"How Are You Finding Khorixas?"

Happy Thanksgiving from Namibia!

It’s been nearly a week since the members of Nam 27 arrived at their permanent sites. It goes without saying that as a PCT I’ve done more adjusting in the past six days than I have in my entire life. It’s been difficult at times and heartwarming at others. (It takes only a minute to realize visiting the third world is a far cry from actually living in the third world.) Most every day has been filled with one type of challenge or another and coming from a comfortable place, that alone has taken some getting used to.

I’m living in a small village called Khorixas with another Nam 27 volunteer. It’s in the Kunene region, about three hours northwest of our home base of Okahandja. Khorixas is a quiet, dusty town with a post office, a Multi-Save, and very few resources. While the other 12 regions of Namibia are known for exporting diamonds and uranium, or producing beef, lamb and goat, the Kuene region has no exports and no real source of commerce. The unemployment rate in Namibia is high, hovering above 50 percent. But here the number is even greater. Of the roughly 20,000 residents, only an estimated 400 have regular work or a continuous source of income.

I’ve been assigned to work with the Ministry of Health and Khorixas State Hospital on community outreach and preventative education. My supervisor is a Nigerian doctor, and in fact, the only doctor permanently stationed at the 120-bed facility. I report directly to the principal nurse, who has been working at the hospital for 35 years. The facility is a far cry from the one I candy striped in more than a dozen years ago. The equipment is dated and there are just two working computers for the entire compound. (There’s no Internet.) Nurses tend to some 3,000 patients each week. Those in need of advanced treatment or further attention are sent to Windhoek, four hours away.

The hospital has just one ambulance to serve an area that stretches as far west as the coast and as far north as Opuwo. But as I learned Monday, that ambulance has been out of commission for some time, and there are no plans for repair. Instead, one of the hospital’s all-terrain vehicles is now being used to collect the injured.

I arrived at my site on Saturday and since then have spent most waking hours getting to know my colleagues, neighbors, roommate and community. I met my Kenyan roommate and was introduced at five churches on Sunday; given a tour of the hospital, introduced to staff, the mayor (who asked me if I knew Oprah or Bill Cosby) and the tribal leader on Monday; shown the preschools, the Ministry of Education, the Craft Center and introduced to a pastor on Tuesday; and taken to the orphanage and the teacher resource center on Wednesday.

These meetings served as more than a way to get to know the people in Khorixas. They helped to identify potential secondary projects for the next two years. During training a number of health volunteers discussed creating a web-based business for local artisans with the help of our IT team to generate income. The women at the craft center, who carve nuts, string beads and design jewelry, would be perfect candidates for this. The orphanage, which houses 18 children in three bedrooms, is in desperate need of new beds, mattresses and more space. As of now, nine girls share just two bunk beds in one room. The woman who runs it also feeds 33 other hungry school children from the squatter village every day. The hospital needs a resource room so that nurses and patients can easily access information about TB, HIV, family planning, childcare, hygiene and proper nutrition, and the teachers’ center in town is in desperate need of materials for classrooms and educators.

We aren’t supposed to tackle anything in our first three months at site (I’ll be returning for two years in a month or so). Instead, that period is for observation, discussion and research. But at least this brief visit has given me the chance to feel more comfortable with my surroundings, to interact with the people, and to identify some of their needs.

It seems, from where I stand, there are many.

This past week has also given me a chance to grow accustomed to what will soon be my day-to-day life. It’s one that involves a 6:02 wakeup call from the neighbor’s rooster, no hot water, no working sinks, washing dishes in the bathtub, using a flashlight to navigate the hallways and a diet of almost exclusively peanut butter & jelly sandwiches.

Strange as it may sound, I still cannot wait to return to Khorixas.

I'm Here! (And So Is My Luggage!)

The good news is I’ve arrived safely in Namibia. After a week of waiting and a one-hour shopping spree in Windhoek, my luggage has finally arrived, too. I survived my first days here with one dress, a pair of pants, some worn-out flip-flops and a t-shirt. When my bag finally arrived I couldn’t help but wonder why I packed so much stuff in the first place. Two weeks in Namibia and I’m already reevaluating the essentials.

The country is amazing. Open plains and clear blue skies. But there’s also a lot of nothingness. In a place twice the size of California with a population of just 1.8 million people, I guess that’s to be expected. The days are warm and dry and the nights are cool and comfortable—the best of both worlds. The mornings are perfect for runs. November and December are considered the “rainy season” but that’s happened only once since we arrived.

We landed in Windhoek on November 2 after the world’s longest flight and nearly a week’s worth of travel. PCVs from Nam 25 and Nam 26 met us at the airport with a giant banner, two massive buses and a bowl full of fat cakes. These simple yeast rolls are made with a bit of sugar and fried in an iron pot. They’re best served warm, but even day-olds were a delicious welcome to a country we’d heard so much about. The ride from the airport to Okahandja was about an hour—long enough to see a bit of the countryside before sunset, plus baboons, giraffe and warthogs. This is Africa, after all.

There are about 25 trainers from the 13 regions in Namibia working with us on our language and cultural skills before we depart for our official sites in January. (We will do a temporary site visit, which includes our first experience “hiking,” next week.) They lined the walkway of our compound the night we arrived and sang songs in Afrikaans, Silozi and Otijiherero—music and voices like I’d never heard before. It was the warmest welcome I’ve ever received, and a feeling I hope to never forget.

Since then, it’s been 10-hour days of cross-cultural training, Peace Corps rules and regulations sessions, near daily vaccines and a whole lot of “getting to know you” time. I’m living in a room with five other girls: a teacher, a public health worker, and three recent grads. They are all absolutely hilarious and have made the ups and downs up this surprisingly stressful experience easier to handle. So far we’ve been able to keep each other sane and laugh at the things that might otherwise make us cry.

Last week the members of Nam 27 were interviewed by our program directors about potential posts, desired living conditions and expectations for service. From what I can gather, I’ll be working in a small town putting together health training materials and developing community outreach programs to disseminate the information. We were placed in our language groups last Thursday, so many of my fellow volunteers have an idea of where they’ll be heading based on what they’ll be learning. I could still go anywhere.

You’ll all be happy to know I’m learning Khoekhoegowab (kway-kway-kovab). And yes, that’s the clicking language. There are about 15 of us trying to perfect the four basic clicks. So far it’s been a struggle. We were told from the start that it’s unlikely we’ll master the language, but despite that, we’re trying.

One of our trainers took us to the Location, a part of Okahandja where black Namibians were forced to live during Apartheid. As it turns out, many of them still live there today, too. We listened to a Khoekhoe choir practice, and then performed a song with them. We learned a dance that none of us were really all that good at, but I’m still convinced we’ll leave this country with more rhythm than when we arrived.

This week we began twice-daily language lessons in preparation for our permanent site visits next week. On Tuesday, my three-man class actually took to the streets to practice with the locals. It was a reminder of how little you can learn in three days. Unless I was asked my name or where I was from, I was useless. But the women were slow and patient and the little boy, Quinton, got a kick out of our trial and error. I’m sure next week will bring more of the same. I’m anxious, and at the same time, can’t wait to see where I’ll be spending the next two years of my life.

For now, half of our days are filled with language and cultural education. The other is technical training. Workshops and lectures teach us more about the health system and the major health concerns in Namibia. From the looks of it, there are many. The sparse population, rough terrain and lack of transportation mean a majority of Namibians have little or no access to public or private medical care. There are just seven surgeons, five pediatricians and two psychiatrists in the entire country. The university has no PhD program, so doctors must be trained outside of the country. Work permits are hard to come by and it’s nearly impossible to find qualified professionals willing to work for next to nothing in the rural areas where the need is greatest. Here in Okahandja more than 100 people are on the waiting list for antiretrovirals at the local hospital. The facility services about 36,000 people, and while the drugs are in stock, a shortage of qualified doctors able to administer the medication means patients can still wait upwards of six weeks for treatment.

We met with one of the two doctors that serve the town on Tuesday. His patients come from as far away at the Botswana border to the east, Windhoek to the south, and more than 400 km to the west. Nearly 40 percent of his patients are HIV positive and at least two or three more people test positive each week. He told us that health information is widely available throughout the country. Namibia even offers free condoms to residents to prevent the spread of disease. But people are still failing to put what they learn into practice. It happens in the states, too, but after talking to trainers and healthcare professionals—even a traditional healer at the Location—it’s clear there are unique issues and challenges at play here.

Gender roles are a reality in Namibia. Men are the decision makers and women tend to be the more submissive partner in a relationship. Males have the final say in all things related to sex: from where and when it happens to whether condoms are used. Sex is often a display of power rather than an act of mutual satisfaction. If a woman voices her opinion on these matters she’s seen as loose. Rape laws were only recently introduced in Namibia. One current volunteer told us that men in his village were actually unsure how to date after this happened. He said before, they just took what they wanted. Courting didn’t exist. But then, neither did rape. It was expected that women would say no, and it was almost understood that that didn’t really matter.

But there are other obstacles facing health education and AIDS prevention in Namibia. The vast landscape, sparse population, and lack of jobs mean that hospital workers, teachers, policemen and miners are often sent to work in areas far from their families. Wandering men can bring the disease home and pass it on to their wives, who in turn, risk transmission to their children during pregnancy and even after birth. Men are rarely tested. At a clinic in Okahandja 1,200 women tested positive for HIV. Of that number just 12 had husbands who volunteered to be tested, too.

As it turns out, the number one risk factor for AIDS in Namibia is marriage.

Although the country offers health care at a relatively low rate, just two percent of the infected population is getting the drugs and treatment they need for advanced HIV/AIDS. In the states, that number is upwards of 80 percent. There is just one ambulance in Okahandja to service more than 35,000 people. And while a visit to a national health center costs around N$6 (about one dollar in the US), an unemployment rate of 50 percent means even that nominal fee can be prohibitive.

It’s been a lot of information to digest and this past two weeks has served as an incredible eye opener. As a westerner, I know it will be difficult to navigate a system of beliefs and a worldview that’s unfamiliar to me. As a volunteer, we’re taught that the information is out there and that many of the resources are widely available. But even so, many residents, including some of our trainers, are still unsure of just how HIV/AIDS is transmitted. While it can be frustrating to hear, it’s a good reminder of why I’m here: to educate, assist, and ultimately, to learn.