Malaria Month in Mozambique

April is malaria month, culminating with World Malaria Day on April 25th. Here is a quick overview on malaria here in Mozambique and what Peace Corps is doing to try to prevent it.

Malaria is a disease that was eradicated in the US through an intensive program headed by the CDC beginning in 1947. The state and local health agencies of thirteen southeastern states combined efforts, mostly based on spraying the insides and outsides of houses in areas of high prevalence with DDT, and were able to declare that the area was "free of malaria as a significant public health problem" by 1949. Strategies also included elimination of breeding areas of malaria-carrying mosquitoes. Without this kind of coordinated governmental effort in Sub-Saharan Africa, malaria remains endemic and is the number one killer. That's right: in a region with droughts, starvation, conflict and sky-high HIV rates, malaria kills more people than anything else.

Here in Mozambique, malaria causes twenty-nine percent of deaths annually, and more than half of deaths among children five and younger. In some areas of the country, over 90% of children under 5 years old are infected with the parasite. Pregnant women are the other group particularly susceptible to malaria, which can lead to premature births and/or low birth-weight or other complications due to anemia resulting from infection by the parasite. Anemia is also a major problem among children who contract the disease. Malaria is endemic in 100% of the country:

Because malaria is such a danger to the lives of people in this region, Peace Corps sponsors a project throughout Africa, called Stomp Out Malaria, aimed at eliminating the disease through education and prevention. Although PC won't be spraying anyone with DDT (thankfully), volunteers are educated in the many simple and effective ways that people can reduce their risk of contracting malaria. Because malaria is spread when a mosquito first bites an infected person, then others, preventing infections starts a virtuous cycle that could eventually eradicate the disease entirely.

Volunteers in Mozambique are taught how to keep themselves healthy and given daily or weekly prophylactic drugs and mosquito nets. We are also taught, whether in the Education or Health programs, a number of strategies ranging from hanging bednets or mounting screens on windows and doors, to simply going to the doctor and being tested for the disease at the first sign of symptoms, that we are encouraged to share with our communities. Many people do not know that local clinics have rapid tests available and will provide free treatment for those who test positive.

I have been lucky that malaria has not had a large impact on my experience here in yet. I take my doxycyl every day (a drug with minimal side effects: heartburn if I don't take it with food and water, sensitivity to the sun and, last but not least, clear skin!), but some volunteers end up falling sick despite taking their meds, using a bednet and lots of mosquito repellent. Just this past weekend, I was with a large group of volunteers following our "Reconnect" conference and two people tested positive for malaria. Over the past month, two of my friends have also had malaria. Since the semester started, three of my twenty-one students have had malaria. Luckily, among the volunteer population and the relatively well-off, educated university population, people know the symptoms and treatments and all have pulled through without complications.

There is good new, however; education and prevention efforts have been paying off. The Mozambican government is stressing the use of mosquito nets and in areas where free nets have been distributed and populations have been educated as to their use, infection rates have been going down. At the current rate, the incidence rate among children will fall to 80 per 10,000 children, which would exceed the relevant Millennium Development Goal.

Because of the push for education in effected regions, there are also more and more locally-developed potential solutions. A friend recently shared a great idea developed by students in Burkina Faso and Burundi, who won a global social venture competition with their anti-malarial soap. The soap makes use of local herbs that repel mosquitoes and should be easily adopted by large populations as it requires absolutely no change in established routines. As one of the inventors explains, it is a very simple solution, " because every one uses soaps, even in the very poor communities."

So if you have some time, this month or any other, please take a moment to learn more about organizations like Stomp out Malaria and

A PCV and Her Ego

I have been thinking about ego a lot lately.  It is something that comes up a lot in yoga. Many teachers and practitioners talk quite a bit about setting aside your ego – your practice should not be about going deeper into a pose or holding it longer than the person next to you. You want to find the balance necessary to push yourself enough to continue to grow, without giving into the ego trap of trying for things that aren’t accessible and hurting yourself. It is easy to take this message “off the mat” and into everyday life. Once I found this happy medium, yoga became an incredibly rewarding practice. One that helped me tap into strength, balance and patience I never knew I had and I was also able to apply to other parts of my life.

Yoga at the Três Fronteiras

Since I arrived in Mozambique, I have kept up a regular practice at home, but without a room full of people around me to compare myself to, I haven’t found that putting ego aside is a big challenge. The place I first found myself thinking about ego was in church. I wasn’t a regular churchgoer before I got here. When people asked about my religion in the US, I usually explained that my mother is Jewish and my father went to an all-boys high school, so he joined a Unitarian youth group to meet girls. Agnostic Jew is probably the most accurate way I could describe myself. But I really enjoy going to church here.

From my experience here so far, religion is a much more fluid, flexible subject than in many other places. The Catholic Church has been here for years and even played a crucial role in ending the civil war. The northern part of the country has a large Muslim population and there has been an influx of Muslim immigrants from North Africa, India and Pakistan. In recent years, Evangelical churches have been popping up at a frenzied pace, most coming from Brazil or the US, some by way of neighboring countries. But traditional beliefs coexist along side these churches and mosques, and people seem to have no trouble blending the practices of curandeiros or feticeiros with more recent imports.

Most non-Muslims here go to church and will ask shortly after meeting you “Onde reza?’ Literally, “Where do you pray?” but meaning “What church to you go to?” My response here is usually that my father’s church, a Igreja Unitariana, doesn’t exist in Mozambique and that my mother is Jewish. No one has blinked at this mix so far and only a few have pointedly re-asked, “but what are you?” I have had people respond with, “Judeus são muito intelligentes.” Another spoke with a pastor friend of his about the fact that my father’s church doesn’t exist here and came back to me with a request for information about how to change his evangelical church to a Unitarian one. 

Bishop of Chimoio; adorable child at church; Igreja Missão Baptista.

 But lately, I have been going to a small evangelical church: A Embaixada da Imagem de Deus, currently housed in a garage that has been opened up and expanded to accommodate the hundred or so attendees each Sunday. The pastor is wonderful. First of all, he speaks slowly and clearly enough that I can understand almost all of the sermon. Secondly, his message is always uncompromisingly positive. I really enjoy spending a couple of hours a week being told that I am loved or that my account has already been settled. And I can completely understand why people facing challenging circumstances here would be drawn to the message. I leave feeling comforted and encouraged.

I also started thinking about how the message he gives compares with the indoctrination of the yoga community, which is where ego started creeping into my thoughts. Both have strong elements of telling you that you can’t control everything and sometimes you need to have faith that if you fill your life with love and trust that God or the Universe has your best interests at heart, things will work out. Both are about replacing ego with love.

So the concept of ego was already on my mind when I had an email conversation with a friend back home about complaining in the Peace Corps and I was finally able to put into words something that has been bothering me about a strange position Peace Corps Volunteers sometimes find themselves in. We end up complaining about the strangest things and lots of times it comes down to ego.

People join the Peace Corps for all different kinds of reasons, both personal and professional. The three that I think we all share are a desire to learn about a new culture, push our limits to see if we can live in a more challenging environment and certainly, we want help people. You could even say that many Peace Corps Volunteers have an “I want to save the world” complex. Then we get sent to a host country that has asked the US government for assistance in specific areas (in the case of Mozambique those are Education and Health), but as I mentioned in my last post, there can be a jolting difference between a volunteer’s expectations for service and the in-country reality.

Many volunteers go into their service expecting that when they arrive at their site in this developing country with so many needs, with training in a particular area of need, and plenty of ideas for other side projects in their areas of interest (maybe access to clean water or youth literacy or small business development or sustainable agriculture: the possibilities are endless!) they will have more work than they can handle. To make a sweeping generalization, Peace Corps Volunteers tend to be go-getters who like tackling problems and seeing results.

Then we arrive in our communities or at our organizations only to find that they – despite their many needs – move at their own pace, which is generally much slower than what the eager PCV would prefer. There is only so much a single volunteer can do to effect change in two years. We cannot force sustainable change on a way of life that is deeply embedded in a cultural and political context. None of us can single-handedly revolutionize an entire educational system. And we shouldn’t try to. Above all else, we should take the time to be sure that the change we are trying to effect is what the community actually wants, needs and can support, that it isn’t just what the PCV came in thinking should happen based on his or her own agenda.

We have to understand that we are each part of a much bigger, slower process and have faith that what we are doing is contributing to a long-term improvement in the quality of life in our communities. To feel that we need to create something tangible and lasting that we can perceive immediately (and put on our resumes and send pictures home to our families who still think we are here saving the world), that we can point to and say, “I did that,” is really about ego.

To be clear, I am not trying to say that building things or founding groups or other acts of creation are bad. Some do a whole of good, and I think that for all of us who come in to try to make a difference in the face of such overwhelming need, it is a very natural response to want to do something that proves you have had an effect. I am currently trying to establish an American Corner at my school. Primarily because I think that a room full of English language materials, with access to research databases and space for an English club or TOEFL prep group would be of great benefit to the university and greater community. But I am also acutely aware that I would love to be able to say I contributed something specific and lasting during my time here. And I know that that is about me; it’s ego.

This PCV-founded preschool is doing a lot of good for the community outside Chimoio

I think that this desire to create, to push for results is exacerbated by the fact that I am benefiting so much from my experience. I am learning Portuguese. I am taking on jobs I would have told you I was unqualified for and succeeding (so far). I am being invited into people’s homes and experiencing movingly generous hospitality from those with much less than what I have. I live in a beautiful house and eat fresh fruit every day. I am meeting people of enormous strength and character who inspire me every day and remind me not to take all that I have for granted. As I have said before, life here is good. So I end up feeling like I need to justify my presence here. Supposedly, I am here to serve; yet I am the one learning and growing.

In reality, we as Volunteers need to learn to be humble enough to accept that it is okay to be the ones gaining from our experience. To be open to all that our communities have to teach us and use that to be more effective in our work, instead of coming in thinking that it is a one-way relationship and that we are here to teach and change and improve the lives of others. To be the do-ers. Again, that is ego.

In my original conversation with my friend, I said that we have to walk a line between “I am here in the service of others,” and the reality that we are here to grow and change ourselves. But as I write this, I am realizing that there is no line. To actually be in the service of others means to listen and remain open to those you are trying to support; to learn about their lives: what they have, as well as what they need and their strengths, as well as their weaknesses. Only then, to offer the experience, skills and knowledge you have that can help them achieve their goals. In the process, it is impossible not to learn and grow.

One indicator for when we are letting ego get in our way is when we start complaining in a way that comes down to, “This poor, needy community just won’t let me help it!” As silly as it sounds, it is easy to stumble into situation where we think we have a great idea for what is needed, but when we try to implement it, we can’t get traction. Which probably means it is either something that came from us, not the needs of the community, or that we skipped a step in an attempt to accomplish something bigger than what the community is ready for. In the end, this doesn’t treat people with the respect they deserve and becomes about us as volunteers trying to prove something to ourselves or each other.

We were told during our training that we would be “planting seeds of fruit that we would never eat,” or something along those lines. But I think that it is difficult for those of us who came here wanting to save the world to realize that sometimes we may need to just lay the groundwork for bigger things that will be able to happen further down the line, and to realize that in the mean time, it is okay – no, it is important – to be the beneficiaries of our own service.