Re-Entry

I only have two months left in Panama, and people have been asking how I feel about coming back home. Of course, there are the obvious good-for-a-dinner-party answers, involving funny culture clashes or developmens in the States that I´ve missed. For example, I have no idea how to use a modern cell phone anymore. When I left, the iPhone had only just come out, and I´d only seen one or two. The iPad didn´t exist yet, and my ungainly old Dell laptop didn´t look as ridiculous as it does now sitting next to the ubiquitous dwarfish netbook. If you think I´m overstating the rate of change, I will tell you that when I visited home in December, I walked up to a paper picture of an iPad in Target and, thinking it was real, tried to scroll my fingers across it.

Sad but true.

And then of course there´s all the news I´ve missed. The BP Oil Spill. The emergence of the Tea Party. Revolutions in the Middle East. The Federal debt crisis. Earthquakes in Haiti, Chile and Japan. Osama´s capture. The Royal Wedding. All of these I´ve-just-come-from-the-jungle-and-I-feel-lost stories are good for a laugh, but I know I can eventually catch up when it comes to scary technology, big headlines and celebrity gossip.

The real reason PCVS worry about their close of service isn´t so much about going back home, but about leaving the country in which we´ve lived and worked for two years. I´ve had a life-changing experience and learned more about myself and this tiny part of the world than I ever imagined I would. And now I am struggling with how to reconcile the old U.S. Catherine with the new Panamanian Cati. My fear is that when I go back home, I will have let go of so much of what I´ve learned and the life I´ve had, in some ways slowly and unconsciously and in others, more abruptly. I know I´ll be homesick for Panama and the way I lived here.

One of the things I like most about Panama is the friendliness and approachability of everyone who lives here. Strangers are always striking up conversation, hanging around and looking out for each other. When you get on a bus, you say ¨Buenos dias!¨to everyone, and most people say it back. If you feel like talking, you just go to your neighbor´s house and pass the time. Here, I feel like I can talk to anyone anywhere about anything. There is a real sense of community.

In the hours I might have previously wasted talking on a phone, surfing the net, or watching trash television, I have made amazing friendships with other PCVs, people who, because of the extreme circumstances we´ve shared, feel closer to me than some people I´ve known my whole life. I´ve loved and been loved by a group of people in my community who I didn´t even know existed two years ago. Panama and the pace of life here offers people this time to get to know each other, to enjoy the company of someone else, and in doing so, become more aligned with one of the essential things that makes life worth living: human connections.

Whereas, in the United States, to a large exent, people have stopped connecting in this baic way. Everyone is too busy with their smart phones to look up and say hi to the person sitting next to them. You could argue that Americans are more connected than ever, with the Internet and social networks that enhance the relationships we have in ¨real life.¨ But I don´t think so. Sharing links or liking someone´s status on Facebook doesn´t offer as much as sitting down and sharing coffee and conversation with that person. In my time here, I have come to feel more connected to myself and the people around me than ever before.

So there is the anxiety that certain aspects of U.S. culture and life now seem foreign or even undesirable to me. But more than that, I am faced with wrapping up one of he biggest, most important periods of my life. I´ve had the time here to figure out what makes me happy, what I´m good at, not so good at, and take on things that at first seemed impossible. I´ve become so much more patient, serene, and open-minded than I could ever have imagined. When I first got here, I lacked the self-assuredness to believe that I could so much of anythuing here. But somehow, I´m still not sure how, I figured things out little by little, and before I knew it, the journalism major who had never been on a plane before was managing a construction project in an indigenous village.

Peace Corps does this to people. It gives you opportunities and responsibilities that you may not deserve, and allows you to run with them. I look back and am amazed by all that´s happened in two years, what the people here have taught me, and how much perspective I´ve gained. An experience this challenging and foreign forces people to evaluate what is really important to them, what they are capable of, and how their life and purpose fits in with those of of the seven billion others. I am sad to let go of this time in my life, where something new happens every day, when I am so constantly challenged, and the rewards for success feel so great. The contrast of highs and lows, combined with the novelty of the things we get to do here, give us the sense of really living and experiencing life completely.

But as much as I have loved Panama, and the life lessons it has taught me, I also have a greater appreciation for the United States and the countless advantages I enjoy for just having been born there. I am excited to go back. I miss my family and friends. I´m burned out by certain aspects of being a PCV and am eager to start the next stage of my life. But I struggle with the idea that the patience, tranqulity and thoughtfulness that have defined my time here will start to fade away. I will miss the simplicity of life, the connectedness to community and nature and the sense that, even if I feel I´m failing, I am still making an effort at something worthwhile. I know parts of this experience will be with me forever, but the pace and competitiveness of U.S. life will surely start to chip away at some of the perspective, patience, and understanding I´ve been forced to adopt here.

It´s difficult to sum up what this experience has meant. It may be something I won´t fully realize until I´ve been back in the U.S. for a while, and even then, something that is so subjective and personal it´ll be hard to articulate. In the mean time, as I tie up the loose strings and prepare to leave, I am being extra-conscious to remember and savor everything I´ve gotten used to-- from the ocean views and rainforest downpours to the kids´ brilliant smiles and bottomless eyes.

I´ve experienced so much , and I can´t afford to forget any of it.

Notes from the Clinic, Part III

A couple of weeks ago, I had to stop by the hospital to get some medicine for an ear infection. (My body, still flummoxed by the environs in which it finds itself, insists on contracting diseases usually affecting small children under the age of five.)

I had the following interaction with a nurse, who weighed me, took my blood pressure, and proceeded to ask some routine check-in questions.

Nurse: How are you?
Cati: Good, thanks. And you?
Nurse: Alright, a little hungry, but that´s not your fault.
Cati: *blink*
Nurse:... do you have a fever?
Cati: I´m not sure, maybe a little.
Nurse: (touches Cati´s arm). AY! My God! You´re burning up!!
Cati: I am? I don´t think...
Nurse: (touches Cati´s arm again) Oh, wait, no, you´re normal.

Without touching a thermometer, she notes 37 degrees Celsius on my chart.

Here´s the thing: They always do this at that hospital. Just ask the patient if she has a fever without ever reaching for the device that would provide an accurate answer. Whyyyyy? Although maybe I should be impressed this time the nurse went so far as to use her finger tip to take a reading, because I mean, it´s the same as a thermometer, right?

I went on to be seen by the doctor, who examined the ear that was bothering me with the ear-flashlight-telescope thing. Then he asked me if the other one was infected. I said I didn´t think so, but wasn´t sure, and he sat down contendedly at his desk and started writing prescriptions. Why wouldn´t you look at the other ear? All he had to do was shuffle six inches to the right and take a peak. WHYYY?!

I always thought of medicine as a science, but am confused by the persistent lack of scientifiy inquiry involved in its practice here in Panama. Just saying, the medical professionals here are doing nothing to convince me that it is inappropriate for me to follow my dream of practicing Dr. Quinn-era frontier medicine in 2011.

Visitor's Pass.

One thing I will miss about Panama and my time here is the sense of community. People talk to their neighbors. They come over just to say hi and spend some time talking to you.

I, the resident gringa, of course receive a disproportionate amount of visitors on a daily basis, mostly children and my former host family, and I´m sometimes overwhelmed by the number of people who come parading by on a daily basis. To give you an idea of daily foot traffic in and out, I have made a list entrances and exits on a fairly typical day.

7 a.m. - My host brother goes to high school at night in Almirante and takes the first bus home in the morning. He usually arrives at my house early in the morning, sometimes just as I am rolling out of bed. I usually try to shoo him away, but as my house is used as a storage bin for all members of my host family, he usually sneaks in to drop something off and then continues to linger until I shoot him enough grumpy morning looks that he gets the hint.

7:15 a.m.- My host family stores their shoes at my house and the kids stop by to wash their feet and put on their uniforms. If I´ve already made breakfast, several moments are reserved for them staring at what I´m eating and telling me it looks gross.

7:30 a.m.- As I am washing up breakfast dishes, the youngest neighbor kids usually come by and ask to come in and play. I usually tell them it´s too early. Unless they offer to wash my dishes, in which case, I pull the stool up to the sink and let them have at it.

7:35 a.m.- Someone comes by with a project-related question. Where is the shovel? Do you have a bucket? How much wood do I need for the walls of my latrine? Will you come and observe every small task associated with my latrine so I don´t make a mistake?

8 a.m.- My former host mother comes in without knocking or announcing her arrival. As I am busy trying to get dressed and ready, she plops down in my chair and announces she is thirsty. If I pretend not to hear or understand, she begins breathing heavily and makes quite the show out of acting tired and dehydrated.

8:30 am.- 4 p.m.- I am out and about working in the community. People come by during this time and report to me later their shock and dismay upon finding the house empty.

4 p.m.- As the children see me coming home from work, they ask to come over. I am usually exhausted and filthy, and it takes my very last reserve bit of patience and benevolence to tell them to let me bathe first. They demand that I call them when I am ready to receive visitors.

4:15 p.m.- Despite said agreement, they yell and ask if it´s time to come over yet. Or they are waiting outside my fence as I emerge from the bathroom, and my dreams of alone time vanish into thin air. I run a comb through my hair and relent.

5:00 p.m.- I kick the children out just in time to have my former host-siblings in the junior-high school come and drop off their shoes, books and clothes.

5:20 p.m.- No sooner do they leave then some other visitors who just got out of class stop by. Often one of my Panama Verde kids or some other directionless youths looking for somewhere to sit and pass the time. My host brother, the one who attends high school otuside of town, usually comes by around this time again on his way to night classses.

6:00 p.m.- By this time my hopes of relaxing in the hammock with a cup of coffee have all but vanished, and I decide to start cooking dinner before it gets too dark. Just as the onions and garlic begin to sizzle, my host dad pops in to drop off his chain saw. He sits and seems like he wants to talk. Sometimes I indulge, other times I refuse to leave he kitchen and concentrate very closely on the onions.

6-8 p.m.- Things are finally quieting down, but at least one person usually stops by to chat, often asking what´s for dinner or if the coffee is ready yet. Sometimes the neighbors send someone over to ask for oil, sugar, or kerosene. Inevitably, the kids arrive and try to come in again, although the ¨no visitors after six o´clock¨ rule has long been enforced.

Please note that this happens in a day when I am out of the house working most of the time. Imagine what happens on the less busy days. I get frustrated with people using my house as a public park and storage room, and sometimes feel that whhole days go by in which I never escape the gaze of visistors and loiterers. But, I do love having neighbors, and being accessible to the community, and I try my best to remind myself that they come by because they like me and that I should soak up all the time I have left with them. But my first cup of morning coffee? I´m not sharing that.

A Ngobe Guide to Healthy Living

Many of the most memorable conversations I´ve had with people in my site are about health and home remedies. People here rely on botanical medicine and some of the local healers have extensive knowledge of the local plants that cure a wide range of ailments. What they know is impressive and to be respected. The only objection I raise to the use of natural medicines is in serious cases, when a person fails to get better, or needs urgent care, and the family inevitably waits too long to take the person to a doctor. Some of the medicine men´s remedies are guesses, and they have no ¨real¨ training beyond tradition. There are limits to what they do, although the people I live with will be just as quick to remind you that the same is true of doctors.

As a volunteer, it´s important for me to walk the line of acceptance and support for local knowledge, while also offering some ideas and tips from a more modern, clinical perspective.

During my time here, I´ve learned a lot about the basic beliefs and superstitions of the people in my area. Here are a few of the most common :

1. For parasites, diarrhea, stomach ache, etc., follow the following recipe:

Boil very stong coffee in only a few ounces of water. Add the juice of one lemon and dissolve an Alka Seltzer tablet. Drink it all and expect relief within a few hours.

Note: People swear by this. I doubt what value it could possibly have, but it certainly sounds like something that would flush out the pipes.

2. Skin infections. When I was having a lot of problems with infections of my legs and feet, people were always asking who I had been hanging around with. This question made little sense to me, until they explained that the sort of infections I was getting are usually contracted when the afflicted person spends time near a pregnant woman. They say that the ¨heat of her belly¨ causes the outbreak. Don´t worry though. There is a simple cure. Go to the woman´s house and ask her for a glass of water. Drink it all and the infection will go away. But it is important that you drink her water, or else it won´t work.

They are aware that this sounds a little fanciful, so they usually say, ¨I know it seems like a lie, Cati, but it´s true.¨

3. People believe very much in curses, and for people who are chronically ill and don´t get better, or who visit a doctor who cannot render a diagnosis, it is assumed that they have been cursed. The doctor can´t see the disease because it is only the manifestation someone´s ill wishes against them. For this reason, people often don´t take medicine given to them if they believe the root cause of the illness is really a maldicción. (Medical compliance is a whole other issue, which could be a post in itself.)

4. Relationships of hot and cold are extremely important and can explain away the onset of virtually any sickness. For example, one must never bathe right after working, because the cold water combined with a hot, sweaty body is a recipe for disaster. You should also only drink hot drinks when it´cold because that is the only time your body can truly handle them. I have offended more than a few visitors by offering hot coffee on a warm day.

I once baked using my neighbor´s stove, and she came in and told me not to bother washing the dirty dishes. She mentioned how I would get sick if I washed them, because I had been so close to the hot oven and taking pans in and out all afternoon. I thought this was her way of telling me she didn´t mind cleaning up my mess, but I washed the dishes anyway. I received a very angry scolding afterwards, and she checked up on me for days afterward to see if I was okay.

5. Worms (of the intestinal variety) are so normal that people believe they are necessary to digest food. When I talk about eliminating contaminants from drinking water, people have asked, ¨but how can we keep eating if we don´t have worms?¨ I didn´t quite realize how strongly people believe in worms being necessary for sustaining life, until a child asked me if I had worms, and when I said no, both he and his cousin asked in unison how I was still alive.

6. You must never eat pork if you have any kind of medical condition, real or imagined. Any kidney condition will be especially aggravated. (Many have already told me I will have to buy chicken for them when I have my goodbye party, because that pig I have been raising is no good to them.)

7. People usually don´t attribute diarrhea to bad water or unwashed hands. It is almost always caused by fresh fruit, vegetables, bread, or virtually any food that that they don´t eat every day. And you know, this may actually be true because some things are so unfamiliar to them, they may upset stomachs. Nonetheless, this belief is a serious inhibitor to good nutrition.

It´s always a challenge to determine if I should offer counter information and when to do it. Even though these things sound ridiculous to us, I am conscious of the fact that me explaining ideas like solar disinfection of water sounds just as preposterous to them. The invisible rays of the sun are killing the invisible microbes in the water? Sure, Cati. How can I convince them that their baby really shouldn´t pick things up off the floor and put them in her mouth when babies have always done that, and most of them grow up to be healthy, functional adults?

When I first came to my community, I was shocked at what I perceived as a blatant disregard for basic cleanliness. What I now realize is that people are very conscious of cleanliness and their family´s health, but their reasons for preventing or explaining illness are very different, and unfortuantely, in many cases, misdirected. They take great care sweeping out their houses, bathing their children, and generally making sure their homes look as neat and tidy as possible. They are doing what they think is best to be clean and healthy. Every mother loves her child and wants him to be well. She does everything with his best interests in mind. This is a universal human trait. If she fall short, it is almost always due to a lack of education or simply traditional beliefs that offer different explanations.

A friend recently explained it this way, and it makes total sense: Very few of us Americans have ever actually seen a germ. By this I mean, to have looked through a microscope and seen a cold virus, bacteria or anything else that causes disease. But we believe it because we have years of education and resources that tell us that it´s so, and we accept it as fact. We have had access to scientific information and education, and that is what informs our thinking and behavior. For people who haven´t had that access, there are other explanations and reasons for things that seem as plausible to them as a cold virus does to us.

Thinking of it that way, how can we look down on someone who has a lifetime of experience that indicates to them bathing right after work might cause the flu? It seems irrational to an American, but we sound equally so to them when we explain that there are harmful things in their water that looks perfectly clean to them.

Part of my job has been to touch on that common desire we all have to be healthy and offer some new ideas and strategies to be even healthier. And sure, I´ll drink that pregnant lady´s glass of water to clear up my foot infection, if she meets me halfway and puts bleach in it first.

Book Report

A blog chronicling Peace Corps life would be incomplete without some acknowledgment of how much we read. Even on my busiest days, I spend an average of three hours reading. And then of course, there are the rainy days, or the slow days, when the majority of waking hours are spent devouring a book while lounging in the hammock.

I feel spoiled to have so much time to invest in books. I was a reader in the United States, but I have read probably 70 books during my service which is certainly the greatest number I've gone through in a two-year period since I graduated from story books. (And somehow, that 70 is on the low end of many PCV counts...) This daily reading binge will soon come to an end, when I go back home and am distracted by the Internet, smart phones, electricity, and actual 9-5 occupations. So until then, I will relish my nightly routine of making a strong cup of Panamanian coffee, lighting my kerosene lamp, and settling into the hammock and reading until I'm too tired for another page. Here is a list of my top 10 favorites:

1. The Ghost Map, by Steven Johnson- This is about the cholera epidemic in 19th century England. It traces the outbreak to a single household and explains how it spread rapidly due to a lack of public health infrastructure and scientific knowledge. It chronicles the independent works of a priest and scientist who mapped the outbreak and founded a new framework for understanding diseases and how they are spread. It beautifully weaves together ideas of epidemiology, urban planning, public health and the future of cities and their environmental consequences. Completely fascinating.

2. The World According to Garp, by John Irving. I've read several of Irving's books here in Panama, including A Widow for One Year,The Hotel New Hampshire, Last Night on Twisted River, and A Prayer for Owen Meany. He has become one of my favorite writers. I'm addicted to his crafty writing and epic stories that follow the characters from childhood to adulthood. What makes his books so remarkable is how he combines incredible plot elements, ie dwarves, weird fetishes, and circuses, with richly-detailed characters who ring completely true. A great storyteller.

3. How the Brain Changes Itself, by Norman Doidge. A book about brain science which overturns any notions about our minds being "hard-wired" and unchanging. Doidge explains the idea of neuroplasticity through case studies involving stroke patients, or people who suffered injuries or birth defects and then went on to train their brains to function in unexpected and highly effective ways. A nerdy pick, but worth reading if you're interest in medicine or science.

4. Little Bee, by Chris Cleave. I had to put off all work-related activities until I finished this book. One of the most affecting novels I've ever read. The back of the copy I own contains only a sentence or two of plot summary because it claims not to want to ruin the story. I'll say this much: the book is narrated by a young girl from Nigeria and a woman in England. Their lives intersect and what results is an incredibly thoughtful book on what it means to have a conscience, memory, and culture and how these things affect the relationship between people in ways we can only try our best to understand. The plot twists and turns and you'll never know what's about to happen to the characters whose voices will stay with you a long time after you close the back cover. Read this.

5. The Grapes of Wrath, by John Steinbeck. Love Steinbeck. East of Eden might be my favorite book ever, and Grapes of Wrath lived up to all my expectations. Who could ever forget the Joads?

6. The Girl with the Dragon Tattoo triology, by Steig Larsson. Page-turning thrillers that will also making you completely uninterested in pursuing other tasks. The second two installments can't beat the tight, expertly-woven plot of the first book, but the Lisbeth Salander character has to be one of the most interesting in modern popular fiction and you'll want to follow her until the end.

7. The Spirit Catches You When You Fall Down, by Anne Fadiman. An extensively researched look at how Western medicine collides with cultural tradition of the Hmong people from Laos. A toddler named Lia lives with her family in a Hmong community in California and is diagnosed with a seizure disorder. Traditional Hmong culture views this as a misalignment or curse of the spirits. Her parents refer the illness as 'the spirit catches you and you fall down' and believe it is caused by a wandering of the soul. While Lia sees doctors at a local California hospital, her parents are confused by their clinical diagnoses and obvious disregard for the soul's role in Lia's healing. Their efforts to incorporate natural remedies into Lia's treatment results in accusations of non-compliance and eventually they are declared unfit and Lia is taken to a foster family. But this book takes no sides. Fadiman showcases the strengths and limits of Western medicine and Hmong culture equally, and makes it clear that neither one nor the other, but rather the clash of the two, is what ultimately failed Lia. It is a compassionate and dramatic story that will challenge the world view of any reader.

8. The Poisonwood Bible, by Barbara Kingsolver. A story of a fervent missionary who brings his family to the Belgian Congo in the 1959 just before the country's revolution. They are dangerously ill-prepared in every sense and in the course of events, Kingsolver shows what it takes to fracture families and countries. This book is certainly political, but I loved it for the story it told and the sometimes breathtaking beauty of the author's writing.

9. The Professor and the Madman, by Simon Winchester. This non-fiction pick is about the making of the Oxford English Dictionary and its most prolific contributor, who sent in over 10,000 entries while he was a patient at an asylum for the criminally insane. This story proves the maxim that truth is stranger than fiction. Winchester tells it with the skill of a novelist as he ties together a violent murder, the obsessive drive of the dictionary's editor and the boggling coexistence of genius and madness in one man's mind.

10. Me Talk Pretty One Day, by David Sedaris. This man is hilarious. His essays are the perfect cure for in-site blues. He can take any mundane event and transform it into sharp, witty commentary on family dynamics, culture, or the simple absurdity of everyday life. He writes about pretty much any topic, and if you listen to to NPR, you've probably heard him read one of his stories. Listen to him here as he explains the Easter Bunny.

Congratulations

...to my brother James on receiving his doctorate. Wish I could be there to celebrate with you, but I did the next best thing: told Nelson to dance. The sign says "Felicitaciones, James!" We send hugs from QP!! And rockin' dance moves.