Category Archives: africa

Bed net + mosquito = malaria?

Asma is sitting in front of me on a hospital bed holding her son Abdalla’s hand. He’s lying down, semi-conscious, with a chloroquine drip in his arm. She’s wearing a black abaya with gold feather trim at the sleeves.

Abdalla was sick – vomiting and in pain – so she took him to the doctor. He’s two years and three months old; children with malaria don’t tend to have very high fevers, so any illness has the potential to be malaria in disguise.

The medical officer I was with asked some questions of his own and informed me that she didn’t understand where malaria comes from. Or rather, she did, but could not connect the vector (mosquito) with the disease. She and Abdalla sleep underneath a bed net every night, yet he still has malaria.

“How is this possible?” she asks. This is a story that I’ve heard before. People are told that bed nets will protect them from malaria, but unless you are completely vigilant about when you travel and how you conduct yourself in the evening hours, mosquitoes can find you. It’s a contradiction that causes people here great confusion. Health education, in Asma’s case provided through her local mosque, could explain that contradiction and help people like her learn proper prevention methods.

I asked what made her happy, or what she looked forward to. She is still mourning the death of her husband this past April, but she is excited for the future. He left her with ownership of a small plot of land. It stands empty now, and she plans to save money until she can build a home there for her and her son. She says she knows that in that home, she will be very happy.

Leprosy and “Kingdom work”

For the last two weeks, one particular session for the Tanzanian portion of our training program had been in the back of my mind, waiting. The itineraries we received in London listed a “Visit to leprosarium,” and we were informed that it was, indeed, a home for those affected by leprosy. I know what you’re thinking, “What does leprosy have to do with malaria?” I’ll address that in a later post. I think the question that is more likely to pop into your head might be, “Leprosy is still around?”

In short, yes. Leprosy is still around, and it still causes much suffering in the world. Not a whole lot, mind you – the World Health Organization estimates that 2 or 3 million people worldwide are permanently disabled by leprosy. The good news: new cases decline with each year. It’s a disease that is on the way out, but it’s not out yet. For that reason, there are communities located around the globe where people with leprosy can seek treatment and, fortunately, solace from a world that in many cases attaches social stigma to those affected by the disease.

We were invited to tour the Nazareth leprosarium, essentially a modern-day “leper colony”. This place wasn’t so much a colony as it was a collection of buildings in Ifakara town here in south central Tanzania, one of the few countries with enough cases of leprosy to necessitate the presence of such a place. We met Enoch, the proprietor of the joint, and he explained to us the various epidemiological features of the disease, the tests employed to diagnose it, and the treatments necessary to cure it. He’s a very funny man, and we learned a great deal about leprosy from him.

Nazareth was built by the local Catholic diocese many, many years ago. Enoch (who’s been there for 25 years) is paid by the district government, but he’s also the only real staff-person; all the other workers are volunteers or employed by the diocese. It has a small chapel on the campus, and is visited twice a month by the local parish priest, Father Mpenge, whose home we had dined at a few days previous. It’s a beautiful example of “faith in action” for reasons that may or may not require explanation.

As we began our tour of the facilities, I knew what we would encounter. Leprosy is a bacterial infection that essentially devours the peripheral nervous system and then starts on the skin. It’s not a pretty illness – opportunistic infections often lead to finger and toe amputation (perhaps even more bones) and massive skin lesions. The facial nerves stop responding so the eyes can’t close. Dust and other debris attack soft optic tissues, causing blindness. We were told to steel ourselves.

The first resident we met, whose name I did not learn, had no fingers or toes. Enoch asked him to join us on the patio and he shuffled over holding a bag slung over one of his destroyed hands. The bag contained a fork, spoon, cup, toothbrush, and comb. Enoch demonstrated the ingenuity of the Sisters at Nazareth – he wrapped a velcro strip around the man’s hand and showed us how he could feed himself, brush his teeth, comb his hair, and drink water by attaching the tools to the strap. The man smiled the whole time and laughed with us. It was a happy encounter.

We spent the next hour visiting the wards and speaking briefly with the people who were staying there. In every new room, I felt welcomed. This was not a place of suffering or worry, it was a home for people who might not have a place to call home. Many of them were severely disabled – imagine having no fingers or feet. But the residents weren’t really helpless. They engaged with us and laughed and opened their home to us. They don’t get many non-family visitors, so we must have been a welcome break in any case! We visited a large garden that provides fresh and healthy food, and we found that many of the volunteers were themselves disabled in one way or another by past encounters with leprosy.

As we walked across the courtyard, an odd thought popped into my head. “Kingdom work” is a phrase that my evangelical friends use to describe a variety of their activities: mission trips, soup kitchens, drug counseling, etc. The idea is that in ministering to those less fortunate, they can hasten the coming of Jesus Christ and the Kingdom of God on earth. I might say that until that day in the leprosarium known as, of all things, Nazareth, I hadn’t found an example of Kingdom work that resounded deeply with my own drive to help others.

Watching Enoch interact with the residents and seeing them smile as they greeted us brought me to a place of great peace. I can’t accurately describe it; I think I was spiritually excited that Nazareth existed, and I was actually sad to leave. There’s a story in the Bible where Jesus heals a leper by touching him, something that in his age would have been unthinkable (lepers were considered unclean). I’d prefer to let Jesus pick his own timetable for returning, but I’d also like to think that the folks at the Nazareth leprosarium are doing a bit of Kingdom work in creating a safe and healthy place for those who may have nowhere else to go.

Making Small Talk

If I could choose a superpower to have whilst traveling, it would be the ability to speak fluently the major language(s) of the area that I’m visiting, and to have a solid grip on all the various cultural practices of its people. I’m skilled with languages as it is, but absorbing them takes time that I don’t have to spare.

Here in Tanzania, as I speak through interpreters, I really can tell that I’m missing something. I wouldn’t know what to name it if I could so for now I will refer to it as “small talk”. Yes, small talk. It’s what happens when you stop by and visit a family cooking dinner outside their home. You can sit down and shoot the breeze for a while. Ask about the weather, make funny jokes, etc. Then, when you’ve become something more than passing acquaintances, you can ask important questions; in my case, about malaria.

I know that there are important stories and observations, anecdotes and humor that come from conversations that have been built on small talk. You don’t get that with a translator. When we travel as a large group of Westerners, it’s hard to have a conversation that doesn’t appear transactional; indeed, many of them end in our interviewees asking us for “support” in one form or another. If we were able to first establish a friendly atmosphere by employing the local language, that relationship would turn our question/answer sessions into…actual conversations.

Interfaith Livin’

I was called upon by our team boss to lead the group during today’s “early morning interfaith spiritual reflection”. Since we’re all young people of faith, I suppose it’s only natural that we learn a bit from each other by sharing something from our own tradition. To be honest, it took a lot of thought to figure out which direction to go with this assignment, but I eventually settled on the Prayer of St. Francis:

Lord, make me an instrument of your peace.
Where there is hatred, let me sow love;
where there is injury,pardon;
where there is doubt, faith;
where there is despair, hope;
where there is darkness, light;
and where there is sadness, joy.
 
O Divine Master, grant that I may not so much seek
to be consoled as to console;
to be understood as to understand;
to be loved as to love.
For it is in giving that we receive;
it is in pardoning that we are pardoned;
and it is in dying that we are born to eternal life.

So I recited this piece and then weighed in. To me, this prayer has two main themes. The first is service to others. It’s about being active in trying to help people. Bringing sadness to joy and darkness to light are not things that one can accomplish passively. The prayer implores god to make him or her an instrument of peace.

But the second theme, and basically the second half of the Prayer of St. Francis, begs to be sufficient in one’s selflessness. I take this to mean that even if I possess super-powers for helping people, it’s better that I do so from the shadows. I’m active, but I’m not concerned with my own station in life. It’s akin to refusing to eat until everyone else has been served.  I put these thoughts out there and let the group silently reflect for a few minutes.

The first comment came from Pritpal. She had led our reflection yesterday morning (the difference between spiritual and material wealth), and informed us that she had almost selected the Prayer of St. Francis for her session. While visiting Assisi in Italy some years ago, Pritpal came upon the prayer and felt a strong connection to it. She mentioned that the especially important part for her was, “For it is in giving that we receive,” and that these words were also very important for the work that we are undertaking as Faiths Act Fellows. But her admonition was curious – Pritpal is not Catholic. She’s not even Christian.

My friend Pritpal is a Sikh, and she has made reflection upon the Prayer of St. Francis is part of her daily prayer cycle. I think this is inspiring. She felt that the message of selflessness resonated with the Sikh tradition, and she draws important lessons from its words, as I do. Although we have very different faith histories and even slightly different interpretations of the prayer itself, we see eye-to-eye on its call to action and selfless service.

Later on, we were invited to dine with the parish priest. The local Catholic church is St. Francis – coincidence? As we sat down to eat, the priest invited Pritpal to say a pre-meal prayer. She recited it its original “Gurbani” form, and the priest thanked her. The prayer called upon us to praise one God, the Giver, whose “bounty is never exhausted”. She and I later discussed with him how our morning reflection session had unfolded and how St. Francis had inspired us both. He was quite happy, and told us that all religions were indeed welcome in the house of St. Francis. During our chat, I couldn’t help but hear the azaan from the local mosque calling the faithful to prayer.

Why do people do interfaith? There are many reasons. For me, it’s the endlessly enriching spiritual conversations that I have with both my co-religionists and those from far-away faiths. I draw strength from the passion and commitment of people driven to do good works because of their religious beliefs. It was most likely the poet Rumi who was asked to describe the different religions of this earth. His reply, “The lamps may be different, but the light is the same.”

On the Kilombero River

After a quick breakfast, our team headed out this morning to the Kilombero River, the body of water that separates Kilombero District from its neighbor. One of our friends from the Tanzanian Training Centre for International Health came along to find some river guides; we made a deal and climbed into two massive dugout canoes. They were ships, really – probably 20 feet long and more than 2 feet deep. Our whole team plus the four river guides fit quite comfortably. We set off on a slow cruise upstream.

I got to chatting with a man named Hatari, asking him lots of questions about the river and the Kiswahili words for things that I saw around the boat. I pointed to a small white bird called “nyange-nyange” and Hatari explained its place in local mythology. If I understood him correctly, the nyange-nyange is considered off-limits for eating. The practical reason is that the bird removes and eats ticks and other parasites from the area livestock. But the other, and probably much older reason, is that it is believed that the nyange-nyange provides the impetus for the growth of human fingernails – these fingernails in turn provide the bird with its brilliant white feathers.

Hatari, one of our river expertsIn time, Hatari came to ask me questions about what I was doing in Tanzania. I explained our work with the Interfaith Youth Core and Tony Blair Faith Foundation and how we were there to learn and observe. I asked him (in Kiswahili, which I am very proud of) if he thought that malaria would always exist. He paused and laughed, saying, “Malaria is…like a runny nose. It is very not rare!” He went on to explain that there are types of malaria that can linger in the body for decades, making it very hard to completely eradicate.

Hatari was adamant that real reductions in malaria deaths were only capable through increased education. I stressed that our team saw the importance of religious communities in dispensing this education along with bednets and medicines. I pointed out that the eight Fellows with me would be joined by twenty-one others who would scatter themselves across the US, UK, and Canada in order to promote interfaith cooperation on malaria. Hatari ended up asking me far more questions about the Fellowship than I asked him about Kiswahili vocabulary. I was quite happy with this turnaround; it meant that he found our work interesting and useful. And when I explained our push for interfaith cooperation on the ground in sub-Saharan Africa, I could tell that he saw the very practical nature of the program.

Still, his answer to my question about eradicating malaria was unexpected to say the least. I had anticipated such an answer to be an adamant YES, but Hatari was saying that malaria was a fact of human existence and would likely never disappear. It reminded me of a maxim that we heard often during our training in London: “Dying of malaria is like dying of a broken arm. There’s no reason why it should happen.” The real struggle for the Faiths Act Together campaign will be combating the perceived banality of a disease that affects millions.