Wednesday, May 27, 2009

In Hospital

Last Thursday I was rudely awaken at 6:45 (had intended to sleep til 10) by a phone call from Tokkie, a sports field consultant from Pretoria who wanted to meet with me. The meeting was scheduled for 9:00 on Friday but he moved it up since he was going to be in the area so he would only have to make one trip to the area. I showed up to the meeting and was walking into the building but started to feel dizzy and staggering back and forth kind of like I was drunk. I told Tokkie and we sat down to start the meeting.

As I was starting my computer and pulling out my papers I started to lose motor function and would miss when trying to complete the simple task of reaching for a book. As I was trying to talk my jaw started to go limp so that I couldn't even form sentences. I called the Peace Corps Medical Officer (PCMO) and she said to sit still and relax. I started to go get much worse and could barely even move my mouth to make words. We called the PCMO back and I forced a few words out that probably made only a little bit of sense and she told us to go to the hospital in Pretoria.

They had to almost carry me to the truck because I had such little control of my body and was almost in a state of paralysis. The part that made it most scary was that my cognitive abilities were unaffected but I couldn't move my body to talk or move so I spent the entire thinking about the possibility of being paralyzed for the rest of my life. About an hour into the trip (Pretoria is 1.5 hours away) I started to be able to talk and move again but I was incredibly dizzy so I couldn't really sit up.

We pulled up to the entrance and they came rushing to the truck and I asked for a gurney because I was so terribly dizzy when I sat upright. Instead they brought a wheel chair; later I foun out they didn't know that a gurney was a metal stretcher on wheels. Since they speak British-English and not American-English the term is "trolley" so they didn't know.

The first care that I received was almost immediate where they inserted an IV into my arm with some basic drip but I can't remember what it was. Then it wasn't really helping me so they said they were changing the drip to something called "Jet Fuel". It was brownish, left a metallic taste in my mouth and it gave me quite a boost so it lived up to its name. After that initial care they put me into a wheelchair and left me there for quite a while since they needed my bed. I hadn't had anything to eat all day since I rushed out and didn't have time for breakfast so they gave me a sandwich menu from which I ordered a ham, tomato and cheese sandwich. I sat there for quite a while and slowly ate it and seemed that I was keeping it down fairly well.

They scheduled me to have a MRI (Magnetic Resonance Imaging) scan done on my head shortly after. When scanning your head they put you in a large tube and make lots of head-pounding noise and it creates a computer image of your brain activity. Just before putting me in the technician instructed me to push an exit button if I felt nauseous and the bed would come flying out and she would burst in with a bucket. Fortunately, just before going in I vomitted up the only thing that I had eaten all day; the grilled sandwich. Problem solved.

Shortly after I was brought in for an electroencephalogram (EEG)which measures brain activity when at rest. I've been having these done all my life and I usually would have to stay up late the night before so I'd sleep through the test without problems. I used to look forward to those tests because that meant my mom would take me to a late movie on a weeknight which was a huge privilege. The last movie I saw was "Bill and Ted's Excellent Adventure" which I remember being totally tubular. You also weren't supposed to eat anything the morning of (I took care of that as previously noted). The technician was pleasantly surprised when I fell right to sleep without any sedation.

EEG technology has improved which was a nice surprise. They still use the electrodes which they attach to all parts of your skull but they've improved the worst part of it; the glue. They used to use this glue that was pink and stuck to your head like superglue and took about a week to fully remove. Now they have this really nifty gel that not only is easily removed without residue it causes a really neat cooling sensation when applied.

Immediately afterwards they brought me to the ICU hooked up to 6 different electrodes for monitoring plus made me wear one of those irritating thumb pulse things. The brought my dinner which in my experience in the U.S. usually involved some type of potato or pasty food, corn, and jello. They brought me glazed chicken and vegetables over a bed of rice with a cream of vegetable soup on the side and a kettle of tea; I was shocked but delighted.

The guy who was in the bed next to me had a neck brace and feeding/breathing tube installed. The whole time I was eating and trying to sleep it sounded like he was coughing up a lung and watever mucus that was in it. The night crew came in so there was a change of nurses. I must admit, my primary nurse was rather cute however she was not a very good nurse. She spent most of her time either away or flirting with me and telling me how much she hated being a nurse and wanted to do something else so it wasn't very comforting. Hopefully she never decides to become a surgeon then tell her patients just before the operation how much she hates it.

One of the monitors I was hooked up to would occasionally start beeping really loud and not stop for about 5 minutes and the nurses would either wait outside or not even come over. If there wasn't anything wrong with me and the nurse didn't need to come check, was it really necessary to have the buzzer, probably not. By the time it was getting late I was feeling much better so I was able to take a shower using surgical scrub so that may have been the cleanest I'd ever been.

The next morning I woke up and I was as dizzy as I was the day before and couldn't sit up without getting extremely dizzy and having to lie back down. I couldn't move my head from side to side without so the phsyiologist said I'd probably be able to try standing by the next day which was absurd since I was up taking a shower the night before (my primary doctor confirmed my diagnosis of the physiologist's diagnosis later). I was starving and anticipating a wonderful breakfast to which was fairly disappointed. The milk that came with the cereal was heated and the egg dish that they brought me was covered with liver in brown sauce. I was able to eat the toast with jam and cereal with warm milk and side of fruit so I was satisfied.

The doctor came in to discuss the results of the EEG and MRI. Fortunately both scans were fine but he was surprised to see that there extra connections between the side and top of my brain; I'm forming new synapses and will become superintelligent, awesome. Not as awesomely he told me they needed to run some more tests and also arranged an appointment with the ear, nose and throat (ENT) doctor, scheduled an X-ray and later I'd be moved to a private room.

I met with the ENT and ran a whole bunch of tests that seemed more like an alien abduction autopsy and diagnosed me with an inner-ear infection that was probably caused by stress. The viruses that cause these infections are apparently always in your blood and are prone to surface when your immune system is down which in this case happened because I was stressed out (see my previous posts and you'll understand why). Then I was returned to the ICU, sigh.

They came back for me a little later at around 2:00 and said they were going to do some x-rays of my neck to make sure I didn't have a stroke. The doctor used a sonograph machine and scanned all the major arteries which was probably the longest 20 minutes of my life. she occasionally said something like "Oh", or "interesting"; both ambiguous statements can mean anything from being oddly shaped, to having discovered a clot or major heart condition. Turns out I do have one valve that is slightly malfunctioning that will cause problems in distant future (maybe in my late 60s or 70s). No clots or anything so it was good. Unfortunately they once again returned me to ICU.

At 4:30 they finally came to move me to a regular "private" room for regular monitoring and care. The room was actually with two older men. Since I had been rushed away from site and didn't have a chance to collect my things I didn't have any money on me. In order to hear the sound on the TV I had to pay R12 to the hospital which was impossible. After trying to convince the staff to give me a pair for free due to the extenuating circumstances and their complete resistance one of the visitors of the patient next to me offered to buy me a set since he felt it was torturous to be there with no entertainment.

5:30 I'm getting hungry and I ask when dinner is being served the response was 6:00. At 6:15 the response was 7:00. At 7:15 they said 7:45. One of the other men who had spent most of his time wandering around with his IV stand came over to me and offered me some of his biltong. Biltong is like beef jerky only it is made from meat from kudu or other deer-like animals instead of cow meat. By 8:30 I still hadn't received my food. I asked one final time and the nurse said, "Oh, dinner was served at 3:00 so you missed it". I said "I missed it? Ok, you need to bring me my food not just now, not now, but now now! I have been going through testing all day long and hadn't had anything since breakfast." They found my food which was cold since it had been sitting in the kitchen so they had to reheat it.

9:00 I would have thought was time for my medicine so I asked when I was going to receive it. A similar series of events transpired where I was told "now", "just now", and "The medicine is being distributed to the other patients and she will be getting to you soon". A couple times I got up to go to the desk to talk to them. At 11:30 they came to my bed and told me they had lost my prescription and could not give me my medicine and had to call the doctor. The doctor finally arrived at 1:30 and apologized profusely and said I "did the right thing waiting up" and he gave me my medicine also offering me sleeping pills. Surprisingly it was louder down there than in ICU because the man next to me was snoring like a bear.

I had spent most of the day watching Boomerang which is a channel that plays all of the old Hanna-Barbera and Warner Brothers cartoons like Tom and Jerry, Merry Melodies, the Flintstones and Johnny Bravo. Interesting fact for all of those Family Guy fans: Mayor Adam West of Quahog is based on the actor Adam West who starred as the real-life character Batman in a 1966 verison of the series. A large portion of the rest of his career was typecast and often focused on making fun of himself. Mayor Adam West and all of his idiosyncracies were develop through various appearances in cartoons including "Johnny Bravo" as Adam West, superhero. One of my favorite shows is "Time Squad" so despite being exhausted I forced myself to stay up and finally went to sleep at 3:00.

After waking up and another 3 hours of watching cartoons I was finally told I was going to be discharged from the hospital. I filled out a comment card explaining that my doctors were nice however there is a complete lack of communication citing the dinner and medicine debacles as clear examples. I was given my file and told to bring it to checkout. I reviewed it and I noticed that his initial thought was that I had a stroke; I am so happy that he witheld that opinion from me otherwise it probably would have caused me to have one anyway.

When I finally walked out of the hospital with a bag full of antibiotics with my driver who was from the embassy I felt like I was being released from prison and was free again. This is Africa.

Friday, May 15, 2009

I've Wasted an Hour and a Half!

I called a meeting on this past Monday at 9:00 AM at Mavula Primary School which is one of the schools involved in the project. I wrote a memo that stated that there was a meeting at the above-mentioned time and place and the things we would be discussing and that either the principal or a representative from the school would be required to attend. I went to each school, gave the principal the memo, sat down and explained it to them, and they agreed to either come or send a representative in their place.

On Monday at 8:30 I sent a reminder text message to the principals about the meeting. My principal didn't show up, two schools hurriedly sent representatives, two principals showed up (one of which was the principal of the school hosting the meeting), and one school didn't send a representative at all. At the end of the meeting we decided to meet again on Friday to finish up the proposal.

I went to visit the school that didn't send a representative after the meeting. I talked to the sports director and he said the principal didn't inform him of the meeting. I went in on Tuesday to talk to her and I was walking into her office and as I was walking in, and like a child who knew she was caught doing something wrong she said, "you're going to scold me, aren't you?". She claims, "It slipped my mind". I reminded her of the memo that we discussed together and that I sent her a reminder message a half hour before the meeting. She claimed her battery was flat and didn't get my message until after the meeting. I asked her why she didn't call me when she got the message, she didn't have an answer. So she knew that she messed up because the sports director told her I was there the day before looking for her and I was mad. Instead of calling me then and apologizing and acknowledging she was wrong, she waited for me to come and see her. I explained to her how much work I was doing, and that all I had asked of her was to write one letter, and come to three meetings since November and she came an hour late to the first meeting, missed the second two, and took 4 months to write the note. I told her that she doesn't seem like a person who is serious about it and must not really want it because she is putting no effort into it even though I'm asking very little of her. She said, "I want it, you can tell I am the type of person that wants it by the tone in my voice". After about another 15 minutes of this charade she appointed the sports director to come in her place.

I was running a little late today and showed up at 9:24 for the meeting and NOBODY WAS THERE! I've learned some things about communicating with people so instead of sending them a text message berating them for not showing up for the meeting at 9:00 I sent them a pleasant reminder: "Principals' meeting starts at 10:00 at Mavula. You or a representative of your school must attend". One principal came immediately; she was the only non-hosting principal that showed up. We waited for an hour and a half and then she said, "This is ridiculous, I've wasted an hour and a half waiting for this meeting to start that I could have spent doing work at my school!". I said, "See? This is what it feels like, this happens to me all of the time". I think I may have actually reached her with that message and hopefully now at least she will start coming to my meetings on time.

I visited each of the schools that didn't attend, all of which didn't send me a message saying they weren't going to make it, and had a discussion with them. I explained to them that the DOE asked them if they wanted a Peace Corps Volunteer at their school and they said no. My principal told the principals of the other 5 schools that she was applying for a volunteer and needed another school to apply with her; nobody wanted one and she had to pretty much force my other principal to sign the form. Even though my principal did all the work to get me here and keep me here, I am still helping them get sports fields and all I'm asking for is them to come or send a representative to some meetings, write a few letters, and give me their input and they can't even do that. When the Circuit Manager calls a meeting they make sure to go to his meetings or at least communicate that they weren't coming. I asked them why they felt it was ok to not go to my meetings, not send someone in their place and not call me to tell me they weren't coming. They just looked at me with a black stare with no answer except that they were sorry and from now on they are going to put more effort into it and work with me; we'll see.

I've been struggling to cope with the lack of effort that the principals have been putting into this project thus far. I have presented them with a huge opportunity to improve their schools by giving their students access to all sorts of sports and they aren't willing to put in hardly any effort to help me. I believe that I may have at least convinced that one principal to have a little more respect for me and my requests for assistance so I guess today's meeting was at least marginally successful. I would love to drop the other half of them from the project but my goal is to bring sports to the community and if I have to deal with incompetence and laziness in the school leadership then that's the way it's going to be.

Project Update: School Renovation

The renovation of the three academic buildings at Mnyamana Primary School was my first big project that I started working on in September and I have made some progress.

I have been struggling with completing the proposal since I've been getting mixed messages of what was required and who I was submitting it to. In short, I completed the proposal and presentation 2 weeks ago but found the more difficult part was submitting it to the Department of Education (DOE).

Both the presentation and the proposal are larger than 25 MB which is the maximum file size that can me sent through Gmail. Someone suggested that I upload it to a file sharing website. I signed up to 5 different file sharing websites and they either wouldn't allow me to upload a file that large or kept timing out. So I downloaded a program that was supposed to allow me to upload it to the website faster and resume the upload where it was if it crashed. I installed that and for some reason it wouldn't do anything. I was getting really frustrated at this point because here you buy data bundles which allow you to connect to the internet and you pay per MB transferred. You can imagine that trying to upload 86MB of data that fails several times can burn through a lot of data quickly. Between trying to upload those files, downloading uploaders, and browsing for uploading programs to download I used approximately 400MB of data.

At this point I gave up on using the internet to transfer the files and sent the DOE an e-mail saying that I would "make a plan" (a very over used phrase) to get it to them. My first idea of burning the files to a CD and then sending it to them in Nelspruit was not a very favorable one. It would take too long to get there if at all. And if it managed to get there it would probably be lost within the DOE building somewhere. Then I had a mild epiphany; FAX! So last week Thursday I submitted it to the Department of Education via fax. In this age of technology I sometimes forget that I am in a developing country and try to use methods that exceed the current capacity.

I finally got in contact with the Director of Special Projects from the DOE in Nelspruit after a week of promised calls and confirmed that he had received my proposal. He is submitting the proposal to a board of investors that handles distribution of funds that have been donated to the DOE. Now I get to do my least favorite thing, wait. Their next meeting is in late June or early July so I won't be able to get the funds until after I return from the U.S. so it is a little frustrating. However, I have reached a milestone with the project and can go to the U.S. with a sense of accomplishment.

Monday, May 11, 2009

"...we will not tolerate laziness and incompetence..."

Yesterday Zuma said when announcing his new cabinet, "We reiterate that we will not tolerate laziness and incompetence and that we will emphasise excellence and achievement from the cabinet and the public service. With these objectives in mind, I am confident that the new structures of government will enable the state machinery to speed up service delivery".

Since I've been working on my projects I have experienced a lot of incompetence and laziness. I ask the circuit manager (in charge of all of the schools in my area) for some information and he said "the regional director of the planning office has that information". I talk to the director "we don't have them the circuit office has them". Then I talk to the circuit manager and he insists the regional director of the planning office has them. The planning office says "oh, WE don't have them, but here's a list of the consultant who have the information you are looking for". A sports and recreation manager said to me, "Jabulani, This is a once in a lifetime opportunity, I'm really excited about this and I'll get deliver this to the municipal manager when he gets back tomorrow". I said countlless times, "I am waiting for your letter of approval to move forward on this project, please have it for me by Friday". 5 months later I type the letter for them to sign and it finally gets done. My service has been plagued by this.

The problem with laziness is it breeds laziness. Sometimes I catch myself justifying my being lazy with someone else's laziness. On Friday, "He probably won't read it until at least Wednesday so I think I will just do nothing today and then fax it on Monday"; instead of getting it done and being efficient and productive. In 3 1/2 weeks I will be going back to the U.S. for a visit and I want to get some of the plans finalized so soon after I get back I can start implementing the projects.

Zuma also warned the civil servants, "the era of hard work has begun". Well, sir, I've been working hard for the last 8 months, I hope that your call for this reform is more than just a rally cry. You campaigned on the slogan "Together we can do more"; well, let's do it.

Project Update: Community Resource Center

Before leaving for vacation in March I wrote about building a small center on my counterpart's land where people go to get help finding jobs and seeking career advice. This project has transformed into a much much larger project. With the assistance of several people I will be building an 1100+/- square meter community resource center on a different piece of land.

The new center will include the following:
-Research Library: with books, magazines, and computers with internet access
-Two spaces for outside organizations: they will be rented to NGOs and government initiatives so they will have direct access to the people. These organizations will focus on employment and education. As time goes on and community needs change we can rent the space out to other organizations
-Community Police Force: This will be a space for the 6 police officers who patrol our community to work from. They are currently operating out of an old camper trailer on a site with no running water or toilet
-Two meeting rooms: These will be used by the outside organisations, community groups that need a place to meet, or people who are using the library.
-Celebration Hall: This will provide space for large workshops, lectures, ceremonies and parties.
-Gym: will be outfitted with weights and exercise equipment and offered to the public on a membership basis
-Librarian's office
-Kitchen: To be used by the employees for a break room and for catering for events
-Caretaker's Room: It is regular practice to have a caretaker who is responsible for cleaning the building stay at the building
-Outdoor Storage: Can be used by the renting organizations or community for storing large equipment used for community events.

I met with Chief Mabena and his tribal council (chairperson, induna, and secretary), the traditional chief of Vezubuhle (my village) and Chris Hani on Tuesday 5/5 with the principal of the high school to discuss the project. First we talked about a money-making project that the high school is doing that involves a steel transport character that is housing an ATM and fax machine and computers with internet access and snacks. Between that proposal and the resource center discussion the chief let me take a picture of him and the tribal council with Flat Stanley; it is really funny how much people are enjoying this Flat Stanley project.

We presented the center and I tried to use some of my Ndebele language skills but the chief said I needed to learn more. I had invited the principal because he wanted to present his container project but it had unintended positive consequences. Since his school is going to be the greatest beneficiary of the center due to the resource library and job/career guidance organizations that are going to be coming into the area it was a big seller that he was there speaking very passionately about it; he is also much better at speaking Ndebele than I am. The land we were asking for was right across from the school and the chairman of the tribal council had said it was reserved for a clinic when I had spoken with him the week before. I knew that if I explained to them the reasoning and benefits for placing it there they would accept it and give me what I wanted. We successfully convinced them and set up an appointment to meet with them on Thursday 5/7 at 10:00 to view the land.

I showed up at 9:45 so I would make sure to be there before they got there. I passed the induna on the way and said hi and then went over to the school and was waiting inside the gate. I was looking around and I see this guy walk up and he looked like the chief but I wasn't sure. He was walking slowly like old South African men tend to do and he extremely oddly dressed. His hat was a beat-up Fedora, he had a large forest green barn coat over top of an oddly patterned sweater, blue mechanics pants, and leather workboots with holes in them; I figured it was just a lonely old guy wandering. Then he walked over and said "hi Jabu" and it was the chief. I was shocked to see him so mismatchedly dressed in public. I didn't expect him to come in full Ndebele clothing (I've never seen him wear it before) or roll up in a black Lincoln Navigator with a body guard and his entourage but atleast in a car with the rest of the tribal council members. Definitely didn't expect him to shuffle up by himself. Maybe he was trying to travel in cognito so as to not be noticed. He didn't or didn't show that he was mad that I didn't recognize him so I don't think I caused an damage to our relationship.

We viewed the property and it is exactly what I wanted and it has been approved. He said that I must "act quickly and build a fence around it before someone else builds something on it". Tomorrow I am going over to the site with some students to pick up the trash, cut the grass, and repair the fence. The architect will be plotting the plan onto a drawing of the site so we can see if we need to change the design to make it more appealing or functional.

Other volunteers have tried to build things like this in the past that now stand unused and abandonned. The reason this happens is because they've said, "Gee, I think it would be nice if this community had a library in it", and then built one using U.S. funders without involving the community in the process or assessing if they know how to use it or even desire it. My approach is different because I've involved everyone in the process. I have support from the principals, the tribal council has approved it, outside organizations have expressed interest, and everyone I talk to likes the idea. Before the doors are opened I am going to make sure that everyone is lined up and ready to use it on day 1.

This project is large and expensive undertaking but I have the resources and support that it will take to bring it all together. In the end, NGOs that have a difficult time reaching people on a grassroots level will be able to directly administer their services and operate at a grassroots level.