ANOTHER mom?! Yep, and new godchildren too.

So it’s been way too long since I’ve written in my blog. I usually only wanted to write in my blog when I had a special experience or profound insight to share… but I’ve realized that what I now consider “normal” or “everyday” experiences are actually still pretty interesting to readers back in the U.S. So I’ve decided to start writing about the daily/weekly “normal” experiences as well as the particularly special or profound ones. I wrote the following on Dec. 7th, 2011:

The past two weeks have been kind of a blur. The week of Thanksgiving I took a young nursing student (my neighbor’s younger sister) with me to the Peace Corp’s national HIV/AIDS capacitation workshop. We both got certificates saying that we are trained in the basics of HIV/AIDS and ready to teach charlas and classes about the topic.

The person that I brought to the workshop is a very bright 20-year-old, and recent nursing school graduate. Yes, she has a nursing degree and is now licensed to work as a nurse in any health post, health center, or regional hospital. However, let me give you an idea of just how thorough Paraguayan nursing school is. In our HIV/AIDS workshop, the first thing we did was take a multiple-choice “Pre-Test,” on the basics of HIV/AIDS. Some of the questions included “Are HIV and AIDS the same thing?”, “Does the birth control pill prevent HIV transmission?” and “Can women get HIV?” Basics.

As I was sneakily peering over the girl’s shoulder, I realized that she was answering almost all of the questions completely wrong. To the latter question, for example, she chose the answer: “No, women cannot contract HIV because female sexual secretions kill the virus.” By the end of the 2.5 day workshop, she was able to answer all of the questions, and some much more complex ones, with 100% accuracy. …Shouldn’t all nurses be able to do the same?

This past week (Dec. 1-3) I took the president of my Fogon Commission, Benita, to another workshop in Asuncion about fostering Volunteerism in our communities. It was not the best experience because apparently the people who planned it (a Paraguayan NGO) didn’t see anything wrong with asking an audience to sit on their butts for 9 hours a day for 3 days listening to horribly boring and irrelevant lectures with little to no opportunity for audience participation. To give you an idea of how bad it was, the workshop started out with some 80-90 participants on Day 1, but by Day 3 so many people had thrown in the towel that there were only about 25 of us left (mostly just the PCVs and our community contacts). Benita and I spent the 3 days elbowing each other when one of us fell asleep, and giggling as we looked around the room at all the people dozing off or in some cases completely passed out in their chairs. Next time, I will be sure to bring a Sudoku book to pass the hours.

Nevertheless, it was still a really good opportunity for Benita to get out and about (she had to ask her husband for “permission” before accepting my invitation). According to her, he only allowed her to go because I have a good reputation and standing in the community and he trusted me not to bring any dishonor on the family. A 50-year old mother of 4 (her eldest daughter is my age), Benita is a traditional, classical Paraguayan woman, very religious, and highly respected in the community. During our 3-day workshop, she adopted me as her daughter and proceeded to treat me as such, the whole time, asking other PCVs “no sabes adonde se fue mi hija?” (“do you know where my daughter went?”) when she couldn’t find me, and when she was ready for bed each night, came to look for me to remind me that it was getting late and I’d better think about getting to bed soon. She also “protected” me from Paraguayan men she suspected of making advances on me, telling one such muchacho that he had spent enough time discussing the seminar with me and that if he had any sense of respect he would leave me alone until tomorrow. Not to mention that the night I got a late text message, my “mom” had no verguenza to ask me suspiciously “dios mio, now who on earth is texting you at this hour, mi hija?”

Needless to say, 3 days of that was quite enough. It was flattering, but do you really think the girl who grew up with 3 moms (my biological mom, her life partner, plus my stepmom) and is now a 23-year-old adult really needs yet ANOTHER mom-figure? Dios mio.

In between these 2 workshops in Asuncion was the great “Despedida” at the school to close out the school year and start summer break. For the preschool graduation I was asked by the parents to serve as a madrina de honor (“honorary godmother”) for the little 4-year-old tykes (my favorites students), and in the ceremony got to assist the other teachers as we handed out their certificates.

The Census

The official, door-to-door Health Census is our first and perhaps most formidable task as Rural Health Volunteers. We must arrive on the doorstep of at least 50 different houses in our communities and ask a buttload of questions such as “Where does your water come from?” and “Where do you go to the bathroom?” It’s surely akward, but it must be done. How on earth can we begin to “help” our communities if we don’t even know what the problems are, what people need, what they already have, and what they want? All development work has to ultimately be done by the people who are “being developed,” which means I have to start with THEIR actual needs and THEIR actual motivations, and not just project my perception of their needs and wants upon them. 

So I am dutifully completing my census (censo) of Potrero Baez, the 120-house community where I now have a house, friends, (probably enemies too), lots of work, regular bouts of diarrhea, and an adorable puppy.

But the work has been very, but very slow. Making my house liveable has eaten up literally weeks of my time: waiting for the construction guy to come, waiting for the plumber to come, waiting for the electrician to come. (Not to mention a few days wandering around asking people where I can find a construction worker, plumber, and electrician. It’s not like they advertise- everybody just knows.) And it’s not like in the U.S. where they say they’ll be there between 10am-4pm and then they show up at 5pm (which is bad enough). It’s more like: He says he’ll be there on Tuesday morning, but he actually shows up Wednesday afternoon when you’re not home, so you have to walk to his house on Thursday to reschedule for Friday, then after ditching out again on Friday, he finally shows up on Saturday at 7am when you thought you were gonna sleep in. Hah, right. Also, making trip after trip on the colectivo to Villarrica (the centro) to buy things like shower parts, parts for a ceiling fan, sink parts, cement, and other household parts/items/tools has also eaten up days or weeks that could have been spent censo-ing.

So yesterday, after a failed morning attempt to get out and “censo” (there was a death in the community, which means everybody goes to the family’s house to offer condolences all morning), you can bet that when I got out around 3pm to try again, I was anxious to check 2 or 3 houses off my list before nightfall at 5pm.

Now, I had always assumed that the town drunk, we’ll call her “Doña Leonida”’s affinity for me would be more of a liability than an asset. Little did I know that my patient tolerance for her annoying, drunken visits, and unintelligible ranting in Guarani would soon pay off. As it turns out, drunk though she may be, about half of a square-kilometer of my community is populated by relatives of Ña Leonida. So after she dragged me to her house insisting that she be the first census interviewee for the day, I could hardly refuse when she suggested that she accompany me to all of her nearby relatives’ houses to do THEIR censo interviews as well. Jaha! She said excitedly, “Let’s go!” 

First we visited one of her daughter-in-laws who is studying nursing at a university, and after completing her family’s censo thanked me for the work that I’m doing, and invited me to stop by the house for lunch any time.

Next, while at another house interviewing Leonida’s sister, I asked “Mboy personapa oiko hina ko’ape nde rogape,” “How many people are there living here in your house?” Three, was her effortless response. “What?” shouted Leonida accusingly, “Don’t you lie to this pretty girl.” They then proceeded to have an argument in Guarani about how many people are really living there. “I know what these census people use this information for,” shouted her sister, “If I tell her that so-and-so is living here, then she’s going to write it down and the government is going to find out!” Don’t ask me why she believes this to be true, or what she thinks is going to happen if the government finds out that so-and-so is living there. Leonida turned to me “There are 4 people living here,” she corrected her sister, and proceeded to provide me with what I assume to be their correct names and ages. 

After that we went to her cousin’s house, where there appeared to be a gathering of 5 or 6 men sitting around smoking and chatting. For a young blonde foreign female, it felt like walking into a lion’s den. But Leonida fearlessly led me into the thick of it. “Come here muñequita,” her nickname for me. (“doll”) She pulled me right into the middle of the circle. “This girl’s here to work,” she told them. “Answer her questions, let’s go!” she ordered her cousin, who looked at me skeptically while making fun of me for surely not understanding any Guarani. I proceeded to explain to him in Guarani that I understand and speak quite a bit and that I had been conducting all of my census interviews in Guarani. But when my still flawed language skills prevented him from understanding one of the questions, Ña Leonida stepped in, “You idiot,” she shouted at him, “don’t you understand what she’s trying to ask you?” and proceeded to translate the question perfectly into Guarani for me. By this point, she had memorized my census questions word-for-word.

Afterwards we went to one of her daughters houses. The daughter is also a known alcoholic and lives with her husband, 8 children ranging from 1-23 years old, and 2 grandchildren in a 3-room house. (Yes, at a mere 60 years of age, Leonida is a great-grandmother.) The oldest son of the 8 children is in jail for armed robbery. The youngest of the 8 children is 18 months old and has an enormous genital hernia that the parents have been ignoring for months. “You have to take him to the hospital as soon as you can,” I reminded the father, even though the nurse at our Puesto de Salud told him the same thing months ago. “At the Regional Hospital, they will do the surgery for free- but you have to take him this week, this is an emergency,” I urged the father (who seemed to be slightly more responsible than the mom). I have often seen this baby sitting outside on the ground, bare-bottomed and unattended in front of the family’s house, crawling around the filthy yard that is filled with assorted garbage and poop from a variety of animals and people. Unfortunately, I will not be surprised if the baby still has not been taken to the hospital by the end of the month. Frankly, it is a miracle that he has reached 18 months given his living conditions, the fact that his mother was 45 when she gave birth to him, and the fact that she continued to drink heavily throughout her pregnancy (according to reports from a variety of community members).

At another of Leonida’s cousins houses, the father mistakenly told me there were only 6 people living in the house- he and his 5 children, apparently forgetting to mention the 7^th, his wife. As we were walking away Leonida suddenly put her arm out in front of me “Wait,” she said, “did you write down his wife’s name on your paper?” Nope. “HEY!” she shouted back to her cousin, a 50-year-old man, “What’s your wife’s name again?!” We added it to the family’s form, and continued on. 

But by this time it was already starting to get dark out; we had to call it a day. “But there are so many more houses to go to,” she said. “You have to come back tomorrow to do more. Will you come back tomorrow?”

Thanks to my town drunk, I had just had the most productive day of censo-ing yet.

“Yes ma’am, you BET I’ll come back tomorrow.”

A Paraguayan Puppy Finds a Home

I did not want a puppy. But now I have one! Here's the story of how it happened.

I originally wanted to get a dog for my house because in Paraguay, having a dog is like having a security alarm system installed in your house: they spend the night outside, and if anybody comes near your house, they start to bark, and if it's a "desconocido," (somebody they're not familiar with) they will attack them if they don’t leave. Plus, living alone, I figured it would be nice to have some company. I discussed it with some fellow volunteers, told them that I was officially looking for a puppy, and invited them to let me know if they got their hands on one for me. 

But then I changed my mind, and I did NOT want to get a puppy. Turns out that my neighbor’s dog also guards my house, and actually sleeps on my porch almost every night. Whenever someone comes near either house, she lets us know. Plus, it occurred to me that if I get a puppy now, it’s going to be a puppy for most of my time here, and will take quite a while before it actually grows into a dog. And then I started thinking about all the responsibilities and costs of having an animal to take care of- buying food, being there every day to feed it (and finding somebody else to feed it if I’m not there, which is often), getting all its vaccines, neutering it, treating all its potential illnesses, catching all its potential illnesses myself, and spending all the time and energy that would be required to teach it how to behave the way that I want it to… Obviously a puppy is not as good of an idea as I had originally thought. No way do I have the time or money for that. 

But then fellow volunteer Ashley called.

“Hey! I have great news! I found you a puppy!!!”  she said.

Uh oh. How was I going to break the news to her? I needed to stall for more time… “Oh? Where did you find a puppy?” I asked her.

“My neighbor’s dog had a litter, and I happened to stop by the house just as they were about to drown the 2 female puppies. I told them I knew 2 people who wanted female puppies, so they gave ‘em to me for free!”

[In Paraguay, everybody wants male dogs. Most people kill the female babies or let them die because nobody wants them, and the average family can’t just keep them because they can’t afford to feed more dogs than they already have.]

“Wow, thanks so much Ash… but I kinda changed my mind about the puppy, I don’t think I want one anymore,” I replied. “Do you know of anybody else who would take her?”

Ashley hesitates. “Are you sure you changed your mind? I really think that once you see this puppy, you’re going to want to keep her. She’s absolutely adorable, and has a great personality. I do actually know some other people who are looking for puppies… but this puppy is super special and I really wanted to give you dibs on her. You know what? I’ll bring her to Villarrica on Monday so you can meet her, and if you still don’t want her, we’ll find somebody else.”

Fair enough. “Alright, see you on Monday, then!”

And the rest is history. When I saw the little tyke, at one-month old and 3 pounds, it was love at first sight. With a cute little button nose and beautiful coloring, my repressed motherly instincts could not resist. She licked my face when I picked her up, and her tiny body was trembling from the cold (it was only around 45 degrees that morning).

“Do you know what you want to name her?” Ashley asked me.

Crap. This was something that had not even crossed my mind. “Uhh… nope, not really.”

 “Well,” she began, “I’ve been calling her Osa because my neighbors think the looks like a bear cub and they’ve been calling her Oso. But she’s a girl, so I figured if we’re going with the bear name, it should be Osa and not Oso.”

I peered at the puppy with a puzzled face to figure out what it was about her that made people think she looked like a bear… I figured it was because of her black/brown coloring, her big round belly (which I later realized was swollen due to the fact that it was chock-full of parasites),  and the funny way she hobbled when she walked (which I originally thought was because she was still learning to walk, but later realized was actually due to a handful of bad pique infections in her feet.)

“Hey, that sounds like a great name to me!” I replied.” Osa it is.”

An old Paraguayan man promptly came up to us asking about the puppy, and reprimanded me for not carrying her inside my jacket to protect her from the cold, “She’s a beautiful puppy,” he said. “You have to put her inside your coat, like this, to help protect her from the cold. A pup that little won’t survive long at this temperature!” he advised. Good call, Gramps. From then on, Osa got used to traveling inside my jacket on my chest. It’s actually one of her favorite places to sleep. She’s so little that most people don’t even know that I have a dog with me unless I pull her out of my jacket to show them. I guess when people see me they just think I have a strange abnormal lump sticking out of my chest…

My first night with Osa was a disaster. I had no idea what to do with her, I was terrified that she was going to freeze to death in the night. Having peed and pooped all over the house throughout the day, I was not at all confident about the idea of letting her sleep on my bed. But, I didn’t want her to die. So, I prepped her doggie bed, which I had bought for her that day, laid plastic underneath her, in case she made a mess in the night, and covered her up in my bed to try to keep her warm. We did not sleep at all that night. Every 1 or 2 hours, she was up crying, meaning that she wanted to be let off the bed to poop or pee. So every 1 or 2 hours, I was up with her, letting her off the bed, turning on the light, and cleaning up her mess, before climbing back under the covers to begin yet another REM cycle that would not be completed.

This was not going to work.

So the next day I went downtown to buy a nice warm blanket for Osa, along with doggie food, doggie bowls, and 5 Liters of disinfecting bleach for my shit-and-piss-covered floor. I set up her doggie bed with her blanket in the kitchen, next to her food bowls, and blocked the doorway to the other rooms so she couldn’t try to come find me in the night. She fell asleep in her bed while I was in the kitchen eating dinner, and didn’t even notice when I left to go to sleep. She slept through the whole night (getting up on her own to poop and pee on the kitchen floor) and didn’t wake me up till morning with her little yips. (Cuz after 8 hours without eating, her worms were huuuuungry.)

There are many more Osa stories. I will post photos soon. But you can also Skype call me if you’d like to see her in video! Casey.conger1

Drinking Cultures: A Surprising Tale of Unhealthy Choices (Part III)

A final comment on alcohol: Alcoholism among Paraguayans is a widespread health & social problem (that was not covered in our training as Rural Health and Sanitation volunteers). 

Spanning across ages and genders, alcohol consumption is widespread and culturally normal among Paraguayans. The most obvious demographic with a high level of alcoholism is men between the ages of 15-30, obvious because there is little cultural pressure to hide their drinking (which is to say that this demographic is culturally allowed to do as they please, openly, without serious repercussions). The majority of my young Paraguayan male friends drink daily, with weekly binge episodes. Alcohol is less-accessible to women because they are literally less-able to leave the house to go out and purchase it. My host-mom Laura (28) for example, always has her cousin Evard (21) go out and buy her a beer if she wants to drink while her husband isn’t home. At the same time, there is an older woman in my site, maybe 60 years old, who is a known alcoholic and always reeks of booze. So, there are various gendered components to drinking.

Perhaps I am too quick to suggest that alcoholism is unaddressed by our Pre-Service Training (PST). I will revise that to say that it was not directly addressed as a training topic. However, one of our main teaching tools is a program for youth called “How to Plan Out My Life,” (Como Planear Mi Vida), designed to address issues related to self-esteem, reproductive health/family planning, and short- & long-term life goals. In this sense I will be working to prevent alcoholism among the jóvenes in my high school, by helping the students to feel hope, to believe that they are valuable individuals, to believe that they can control their futures, and to help them feel motivated to improve their own lives, rather than to deal with their problems by self-medicating with alcohol or engaging in other self-destructive behaviors.

It is probably unreasonable to think that PCVs can realistically attempt to treat current alcoholic behaviors in their communities (especially given the lack of treatment facilities in the campo), but as health workers, we can at least teach young people the risks, symptoms, and prevention of alcoholism to help them avoid getting to the point of needing treatment later in life. I think future RHS-PST should include an alcoholism-prevention component.

Drinking Cultures: A Surprising Tale of Unhealthy Choices (Part II)

The second aspect of “drinking cultures” that I refer to has to do with alcohol consumption on the part of PCVs. 

I started to notice during training that every time PCTs (Peace Corps Trainees) got together to hang out during our free time, the activity always centered around alcohol, and there was no alternative group to hang out with because everybody wanted to go to the alcohol-centered get-together. (Our PCT group never wanted to split up into cliques, we always wanted to do everything all-together.) On weekends in Guazu Cora, we would sometimes do 3 evenings in a row (Friday, Saturday, Sunday) of get-togethers that centered around drinking games. A beer or two was certainly welcome after a loooong week of training, but between the Brahma beer, local Vino, and Paraguay’s main liquor caña, many of these nights did not end well for some volunteers (including me once or twice). As somebody who went through my “drinking phase” in college and was quite over it, I often found myself wanting to do other things with my compañeros. But the group was clearly set on drinking, even to the point of being determined to drink. Not attending group get-togethers was also not an inviting option, since we were all very dependent upon each other for moral and emotional support during this extremely difficult time. We needed to be with each other as much as possible. I remember feeling stuck between a rock and a hard place, needing to be with my training companions but at the same time feeling unenthusiastic about the drinking aspect of our get-togethers. 

The alcohol was a crutch for PCTs, to help us deal with the stress of training, and to help us all get along and bond. Peace Corps Training is an extremely difficult and trying time for a trainee; you are undergoing major life-changes and dealing with major physical, emotional, and psychological stressors. You do not have the liberty of choosing what kind of friends you want to spend time with, it is simply imperative for your emotional and professional health that you get along with the PCT group with whom you’ve been plopped down. Somehow, all of these factors combined to make drinking a prominent activity among PCTs.

I also suspect that there is a relatively high incidence of alcoholism among PCVs in Paraguay and world-wide. Alcohol is readily available and cheap in most places in Paraguay, and I suspect in most places where volunteers serve throughout the world. When I visited a current volunteer for a few days, she drank alcohol every day, by herself, sometimes starting early in the day, and drinking into the night. I was a little bit shocked, but when I thought about it, it all made pretty good sense. Peace Corps Service is an extremely stressful experience. A person is removed from their familiar surroundings, many struggling with the loss of their significant others, removed from their family and friends, and put in a place where everything is new, language barriers make communication difficult, and there may or may not be a good friend to turn to when you most need emotional support. We all develop various healthy and unhealthy ways of dealing with these challenges. (Everybody knows that my best friend is Nyquil...) Especially for those with a genetic predisposition to alcoholism, Peace Corps service presents the perfect stressful situation to trigger it. 

But these explanations do not make binge drinking or chronic alcoholism any less dangerous for a PCV. The health implications are numerous. The extreme stress of Peace Corps Service already renders the majority of volunteers somewhat immuno-compromised, and PCVs also often face nutritional changes and/or deficiencies that can weaken our defenses. Alcohol usage, both binge and chronic, further compromises our bodies’ ability to protect itself from illness. And for most PCVs, service is one of the worst times to be immuno-compromised; we are faced daily with foreign bacteria, viruses, parasites, and other infectious and non-infectious diseases that our bodies are already ill-equipped to handle. For example, alcohol consumption (especially binge drinking) often gives intestinal parasites (Giardia, roundworm, hookworm, etc.) an opportunity to grow and strengthen while the body’s immune system is compromised by the alcohol- most people with Giardia will tell you that the symptoms worsen during the week after a night of binge drinking.

And of course, chronic alcoholism leads to liver cirrhosis, vitamin deficiencies, and a whole host of other physical and psychological health problems. 

But in addition to compromising our health, alcohol usage in the Peace Corps also compromises the safety and security of volunteers. Alcohol consumption is involved in nearly all incidences of rape and physical assault in PC world-wide, indicating that alcohol may be a significant risk factor for this kind of crime. In general, alcohol impairs our judgment and makes us less-able to identify and deal with unsafe or risky situations. (Probably also plays a role in spread of STIs/HIV & unwanted pregnancies among volunteers, things which DO occur in the Peace Corps.)  

Furthermore, excessive alcohol usage can make us less-effective volunteers. It can impede our ability to do good work and perform at the level of excellence of which we are all capable. It can impede our community’s ability to see us as professionals and respect the work that we do. Personally, I make a conscious decision not to consume alcohol in my community, and to consume minimally or not at all when spending time with other volunteers. Although it may not be popular or typical, I believe that it makes me a healthier, safer, and more effective volunteer.

Drinking Cultures: A Surprising Tale of Unhealthy Choices (Part I)

Paraguayans, for reasons I have yet to understand, do not believe in the idea of individual drinking glasses. All drinks, with few exceptions, are shared. A dinner table of 5 people will be set with no more than 3 glasses to drink from. (If there is a drink and glasses at all…)  Además, the traditions of tereré and mate (practiced by ALL Paraguayans, EVERY day) involve passing around a shared glass where everybody drinks from the same straw. Basically, in this culture, there is almost no individual or private drinking of liquids. Almost all instances of drinking take place in a context of sharing. I cannot stress enough how deeply ingrained and prevalent this cultural custom is.

A couple interesting things logically follow from this custom. First and most obviously, there is an excessive sharing of germs. Paraguayans get sick together because they are constantly sharing germs with each other via drinking glasses and bombillas. During training, me and my entire host family got a horrible tonsillitis infection when my 5-year-old host sister came home from school with it. She was very sick, missed school, and couldn’t get rid of it for over a month. Within a week, me, my host-mom Laura, and my host-dad Carlos had the same infection. We all had to take antibiotics for it, which, by the way, can be bought over-the-counter in this country with no prescription and no instructions for proper use. AND, there was absolutely NO effort to avoid spreading it to friends or other family members. Tereré glasses were still passed around when outsiders came over to say hello, and the outsiders didn’t miss a beat when they found out we were all sick. “Oh that stinks,” they would say, as they took a hefty swig of shared tereré. “I hope you guys feel better soon!”  It’s as if there is absolutely no concept of “contagion,”and absolutely no sense of what germs are or how illnesses are transmitted. You can already see the extent and variety of larger problems presented from this whole germ-transmission standpoint. (Antibiotic-resistant bacteria, children missing school, parents missing work, and just being sick/miserable, for starters.)

Secondly, there follows an unexpected cultural rule of thumb from this custom. Drinking can never take place during eating. No drinks are ever poured until after the meal. I assume that this is because it is considered disgusting to share drinks containing backwash that might include pieces of food. Small children who complain of thirst while eating their dry, salty, fatty meals are reprimanded for being so “uneducated” as to desire liquids while eating. “Finish your food and wipe your mouth off, and THEN we’ll talk about getting some juice,” says Dad. “You need to learn some manners, cochina,” adds Mom. As a privileged guest, I am often extended the courtesy of my own glass at a meal. But it took me a couple weeks to realize exactly what was going on with the drink situation at the dinner table. For a long time I didn’t understand why my family stared at me with incredulity when I, thirsty during my meals and confused by the lack of drinks, started bringing my personal water bottle to the dinner table to drink from as we ate. I don’t know that there are any immediate health risks posed from this cultural difference, or whether it is necessarily better or worse than alternative ways of doing things, but it is an interestingly stark contrast to how we conceive of drinking liquids in our country.