Farewell to Swaziland

Swaziland has a fairly transient expat community …. There seems to be a leaving event of some sort about every other week, so instead of doing the normal braai at someone house, Allie (who is also leaving) and I decided we would move the braai to a remote corner of Swaziland.

We had a fantastic weekend, starting off with helping with Teen Club Christmas party (a youth group for HIV Positive teens).  I volunteered for face painting and became quite adept at drawing snowmen and Christmas trees … but struggles a bit more when there was a craze for South African flags … I’m sure it is one of the most complicated … why does any flag need five colours!

We then headed out into the country side to say at a place called the Rock Lodge, the clue is in the name and it is a fairly basic place built around a rock formation and perched on the edge of a cliff.  An amazing location, once you find it, which we were a bit uncertain about when we were given a hand drawn map to help us get there, with useful instructions such as, take the second track on the left after the concrete posts and then follow the road until you reach the last homestead…. What could possibly go wrong?!  Amazingly we made it without getting too lost.  And had a fun braai in the evening and a walk down to the river in the morning.  I hope the photos give a bit of a flavor of what it was like.

A room with a view!

Weather

I have been very quiet on the blog front, so I thought I would add a couple of things before I leave.  The first one being a subject close to most peoples heart’s in the UK… the Weather!

You may think that I have been enjoying non-stop sunshine since I am in Africa…. If only that was the case.  For my first couple of months it was cold, or more precisely sunny and warm during the day and then dropping in temperature significantly in the evenings.  Which you would think would be manageable, apart from the fact none of the house are built to withstand the cold so during a nice warm sunny day the office or your house would be a good few degrees colder.  I lived in the one coat I brought with me!

It has now warmed up, but summer also brings the rainy season so one day you can have glorious sunshine … 

  …. And then the next day it can look like this when Mbabane is basically in the clouds!

Or you can have absolutely crazy lightening storms,  often with torrential rain, golf ball sized hail stones and hugely windy.  It can be quite surreal, if it looks like a major storm is brewing then things start closing early so people can get home before the storm breaks.  This is not as odd as if first seemed as Swaziland has the highest per capita rate of lightning strikes in the world.  So you really don’t want to be caught in the wrong place during a storm! 

It's the little differences....

Sometimes Swaziland can seem so normal in some aspects and the people you work and interact with so like everyone at home that you forget they come from such a different background.  This has been brought home to me a number of times.  For example, during a meeting I was talking to Dumile who is the National Laboratory Supervisor and Deputy to the Chief of Laboratory services, she is great to work with, very intelligent and capable which lulls you into the assumption that  she’s had a similar background of school and then university to yourself.  Which she has, but with a difference.  We were talking about her home area, and she was explaining where it was and then commented one of the things she always appreciated when she visits now is that she can go by car.  She has not so fond memories of when she was young of having to walk the 10km from the nearest food shops etc with 10kg of mealie (maize) on her head, and usually carrying 5 kg of fruit as well….  

The other occasion recently talking Phumzile who has many jobs, one as a member  Pele Pele (a local drumming and dancing group), then as a driver for a clothes manufacturing company and then a little sideline teaching a few expats drumming once a week…  When they come around they love using one of our computers to access facebook and it so you just assume that they know and have some understanding on how to use things other than the internet.  But when we were talking, and he was explaining he could access facebook on his phone, and then proudly told us he could also access it on a computer at work, as he had access to learn how to use the computer as to develop other skills as well as driving.  Which just took some of the assumptions I hadn’t even realized I’d made right out from under me…    I had just assumed that being able to use some aspects of technology implied being able to use it in the other areas.  I really should really know better, as I find myself having to explain what I would consider really basis excel concepts (how to add things together, and put filters on) to people who for Swaziland are quite expert on the computer ….

Teen Club

This weekend I volunteered at Teen Club, which is organized via Baylor International Pediatric AIDS Initiative.  The club is set up for HIV positive youth, ranging from about 8 to 18.  Although, in Swaziland they all look much younger as they are so small due to the high level of malnutrition. It was amazing to be involved, they meet monthly and run a series of workshops on different themes, which vary from helping the teens understand what HIV is, why their medicine is important, things around disclosure of their status (there is still a lot of stigma in Swaziland about being HIV+ even though one in four people are).  This weekend it was about dealing with stress, there were three different workshops which they participate in each lead by a Swazi teen leader who themselves participated in teen club.  In one workshop they discussed what kinds of things may help them deal with stress or increase stress levels and thought about what they could do to increase the things that decreased stress.  In another workshop they tried out different methods to reduce stress such as breathing techniques and meditation techniques.    Then they end each club meeting with a singing along to a song by R Kelly called ‘I am the world’s greatest’ complete with actions to go along with it, it is very sweet.  I will definitely going to try and help out at some more of the meetings…. And hopefully get some photos!

Umhlanga / Reed Dance

I am a little behind myself, but a couple of weeks ago, was the Umhlanga Festival (or the Reed Dance), this is a festival for all the kingdom’s maidens (women who are less than 21 and haven’t had any children).  It goes on for about 4 days, starting on a Thursday, with all the maidens who want to participate being transported to the festival location near the royal enclave in the back of open trucks, which is a bit of an odd sight in the first place.  On the Friday the maidens are told where they are to collect reeds, they aim to collect the longest reeds they can.  The Saturday is a day of preparation and then on Sunday all the maidens present their reeds to the Queen Mother.  This is accompanied by a lot of singing and dancing. The reeds will then be used to repair the royal enclave.  The culmination of the festival is on the Monday when all the maidens dance for the king.

It is quite an impressive sight, all the maidens sing and dance in groups with other girls in their community.  They move around the stadium field singing and dancing.   They are all singing different songs at the same time, so it is quite a cacophony of different sounds and sights.  They all were different forms of colourful traditional wear.  Later in the afternoon the King arrives with his warriors also in traditional dress and after they have watched the dancing for some time they go down into the field to dance and inspect all the maidens and if the king wants he can pick a new wife…. to add to the 13 he currently has!

 The King and his warriors inspecting the maidens

Wildlife

A lovely Sunday afternoon….

I went to my first game park in Swaziland, and it was fantastically low key, on Sunday afternoon we just decided to go to Milwane (it is only about half an hour drive from Mbabane).  We left our cars at the only camp in the park and stumbled across 2 different types of antelope grazing in the camp, monkeys running through and 2 hippos by the side of the lake only about 5 meters from where we standing!  We then for a walk through the park, apparently because there are no big cats it’s safe (although I thought the crocodile we saw could have done some damage if it wanted to).  Anyway we survived and saw some great scenery and antelope, wildebeest, warthogs and the most enormous crocodile I have ever seen.

I’ve uploaded my first set of wildlife photos to bore you with.

Procurement - Swazi Government Style

In classic Swazi style Alison, our Country Director, received an invitation to participate in the Laboratory tender assessment session on a Friday for a meeting scheduled from Tuesday to Friday the next week.  As the current link person to the laboratories this opportunity was quickly delegated to me.  From my questions about the agenda and the process, it was clear that it was going to be a very different procurement process to anyone I have ever run or participated in…. It has been an fairly frustrating four days, and we haven’t finished, I’ve been advised we are needed back Monday and Tuesday next week as well.

All the tenders had been submitted as very weighty tomes (with an original document and 4 copies) and the meeting was run with strict formality, even though everyone in the room knows each other well and works together frequently, there was a chair and the procurement team of two where the ‘secretariat’ to document decisions and confirm the data the decisions were based on.  I would have expected the procurement team to have reviewed, assessed all the tenders and then provided a summary of it to the assessment team to review and check some original documentation to confirm.  In fact the opposite was the case, the assessment team was expected to review all of the tenders to confirm the information and criteria were met…. Which sounds kind of fine, until you have to check supplier by supplier (all 21 of them) that the 92 pages of pricing proposals have been correctly transcribed into excel and if they have quoted for the correct pack size.  Then to review it all again to confirm they have authorization from all the manufactures they quote for to sell their material.  I had suggested if we were going to eliminate the ones without manufacturing authorization we may want to do it the other way around, but it wasn’t supported.  Painful is the only word for it, especially as 3 of us out of the 9 people in the room generated 75% of the output and the rest spent a lot of time talking about how hard work it was!

I have been commenting and capturing improvement suggestions as I go through, I just hope some of them will be taken on board,  I think they are coming around to my number one suggestion of a pre-screening so they have a more reasonable number of suppliers to assess at this level of detail.   Also, it seems as though the laboratory people are valuing the learning experience of going through the information in detail.  And I hope they remember next year the importance of clearly defining assessment criteria up front and being very clear regarding the documentation you want suppliers to provide to enable you to do the assessment.   Hopefully it will be downhill from here!

PS … I have been a bit late posting this, and it has not been downhill, it’s going to take longer than the additional 2 days they planned for at the end of last week…

This is Africa!

Today I had particular exposure to – this is Africa…. I went to pick up my work permit.  I thought the hard part had been done with the application, and I had confirmed before I went that it had been approved.   How wrong I was!

First, I was directed to Room 117, where amazingly there was no queue, they confirmed the work permit was ready and then sent me to Room 101.  Room 101 was piled high with stacks and stacks of yellow folders on the floor on the desks.  It was so full that at first I couldn’t work out if anyone was actually in the room, following a tentative hello from myself someone popped up from amongst the stacks.  Apparently I had to give him my receipt and my passport and then go and wait in the queue for Room 103 to pay my fees, he would find me in that queue to return my receipt.  So back down the narrow, dark and busy corridor to the queue for Room 103, I was feeling a bit heartened, so far it hadn’t taken too long and the queue for Room 103 had been much longer when I’d come to apply for the work permit. 

Eventually I got to the front of that queue, paid for my permit and was directed to Room 119….. Excellent, I thought, when I saw there no queue. Except it turned out that the door was locked which meant that no one was in, still I was hopeful they had just gone out and would be back shortly, I had seen lots of people heading in and out of their offices locking the doors behind them.  So I waited, watching a lady walk up the corridor carrying my file including my passport, try the door and then walk off again, saying that I should wait … This carried on for a long time, in fact, until it was lunch time.  I had to do something, so I headed down to the far end of the corridor to the man in the room of files and explained my problem, he took me to Room 107, to see the lady who had been walking up and down the corridor.  It turns out that the one person who can sign work permits was in a meeting (and then probably going for lunch).  Did I have any options I asked, well I could wait, or I could leave everything and come back after 2pm, at which point hopefully the person who could sign the permit would be back.  Having already been waiting in the dark narrow corridor for an hour and a quarter I didn’t really fancy waiting out lunch time as well.  So I headed back to the office really hoping that my passport would stay safe and get back to me.  About an hour and a half later I headed back to Room 119… oh dear a queue, luckily my man from the filing room was just coming out and let me know that I didn’t need to queue here as the permit had already been signed, so I could just go to Room 107 to pick it up.  Yipee!  So after visiting 5 rooms, a lot of queuing in a dark corridor I now have my work permit! 

A new office

Due to the new project we launched recently, and the activities to support it, the CHAI team in Swaziland has been expanding.  Our old office had enough desks for 7 people and there were 10 of us working there.  It was generally okay as we had a conference room which we could use as a place to work, it did become a bit more interesting when we actually wanted to use the conference room for a meeting, that usually involved some convoluted musical chairs to sort things out. 

This week we have 4 new people starting, so something had to change.  Alison our Country Director has been working on new offices for some time, and when I arrived the leaseholder was threatening to offer the office to someone else if we didn’t move in by the 15^th July.  It is a new building and the offices hadn’t been fitted out when I arrived, so we really didn’t think it would be finished by the 15^th … we did hope that they would finish by the 1^st August though…… They haven’t, which means we moved into new offices that doesn’t have internet, enough desks and has builders apparently randomly drilling things, taking doors off the hinges etc.  The aim of moving in was to try and force them to finish things quicker than they may have done if we weren’t actually in the offices.  I’m not sure how successful that has been, luckily I have had a lot of meetings at other offices.  This offices will be a huge improvement once they get sorted, but this week is a bit of a transition week.  We are definitely going up in the world as we are all to get our own phone and extension number, rather than sharing 2 lines between the whole office (one of them being the fax line).

Trying to work with 4 builders and two drills in the area!  

Sibebe Survivor

This weekend saw the annual charity walk organized by the Rotary Club of Mbabane Mbuluzi, this involved 3,300 people walking, running and singing their way up to the top of one of the world’s largest granite monoliths.  It is kind of an interesting event in Swaziland as there isn’t really the culture of raising money for charity and generally when Swazi’s gets to the position where they don’t have to walk as a means of transport then they don’t do it for recreation.  This meant for most of our Swazi colleagues who came on the walk, the fairly gentle 6km hike was quite a challenge!

I live just off the only road to the starting point of the walk, on a normal morning I’d see two or three cars go by, on the morning of Sibebe Survivor there was a constant stream of fully loaded cars, buses and kombies (minibus taxis) heading down towards the start.  Mbabne is normally fairly quiet and we don’t really know what a traffic jam is, on the day of the walk there was a queue of traffic for about a kilometer before the start line and the parking area, it was great to see so many people out and participating in the event.   

If you want to know some more about the event and what the money is used for this takes you to the Rotary Club webpage.

http://www.sibebe.co.sz/index-2.html

A colleague of mine, Laura, designed and made our team t-shirts at her screen printing class, below are photos of the team at the start of the walk and at the top of Sibebe.

Eric or ‘just the intern’ as he has been known to describe himself took on the job of carrying our snacks up the hill.  Joe, who was organizing our team had very thoughtfully brought the snacks, but hadn’t thought through the container, he managed to pack them in a tub that wouldn’t fit into any of the rucksacks we had with us.  Well done Eric for carrying the tub all the way up and down the hill!

Laura then hosted a Sibebe Funday at her house to reward the ‘survivors’ with a braai and fun and games including a bouncy castle, a three legged race, egg and spoon race…..  Below is a very out of focus photo of one of the egg and spoon race heats.  I think I was laughing so much I couldn't hold the camera steady, the course involved running down the garden, through the bouncy castle and then back to the top of the garden again, you really got to see peoples competitive sides coming out!

Back to reality

After the crazy week that was the launch week, this week has returned to more of normality and no trips to the community.  At the moment is a relief but I’m sure I’ll miss shortly, as I don’t think I’ll have much reason for more trips as my role is primarily working with Clinical Lab Services unit of the Ministry of Health, which is based in Mbabane. 

This week has been focused on meeting with the key people in the lab unit to help me understand how they work and digging a bit more into the areas we have identified for support.  The one point that is becoming a common theme is the expectation that our support comes with funding attached.  Currently the whole of Swaziland is suffering from increasing disruption due to lack of funds from the government, therefore even though they need support in many areas their current burning platform is money to purchase reagents.  I have to keep on guiding the conversation back to areas I can help with, rather than things that are somewhat out of my hands….

Rest and Recuperation

After the crazy launch week, we were really fortunate that the Friday was a bank holiday to celebrate King Sobhuza II’s birthday.  He was the previous king who ruled from 1921 until he died in 1982, and negotiated Swaziland’s independence from Britain in 1968.  I hadn’t really realized that it was coming up, but luckily for me some others were more organized and arranged a trip to Blyde River Canyon in South Africa (apparently one of the largest in the world).  It was great to see some on the area near Swaziland, do some walking and have a very relaxing weekend.

Below are some views from our walk.

The Launch

It had been a very late night and a very early start for us all, the aim was to get everyone on the road at 7am so we could be at the site by 9am.  It did not start alarm’s not waking people up.  Then when we started to pack up the cars, the at our office wouldn’t let us out the doors with all the boxes and bags without a signed letter, despite the fact that they see us every day….  So everything was stopped while I got my computer out, wrote a letter, checked it would be okay and then dashed back to the office to print it!  While that was going on we also found that the minibus driver only had a permit to drive via Pigs Peak which is a takes significantly longer and a far more winding road than the other route, which would mean that most people were going to be even later ….

Anyway we eventually got on the road and could have a couple of hours to relax and then plan what we needed to do when we got to the site.  It was promising to see people when we arrived, as there was always the worry that no one was going to turn up!  We then had a frantic hour of moving some tents around and setting up tables for the information tent and for distributing the scratch cards and trying to encourage people to write on a Dream Wall which was aiming to capture and create a collage of what peoples hopes and dreams were for Swaziland in relation to the HIV epidemic.  There was an entertaining half an hour with the team trying to attach large pieces of cloth between two very old basketball poles and then pin all the smaller pieces of cloth to them.  Then even more of an initiative test to work out how we could keep the poles upright without the wind catching the cloth and blowing them over, there was a danger that it was going to become a dream carpet rather than a wall….  Luckily someone thought of tying the poles to the stage and we were sorted minutes before all the guests of honour such as the Minister of Health, one of the Royal Princes arrived, the President of CHAI etc! 

Waiting for the Guests of Honour to arrive

The event was very successful with a mix of speeches, entertainment and a quiz the scratch card raffle.  It seems that everyone in Swaziland is mad for free branded goods we had a few bandanas and t-shirts which as a helper I had to wear and the number of requests I had for me to give them to people at the end of the event was unreal.  However this mania for goods did mean that there was great participation when the Minister of Health did a quiz with questions on HIV with the potential of a free t-shirt if you go the question right!  

The popular gospel band Emagawugawu got everyone up dancing, including the Prince (the one in the red traditional dress) and his police protection officers!

The event has generated a lot of energy and the challenge is for the team at CHAI to capitalize on that and move forward the key projects. 

Preparation for the Launch of Max ART (Anti-Retrovial Treatment); For better health and zero new HIV infections

19^th July 2011

This week has been an interesting week, I have been taken off my main project to help with preparation for the community launch for this project.  It seems as though it has been quite a challenging event to coordinate as it involves so many different groups.  As it is a Swaziland initiative it needs to be seen to be lead by the Ministry of Health, but the key partners who were granted the funding are CHAI and a Dutch group called STOP AIDS NOW! who do not have anyone based in Swaziland.  This has lead to some interesting debates where things that the MOH and CHAI were really excited about and supportive of, may not be seen the same way in Europe by SAN!, which can make it very challenging to get even the smallest thing agreed to!

Also as it is a community launch so the aim was for the community to lead the organization of the event, however when we went in to go through the last details it was clear that not everything is quite as sorted as we hoped.  CHAI has agreed to fund the food for the event, it turns out that to cater for the anticipated 2000 people we need to purchase two cows.  It seems that as we are paying for these then the activity cannot be delegated to the Indvuna (the chief administrator for the region) so today (the day before the Launch) started with us getting up very early to view, negotiate for and purchase cows, negotiate the price for transporting the cows to the butcher and then negotiate the price for the butchery of the cows.  It now transpires that we have to get a representative to the butchers at 5am tomorrow morning to watch the butchery of the cow to make sure there are no disputes later about if we received all our meet!  You can see the photos of one of the cows we bought!!

Trying to Get away ….

Things are definitely happening in african time, we arrived at the location of the launch at noon hoping to check that the toilets had been dug in the right place (they were going to be done ‘first thing’)…. It hadn’t started yet and the tents were due to arrive at noon …. It’s 3pm and counting!!

Waiting for Tents

Well the tents eventually arrived at 4 15pm, then it was a race against the light to try and make sure they were up, in the right place before it got dark.  We stayed to make sure that the tents were at least up in the right place and then left to head back to Mbabne, to find out what last minute things needed to be done back in the office before the launch event.

There was lots of last minute preparation … such as stapling raffle tickets to the back of 2000 scratch cards which we had designed with questions relating to facts and myths about HIV!

Stapling Scratch Cards late into the evening ....

Initial Impressions of Swaziland

Swaziland is a small landlocked country in Southern Africa, it has a population of approximately one million and it is estimated that HIV prevalence in 15-49 year olds is at 26% and 41% of pregnant women have the virus.  The high HIV infection rate has devastated the country it estimated that orphans and vulnerable children account for 15 percent of the total population and the life expectancy in the country has dropped from 56 years in 1997 to just 49 years in 2008, one of the lowest in the world.   I am working with CHAI (Clinton Health Access Initiative), they do significant work with the Swazi government and Ministry of Health to improve access to HIV testing, treatment and care.  They have recently received a new grant from the Dutch Post Code Lottery to dramatically increase efforts to improve access to care across the country, with the ambitious target of ensuring 90% of those eligible for treatment are on treatment by 2014.   I will be working to strengthen the laboratory supply chain systems, they are a crucial function to support all the testing that is required for treatment of people who are HIV positive.

Swaziland seems different to some other African countries I have been to.  Over 80% of the population live in rural areas, and even the capital city (Mbabane) is not really a city more a small town.  The CHAI offices are 5 mins walk from the centre of town and on my first day at the office I one of my colleagues took me out for lunch to give me a bit of an orientation a walk around the ‘city centre’ which comprises of two malls across the street from each other took a maximum of 15 mins and I had been pointed out the major sites ie the best place to do most of my food shopping, where was good to eat lunch etc. 

The thing that really struck me was that there wasn’t the huge density of people that you often experience in Africa, India and other areas and that there was virtually no ‘hassle factor’, just about the level of begging you may see if you walk around central London.  Which if you consider that approximately sixty percent of the population live in poverty, it is slightly unexpected, but probably due to the fact that most of the people with really low incomes live in rural areas and not in Mbabane.

My first week in the office has been really focused on increasing my understanding of the HIV landscape globally and in Swaziland, and also getting an appreciation of the other organizations working in the same area.  Also there is another language related to HIV and specific Swaziland terminology and abbreviations.  If you though GSK has a lot of acronyms then you’ll understand what I’m experiencing now!  My current favorite is  SWANAPPA (The Swaziland National Network of People Living with HIV/AIDS).  I’m sure it will all become clear before I know it, but at the moment I am asking a lot of questions!  Another challenging factor due to the number of NGOs you very rarely just interface with the MoH because there is often another NGO working in a similar areas so there needs coordination to ensure all parties are on board and we’re not duplicating.

The team at CHAI have been really welcoming and great in including me in weekend and evening activities and making sure I’m not too isolated during my move.  So far they have introduced me to the weekly activity of ultimate frisbee and African drumming, which were both new experiences which I really enjoyed!  If I have the time they are going to feature in my weekly activities….

Here are are a few photos from my first weekend in Swaziland.  It is winter here at the moment, so everything is very brown and dry.  Mbabane is in the highveld so although it the weather is quite nice during the day if it is sunny, it is cold at night ... a lot colder than I imagined Africa would be!

Getting Ready for School on Monday