feel that way periodically anyway.  Ideally, days with more clarity come.  And they tell you that you are part of something bigger than the daily grind.  You have been given an opportunity that few have.  It's not about being a representative of the United States.  It has nothing to do with John F. Kennedy or Peace Corps.  At the end of the day, your legacy is your own.  People may not remember any of your failed projects, but they will know that you cared.  And that matters.  Peace Corps gives you the opportunity to examine yourself.  After two years, let's hope you like what you find.