Ouch. An ant bite. That is what it takes to get me indoors to the keyboard to write about this week. The ant probably climbed into my pants to get out of the sun. Some would say she was smarter than me. After all, I was the one outside carrying rocks to build a raised bed in the area the grounds man says is too marshy for planting. I was outside in the hot sun, in equatorial Africa, in the middle of the afternoon, doing rather than thinking.
So, what am I avoiding? The reality of Africa that I witnessed this week, I think. It kind of feels like when I was a little girl and staring up at the night sky in its enormity: I remember being overwhelmed by the smallness of life on earth, and brought to tears to think of how brief and inconsequential my consciousness was. (Not in those words of course—I was only 7 or 8—but you get the picture.) Admittedly, one cannot see the whole elephant from Matoso, Kenya, or more accurately the area around Ochuna and near the border of Tanzania. So this is no more the “reality of Africa” than the building that fell in Nairobi last week, or the policemen killed by Al Shabab in the north the week before that, or the hopes and dreams of each young person I meet who wants to go to America, where life must be better.
The man leading the Public Heath Team, the “Public Health In-Charge” here in Lalmba Matoso, asked me to accompany him on some home visits. These home visits are to the families with an infant or young child who is malnourished, to try to understand and address the causes of the malnutrition. The idea is to visit where people live, and ask about such topics as breast feeding, cleanliness, illness, sources of water and income, and how these affect the family, and thus, the child. The interviews are carried out in the Luo language by the In-Charge and a local woman who works as a receptionist at the remote Ochuna Clinic. We can only visit two homes in the course of the day because after the morning meeting and picking up the local worker in Ochuna, we must drive to more remote areas still, park the vehicle, and then hike in approximately one mile from the road to get to each home. Both families welcomed us in to their homes and made sure we all had a place to sit, even if they had to borrow chairs. No one seemed to get angry or resentful, and we were never evicted before the hour or so interview was over. It seems clear that compassion and respect are shown, even as we ask questions that might reasonably be perceived as critical or condescending: “Do you teach the children to wash face and hands before eating? Do you use soap? Do you boil or treat your water? Is there a latrine? Where does money come from? How many meals did the child eat yesterday? Did you feed the child breast milk or cow’s milk and/or other food?”
The houses are built with local resources: Sticks or poles in a network to make a cylinder, filled and covered with clay, and roofed with grass thatch over a cone shape made of more sticks. The first one is about 10 feet in diameter, and it is divided by a 6-foot high wall, with the bedroom on one side, and living room on the other. This family has both a mother and father, with their 6 children. Their only source of support is farming their plot of land. The father looks very thin and ill, and he says he has tuberculosis. The mother looks healthy, and she tells us she is HIV positive, but her youngest, 6 months old, has been born negative and stayed negative while she has been breastfeeding. We three visitors meet with the mother (holding the infant) and father. We can all sit on the wooden couch and chairs. The furniture is a kind of Early American style with exposed wooden arms and wooden frame, meant to be fitted with loose cushions. There are no cushions, but the couch does have a sheet covering most of the sitting surface. The floor is dirt, packed and smooth. I don’t remember seeing a place for cooking inside, but it was likely there in the living room. We can see a pair of men’s shoes, some clothing, and a tin watering can tucked up where the ceiling meets the wall. Two young boys are hiding among the maize stalks when we arrive, and they stay there during our visit. A small girl, maybe three years old, plays quietly in the shade right outside the house. They obtain water from a nearby river, and “take it like it comes.” This last comment is in answer to how they clean or treat the water before using.
The next house is smaller and even poorer. It has one room, about eight feet in diameter, with a sheet (or what looks like a very old dust-ruffle) hung across a string as a room-divider. We are allowed to peak at the bedroom, where there is a single full-size mattress on the floor for the parents and four children. The one chair, a folding wooden one on which the back is broken, is given to me, and is clearly meant as the best seat in the house. The other health worker sits on a square plastic container somewhat reminiscent of a gas can, and the mom disappears for a minute and comes back with two plastic chairs from a neighbor for herself and the In-Charge. (He sits outside. He might fit inside, but it would make it very snug.) The only other furniture is a table about 24 inches square with a faded embroidered design and hand-stitched hem, now mostly frayed and coming apart. We meet just with the mother, and the malnourished child stands by her side. The baby is almost two years old, and is quite thin and quiet. I estimate the weight to be 10 kg, or 22 pounds. The father is away working, which he does whenever he can get a contract. She is preparing some maize from their fields, which she tends while the dad is away. Sometimes, when he comes home, they are able to go shopping to buy soap and other things they cannot grow. Both parents are HIV+ and under care. I am sitting right next to the place for the cooking fire. It is a low mud curb, maybe three or four inches high, built out from the wall of the house like two parentheses. They are wider apart at the top, and almost meet at the bottom, leaving a 4 inch gap where one could sweep out the ashes. This makes an almost complete circular support for a pot above the small wood fire, well protected from the wind. The door is wooden, about four feet tall, and is lined on the inside with pieces of metal that are embossed with a Shell Oil logo. When asked the question about water preparation, the mother explains that she filters the pond water with a tea strainer to remove impurities.
Neither family has an outhouse or latrine, soap, or clean water. I saw one small solar lantern at the first house I think, but no other electric device of any kind. They do not have phones or any mode of transportation other than by foot. They do have iron-age tools like a heavy hoe, and a machete. We brought them only questions. Vaccinations and vitamins are given at the facility in Ochuna, as are once weekly cooking and nutrition lessons with a meal for each mother and child, shared around the demonstration kitchen. Sometimes, a week’s supply of supplemental food can be sent home for each child, but there have been problems somewhere in the supply chain, and none to give out since March this year.
I am face-to-face with my inability to materially help these people, and the many others all around me. My Lalmba teachers tell me that being here with people, spending my time and compassion, is my job right now. Ram Dass says “be here now.” Pema Chondren advises that we must begin where we are, and that we cannot have compassion for others until we can discover that compassion for ourselves. So, I am praying for the strength to do this hard work, which at times feels like doing nothing. At other times it is an enormous burden and I run away into outdoor work and ant bites! The elephant is not likely to be wholly visible to me ever, but perhaps I can come to appreciate this tiny bit of its toenail. Another wise man, Jimmy K, wrote, “Understanding comes slowly, over a period of time…” Patience and compassion—may you have all you need of both this week.