Thursday, May 03, 2007


Sunday, April 22, 2007

Game hikes and Katatura


So far this had been quite an adventurous weekend!

Yesterday I was invited by one of the doctors here togo on a game drive in the local game park near Windhoek. It is situated about 20 miles outside of town and is known for its rare mountain zebra population. Four of us went on the drive in the doctor’s large 4X4 vehicle. We left the city about 2:45 and began driving on the 4X4 road through the park. On of the unique features of this particular park is that you can get out and walk around as there are not the dangerous animals, like lions and hippos that you would see in other parks. We drove about a third of the way through the loop having seen several species of animals and birds, including kudu, springbok, wildebeest, oryx, and warthogs. About a third of the way through the loop, we decided to get out and look out over some of the hills to see if we could see anything a bit further away. We did sowithout much luck and then got back into the car tocontinue on our drive.

However, when we got back into the vehicle it wouldn’t start. We tried and tried, and nothing! Not even a hint of life left in the car. Luckily this wasn’t a dangerous park, so we decided we would walk along the road and then hopefully another group would pass us and take us to the office where we could get someone to come and help. We began walking around 4:00p.m. along a rough dirt road and I unfortunately had stayed in my flip flops thinking I was just going to be riding in a car. Not the best hiking shoes !

As we walked through the rest of the loop, we were able to see a very large herd of Zebras, which is quite unusual as they normally stay far from the road. Perhaps since we were not in a vehicle, they had not yet run off. The herd had probably 6-10 zebras, one of which was a beautiful baby. We tried to walk quietly to get a closer look and take some pictures. In doing so we saw the entire herd run across the road, probably 20 feet in front of us. The main group went over the hill to avoid us, but the large male of the group decided he needed to make sure we stayed away. He began grunting and stomping his feet at us, tryingto scare us away. At this point we tried very hard to move quickly and quietly as zebras have a notorious reputation for being quite mean and it isn’t unheard of them to charge and bite. Luckily he seemed to be fine with us leaving and we moved on along the road. We continued on and also saw a large herd of giraffes in the distance. We even came across a giant wildebeest about 5 feet from us as we came around a corner. It sort of startled us all, but it was amazingto see it so close. Everything was just beautiful!

Unfortunately, throughout this entire walk, not a single person passed us on the road. We finally arrived at the park office around 5:15 and were able to call one of the park employees for help. We all piled into the back of his pick-up truck and rod sure it had to do with the battery. The gentleman helping us decided to go back to the office where hehad access to another car battery (we found out later from his own personal car) to see if we could get it to work and get us at least out of the middle of the park. At this point it was starting to get dark. The park ranger left and we went to work taking out the old battery and discovered that it was completely dry, not a drop of water in it. Hence it made sense that we were having the problems that we did.

Even though it was not the best of scenarios, we were e backover the same very bumpy road to the car. As it wasgetting close to dusk, the animals were reallystarting to come out and we saw quite a few more, onlythis time we were driving very fast and had to lookquickly.

Back at the car we tried jumping the battery, stillnothing. We tried a few more tricks and for whateverreason, nothing was working, although we were pretty able to watch an amazing sunset coupled with a fastmoving thunder and lightning storm coming toward us.It was amazing to watch the entire sky light up into amillion different colors, backlighting the trees full of bird nests. Amazing!

Finally, with the help of the borrowed battery, wewere able to get the car started and get home, withthe promise that as soon as the shops opened in themorning, the doctor would buy a new battery and bringback the borrowed one so this nice gentleman would beable to drive his car again. What had started out as asimple game drive turned into quite a hike andmemorable adventure.

Today, a friend and I went on a tour called the “Faceto Face” tour of the local township, Katatura and thesurrounding informal settlements. Katatura wasoriginally built under the Apartheid system tosegregate people according to their skin color andethnic background. This meant that people who hadbefore worked near where they lived were forcefullyrelocated to a place far away from town and segregatedby tribe. The government was afraid that if youallowed people from different tribes to be unified,they would unite and try and throw out the government.Thus it was very important to try and keep people asseparate as possible to maintain power. We visited agraveyard where many of the freedom fighters had beenburied. It was upsetting to see how many of the graveshad no name, just a small stone or rock with a numberon it. The records of who is buried there had longsince been lost.

The tour also included us going to the local market tosee what was there and to talk to many of the people.The tour specifically aims to allow people to interactwith the people you are learning about and tounderstand who they are. In the market, we saw manyshops as well as a large meat market and BBQ area. Iwas reminded once again how much Namibians love theirmeat. About 6 BBQs were lined up and people weregrilling fat and strips of meat that were then cutinto bite size pieces that you could put in a newspaper "cup¨ and take with you. You season it with some salt. This however, is not considered ameal, but instead a snack. As it was 10:00 in the morning, I passed on the "snack¨ of steak, especially after having just walked through the areawhere they were carving up all of the meat for peopleto buy and take home. We also met several women makingHerero and Ovambo dresses which were very interesting. The Herero dresses are especially intricate andinclude a headpiece that has long "horns¨ that stickout of each side. Hereros are traditionally cattleraisers and the hats are made to look like the hornsof a cow to honor them. I’m fascinated by the hats and would love to see how someone makes them.

The tour continued through the township and into theinformal settlements on the other side. The informalsettlements are small plots of land that thegovernment sells to people very cheaply and they canbuild a small house, usually of corrugated tin, on theplot. There is no electricity and water is availableonly at a tap point every 200 meters. There are alsopublic toilets and showers that people can go to. Mostof the people living in the informal settlements arethose who are moving to the city from the villages,and a few refugees from other countries who come tothe city to find work. However, there is very littlework to be found in the city and thus most peoplecontinue to live in poverty. The informal settlementshowever, are not squatter communities. They are fairlywell planned, have a road system and people have topurchase the land. With the purchase it means thatthey have a right to the land so the government cannotcome at any time and take it away from them like inmany other cities with the same issues.

It was interesting to compare the areas with otherplaces I have been in Southern Africa. The poverty wasevident, especially in the informal settlements, butthe organization and cleanliness of the areas wasastonishing to me and somehow made it feel less dire.It was a strange feeling as I know that hunger ishunger, regardless of whether your house is made ofmud or tin. I’m still trying to let the experiencesettle in to really sort out what I think about it.It was very interesting to see and to discuss with ourguide some of the feelings surrounding this area andthe mass migration to the city. Our guide, Philadelphia, told us that coming to the cityrepresents hope for many people. However, many of themend up living worse than they did when they were intheir villages.

I’m now getting ready to go to a lodge for meetingsfor the week. It is just outside the city and I’mtold it is quite nice, especially if you are able toget out and walk around a bit. The change of scenerywill be nice but it will also mean that I will beworking through most of the evenings. Hopefully itwill be a productive trip and that we will be able to accomplish what we set out to do.

I hope you all are well and enjoying springtime!

Keep well,


Unfortunately No Brangelina

4/18/ 2007

I’m currently sitting outside my room enjoying another beautiful African sunset and appreciating the chance to be in Southern Africa again. This is the end of my second day here and although I am still groggyfrom the journey, I’m remarkably coherent andproductive for this time of night.

It’s good to be back in Africa. I was really mixed about coming back, not so much that I didn’t want to come to Africa, but the timing wasn’t the best forthe rest of my life. However, I’m finding myself feeling right at home, almost to the extent that it doesn’t feel "foreign" to me, and that is nice.I’m enjoying reuniting with many work colleagues and meeting the new people who have come to this growing office.

So far my time here has been spent in the office, either in meetings or training the person who will be helping with the materials development for this project, so I haven’t been out much. However, since I will be here a bit longer this time, I’m determined to get out of the city a bit and see a bit more of this beautiful country - even if its just a quick trip. I did manage to see about 15 baboons onthe side of the road on my way from the airport, so if all else fails, I can count that as part of a wildgame drive.

I’m staying at the Tamboti Guesthouse which is a small bed and breakfast here in Windhoek. It is run by a German couple and has 13 units. The rooms are pretty simple, but the grounds and the hospitality are fantastic. Ziggy, the owner, is very friendly and immediately helps you to feel at home. She has taken a genuine interest in me and what I’m doing here, making sure I have what I need which is nice, always good to have someone looking out for you in a foreign country. And, of course there is the dog, Schlumpy (said “Schloompy”). He has shown me around this evening, making sure I knew where to pick up my Coke Light and showed me all the good places to take a picture. Outside my room I have 1 carved rhino, 2 warthogs and a giant 8 foot tall mask which greet me as I go in and out. Overall, it’s pretty nice and I think my time here will go fast.

Aside from work, I’m having a good chance to catch upon the finer points of the Cricket World Cup which is on every time I turn on the TV. I still cannot figure out the game and am coming to terms that I may not ever understand it. Jetlag has also led me to discover that there is such a thing as the World Darts Championship and that it is popular enough to actually be broadcast on TV (in the middle of the night, but TV nonetheless). Who knew?

19 April 2007

So today begun with a lovely walk to work. Another consultant here is staying in the same place as I amand he walks to work each morning and today I decided to join him. It’s about a 10 minute walk and was a wonderful way to start my day.

This trip my role is to finalize the documents from the IMAI adaptation that I worked on last year. IMAI is a programme that is designed to take the burden of caring for and treating HIV off the limited numbers of doctors in the country and empower more nurses, especially in remote settings to do more acute and ongoing care. It’s a complex programme and equally complex training. There have been some stalls and delays in the project over the past year, including national polio epidemic so things have not gone as smoothly as we had hoped. And, due to some communication breakdowns, it was necessary for me to come here to clarify some things face to face. Initially I was a bit anxious about the prospect of coming here again with all the troubles surrounding the project, but luckily things have been very positive thus far. The materials I’m working on and mentoring a consultant to work on are going very slowly. Its some what frustrating and tedious work andI spend a lot of time solving technical problems instead of actually integrating the revised content. But, hopefully once the documents are correctly formatted, we will have some great looking, and more importantly, highly useful documents.

I also attended a digital video conferencing presentation this morning by Dr. Katjitai (for those who might remember last year, this is the doctor who had elephants breaking down his fence regularly). The conference included medical professionals from 3 different remote sites in the country and all were able to watch and interact with Dr. Katjitai. I was very impressed with the use of the technology and am excited to see more ways in which it can be used. It’s an amazing method of reaching even very remote clinics and giving the clinicians there very important training that they would most likely miss out on if it required flying a doctor to them or them to the doctor for the same training session. At the end of the training I was asked on the fly to say a few words tothe participants about IMAI. Thank goodness for adrenaline and all the things it helps you to make up as you go when speaking to large groups of total strangers. But, luckily I didn’t embarrass myself and the country hasn’t lost faith in the person helping with their programme. Dr. Katjitai invited me to join him in rounds during my stay here and I’m hoping to have time to do so. I would love a chance to see Katatura hospital and the HIV ward specifically which I’ve been told is a model for the country. Keep your fingers crossed that time will be kind.

Overall things are good and I feel quite blessed to have things going as well as they have been thus far.

Keep well,


Tuesday, December 19, 2006

Because Lisa wants a "kissy" picture

Tuesday, June 20, 2006

Last of the Photos

Last day . . .


Well, we survived the final day of our meetings and after a lot of hard work, debating, meat eating, and planning, we have a strong start in the IMAI strategy for Namibia. Everyone left with their own list of things they must do to keep up the momentum of the meeting and if all goes according to plan we will be rolling out IMAI by year’s end.

At the end of the meeting, we all ate lunch together and took several pictures. The lodge was preparing for a new group to arrive who were having an awards celebration with a fiesta theme, so there were sombreros and southwestern themed decorations all over the place. I would not have been shocked to see some African Mariachis coming from the back room. It was really quite funny. After a brief “planning the next steps meeting” we packed up our trucks and headed back to Windhoek…and now the real work begins!

Toward the beginning of my first trip to southern Africa, I met a woman who was originally from the UK, but had been living in South Africa ever since she came here for a vacation. I asked her why she stayed, and her response was, “Once Africa has touched your heart, she will never leave you.”

At the time, I had an idea of what she meant, but it wasn’t until after I had spent more time here and experienced the place more fully, that I really began to understand this woman’s statement. Since then I have left and returned a few times, and no matter how long I’m gone, Africa remains with me…in small ways usually, but it has become a part of who I am. Africa is a place where I learned a lot about who I am and who I want to become. Africa taught me how to be still and quiet inside, she showed me how to laugh with my whole body, she fuelled my desire make things better than they are, and most importantly she allowed me to love more fully. I’m grateful to have been reminded of these things again on this trip, and as I return home I recognise that once again, Africa has touched my heart deeply, and she will never leave me.


Wednesday, May 17, 2006

More Photos

Clouds over our hotel

Craft store in Windhoek

The lodge Lisa is staying at

Monday, May 15, 2006

Ah Africa...


Ah Africa…this is the phrase that was repeated several times at dinner last night…mostly in response to the dire and complex condition most countries here find themselves in…my dinner companions consisted of Drs. Hudson and Mutebe from Uganda representing the WHO, Dr. Oke from Nigeria who is the head of WHO Namibia’s HIV/AIDS initiative, and Iggy (Zimbabwe) and Alexinah (Namibia) from ITECH Namibia…I am always in awe over how passionately many of my African friends speak of politics and wish I felt more informed to be able to really understand the complexity of things here… Ah Africa…how does she manage to replace colonialism with local dictators through "free and fair" elections…Ah Africa, how is it that things have gotten to the place that they are…even though her capacity and resources are enormous…Ah Africa, how can such a beautiful and culturally rich place exist alongside such rampant poverty, illness, and war…Ah Africa…

I arrived in Okahandja yesterday evening and am enjoying the break from the city feel of Windhoek. We are in a lodge just outside of town (a small town) and I would not be shocked one bit if a giraffe was hanging outside my back window in the morning. It is really peaceful here, and aside from the large quantities of birds, it is fairly quiet. A few of us went on a long walk along one of the side roads and enjoyed another beautiful African sunset… there are few things that can compare with the orange and red backlit scrub trees of the African bush.

Over the weekend I was able to explore a great deal of Windhoek and managed to walk around the entire downtown area of the city. My colleagues recommended going to the Namibian Craft Centre which has several local artisans and their reps who sell traditional Namibian items (and a few not so traditional). I was impressed with the variety and quality of crafts and managed to purchase quite a few souvenirs. Sunday I also did a lot of walking. Not far from my hotel was a large Dutch Reform Church and since it was very difficult logistally to go to my church, I walked up the hill and listened outside to the hymns, read for a while, and then followed a group of German tourists around to the Parliament buildings.

There is also the national museum of Namibia which I went and walked through…it is small, but very interesting. Namibia is still a very young country and is working to overcome the effects of apartheid. The museum focused on the struggle of Namibians to gain their independence starting with colonialism and then from South Africa…there was a lot of memorabilia from the independence movement of the 70’s and 80’s and documents and images from the first free elections held here. Part of the museum was also dedicated to the rock art which is found all over the country. The San/Himba people (Bushmen) make up a large part of the population here and so you can find all sorts of things relating to their history (including ample copies of "The Gods Must be Crazy" in several languages).

Around lunchtime I made my way to the Grand Canyon Spur, (one of the few restaurants open), which is about the South African equivalent of a Chile’s…only more meat and less variety. When I was in South Africa, we ate there a lot and each franchise has a different US State or landmark…hence, I think I’ve been to the Utah Spur, the Indiana Spur, and now the Grand Canyon! I sat near the kid’s play room and there were kids running everywhere who had all come out for Mother’s day. At one point I was watching the kid’s room monitors trying to keep kids from severely injuring one another on the trampoline, with a really terrible Musak version of "The Rose" playing in the background and the group of servers started in on an African drum accompanied version of their happy birthday song and I couldn’t help but wonder, "am I really in Africa, and how exactly did this become part of my job?" It really was funny…and an odd juxtaposition to the rest of what I am doing here.

Our meetings went well today. For the first two days, we will be debating policy issued related to the implementation of IMAI, e.g. what type of policy changes need to be made to allow nurses to prescribe HIV drugs and what qualifications/training must those nurses have. There are a lot of divided opinions from stake holders and many of the workgroups worked well after we were officially done for the day. The logistics of rolling out such a huge and complex program is a bit overwhelming, but when we look at the current state of the health care system, there is no question that it is needed. Tomorrow the workgroups will present their recommendations and we will try to come to consensus as a group so we can move forward. It should be an interesting debate. The last three days will be dedicated to making adaptations to the generic curriculum modules to localise them to the Namibian context. Then my real work begins...yikes!

We had a brai (BBQ) for dinner tonight…did I mention that eating meat in Namibia is an artform? The lodge set up the tables outside, which at lunch was very nice, but tonight it was a bit cold and I couldn’t help but laugh at many of the group members who had wrapped themselves in blankets to sit outside and eat their dinner. We have a fun group here and when it comes to work, they are serious and passionate about improving the conditions here, but they also know how to relax and enjoy themselves and laugh a lot. And maybe that is what I appreciate most about Africa…that no matter how serious or how bad things are there is always room for laughter and joy. Ah Africa …

Keep well,


Sunday, May 14, 2006

Map of Namibia

First Leg - Windhoek/Second Leg - Okahandja

Acronym Soup


Dear all,

I hope this finds you all doing well and having an excellent Friday!Today was a good day in Namibia! Today has been one of those days that I am reminded of how much I enjoy my job and how blessed I am to be in a position that allows me to meet good people from all over the world dedicated to changing people’s lives. How lucky can I be?!?

Quite a few of you have asked me what it is I am doing in Namibia…and aside from living on Luna bars and Satsumas and watching a lot of soccer in the evenings, I’ve been assigned to come to Namibia to work on the adaptation of a WHO (World Health Organization) curriculum called IMAI—Integrated Management of Adult and Adolescent Illness. This curriculum is a generic tool developed by the WHO to assist resource poor settings in managing chronic and acute illnesses such as TB, Malaria, and HIV/AIDS (and its associated problems). It is written at a very simple level and gives very basic guidelines to be able recognize and treat the majority of illnesses that plague resource poor settings.

Many countries, like Namibia, have shortages of trained health care workers, especially doctors and nurse practitioners are essentially unknown. Consequently, there is a need to be able to transfer some of the tasks normally performed by a doctor to other healthcare workers such as nurses, pharmacists, etc… Many places have clinics in smaller, rural areas, that have no full time doctor. Nurses are running the clinics with huge patient loads, but don’t have adequate training or authority to treat many of the people and cases that come in the door. Others may have a doctor, but one that is not trained to manage more chronic illness such as HIV. Namibia is working to adapt the IMAI curriculum to their local context to train and empower nurses especially, to be able to assist with the patient burden the country is experiencing. This not only will help with patient care, but will allow individuals to be treated without having the burden of travelling long distances at a great expense.

Of course there are numerous barriers to this being able to more forward including policy issues, training and capacity deficits, etc…and this is what the meeting I will be attending next week will be dealing with. My job will then be to take all the information we gather and work we do to start the adaptation and then create the Namibian IMAI training. I’m really excited about the project and looking forward to next week.

Today the WHO delegation arrived so we were able to meet. Liz Stevens, the I-TECH Namibia country director, and I met with CDC Namibia, WHO Namibia, and WHO IMAI delegates to discuss next week’s meetings, go over the agenda, and determine if anything else needs to be done in the planning. Several workgroups have already been meeting to discuss some of the policy issues. While we were meeting, we all took a quick field trip to meet with the permanent Secretary of the Ministry of Health and Social Services to have an audience with him and meet him. He gave his blessing to the project (which has been a problem in the past) and everyone left very happy and confident that this project will now really start to move forward.I’ve been trying to get back my “African ears” to be able to understand everyone’s accent and the quiet way many people talk. I’ve even picked back up my continual “hmmm’s” of assent as people are talking…kind of the southern African equivalent of nodding your head or saying uh-huh. I’ve also realized that I’m starting to speak much slower and clearly so people can understand my accent…so all in all things are good and I’m enjoying myself.

Tomorrow I have some free time to explore the city and do some souvenir shopping. I’ve been told there is a history tour of one of the townships which I’m currently on a quest to find information about…me and the ladies at the hotel desk have diligently been trying to figure out how to find out more information. They’ve been very helpful so hopefully tomorrow will turn out to be a good day. The Windhoek film festival also starts today so I may try and see some of the films it has to offer tomorrow as well.

Thanks to everyone who’ve been emailing, sending good thought my way, etc….I appreciate it. Keep me posted on how things are going on the other side of the world.

Keep well,


Photos from Windhoek

Gazebo at the Office

View from the office

Harold & Rosemary

View from the Hotel

Farming Elephants


Greetings from Namibia!

I've managed to survive my first day in the local office--jetlag andall--and must admit that I'm really enjoying being here. The I-TECHoffice is located in a nice house in one of Windhoek's residentialareas, which is a lot like where I worked in Zambia, so I'm feeling abit nostalgic. My temporary office is in the equivalent of the diningroom and looks out onto the backyard/patio which has a nice thatchedgazebo sitting area and a pool. Everyone told me before I came that ithas been very cold here and I should come prepared...but it feels anawful lot like Seattle right now, only dryer, so its actually reallypleasant. Perhaps it wasn't necessary to bring my wool coatafterall...but just in case, I have it and won't be cold :)

Today has been very low-key since the group from WHO that I was supposedto meet with today will not actually be arriving until tomorrow to meeton Friday. So, instead I've spent my day meeting the office staff andsitting in on another technical workgroup meeting of physicians who arelooking at one of our curricula on HIV/AIDS medications. We met outunder the backyard gazebo and went through some of the trainingmaterials and I found myself fascinated by the characters in the groupand the amount of knowledge and passion they have for fighting thisdisease. All have been involved on some level in developing andmodifying treatment guidelines for the country and are considered theleading local authorities.

At one point in the discussion, Dr. Ishmael F (whose last name Icouldn't quite understand) was asked about his elephants...this ofcourse immediately caught my attention, as this is typically not a pointof conversation in most of my meetings...and it turns out the Dr.Ishmael has a cattle farm which a group of abnormally large elephantshave taken a fancy to...and since Namibia has had a lot of rain thisyear, the normal feeding grounds for this particular group of elephants,had been flooded out, so they discovered the lush feeding grounds of theDr's farm and decided to push down the fence and help themselves, muchto the dismay of the cattle and the doctor. He has repaired the fencemultiple times and tried several things to keep the elephants fromcoming back with no luck...he thinks he might be stuck with them for theseason...So, the moral of the story is, if you're going to own a cattlefarm in Namibia, be prepared to share your fields with gangs of hungyelephants.

I've also been reminded today of some of my favorite things and phrasesfrom southern Africa--first, the fabulous soft drinks Grapetizer andAppletizer...delicious! Basically like sparkling apple cider and grapejuice, but so much better...Everyday/meeting also includes a morning andafternoon tea break, complete with snacks--I should have remembered tobring my hot cocoa...always a treat! One of my favorite phrases alsocame up today--"Are we together?"--basically asking if we're all inagreement--but I just like the phrase.

Anyhow, I'm doing my best to combat the desire to go to sleep at 3:30 inthe afternoon and wake up at 2:00 in the morning, but the jetlag willwear off soon, I'm sure...just in time for me to come home mostlikely...but all is well adn I'm sure that things will become a bit moreintense as we head into next week's meetings, but for now I'm enjoyingmyself.



Safe and Sound


Hope this finds you all well.

Just wanted to let you all know that I have arrived safe and well in Namibia after many, many, many hours on a plane and minimal sleep. But, aside from the trouble of getting here, I can definitely say it is good to be back in Africa! I’ve missed it here and as the sun is going down, I’m reminded of how beautiful the sunset can be!

My flights were actually pretty good, and considering the distance that I travelled, didn’t take terribly long. From Atlanta to Johannesburg, I sat next to a very chipper man named Wally who is a 69 year old minister for the Church of the Nazarene and one of the heads of the Association of Evangelical Ministers in South Africa. During our 18 hours of being seat neighbours, Wally told me all about the things and people I should look for while here in Namibia and also all sorts of interesting things about his ministry, his family, and life in general in Southern Africa. I helped him to work the in-seat entertainment options and smiled when he would whistle hymns without thinking about it…all in all a pleasant journey.

Harold, the driver, picked me up at the airport, which is about 40 km outside of Windhoek. We are situated in the middle of a desert and there is next to nothing but scrub bush between the airport and the city…that and a couple of baboons on the side of the road (did I mention that I have missed Africa?). My hotel is in downtown Windhoek and is actually located in the middle of a shopping mall…so if I get bored, I can go wander around the shops a bit. I’ll start work in the morning, meeting with people in the office here and at some point the WHO delegation is supposed to arrive. In the meantime, I’m hanging out in my hotel, trying to stay awake until normal sleeping hours, and flipping between the soccer channel in English and the cycling channel in Italian…life is good :)!Hope you are all well! I’ll keep you posted as things continue.

Keep well,