Category Archives: Humanitarian work

The circle of your passion

It’s been a week. For me, it’s been a week of finishing the draft, enjoying a brief high, then falling (temporarily, let’s hope) into a big black woeful hole of not feeling like doing anything at all, and wondering how we can possibly have been in Laos three months already, and whether the rumours are true that we’re staying here for the next couple of years. On that front, it appears so, unless the powers that be mandate otherwise. I’ve had ample time to mull all of this over during a string of nights when sleep eludes me until late – midnight or 1am – and sometimes only arrives after the sort of help that comes in little bottles with child-proof caps on them.

For Mike, it’s been a week of waking up early – in the 3’s or the 4’s, occasionally the 2’s – with his mind jumping ahead to the day. The biggest meetings of the year took place yesterday, and coincided with a week-long delegation of all sorts of people that be all sorts of powerful, and not all of whom arrived on the scene happy. We think they be leaving happier, we think. There was a lot of smiling and nodding at the big partnership dinner last night – then again there was also lots of beerlao, which tends to help with the smiling (but not with the sleep, no, not with that).

A couple of weeks ago Mike and I had dinner with a friend, Gabrielle, who Mike first met in the Vanuatu almost three years ago. In January we had dinner with her in Melbourne. Since then she’s moved to Hanoi. Two weeks ago she swung by our new town.

So we met at Utopia and drank Saffron Robes and cheap Chilean wine and gazed upon the Khan River and talked. We talked of things that humanitarianers often seem to talk about when they cross paths for an evening and drink and look at rivers.

  1. How and why did you decide to make this last move/take this last job?
  2. How are you finding this massive uprooting and replanting of your life?
  3. What about the job itself – where are the rewards and the pressure points?
  4. Is it worth it – this move, this job, this whole field …

There is a lot wrapped up in that last question. I could write a whole series of posts just on the different variables that come into play when trying to calculate the opportunity-cost of this work and of this lifestyle. There are issues of meaning and purpose to be considered. And efficacy, community, motivation, finances, and safety. And, of course, passion.

Gabrielle calls this sort of conversation tumbleweeding, which I think is a delightful word. It brings to mind a tangled ball of wiry stalks all intertwined – dense enough to hang together in a round yet light enough to be moved by the wind. A tumbleweed bounces and spins at the same time as it skips along. A tumbleweed goes places. (Sometimes it just goes in circles, but that too is appropriate.)

I wonder what usually happens to tumbleweeds in the end. Do they pick up so many leaves and twigs on their journey that they eventually stop moving and settle into being just a pile of sticks? Do they get snagged on bushes, never to work themselves free? Or do they break apart – thin pieces of brush skittering and sliding in every which direction?

So, passion. That was our primary focal point that night.

“Are you passionate about writing?” Gabrielle asked me.

“Sometimes I get a great day, or hour,” I said. “Those moments are incandescent. I lose track of time. Afterwards I’m tingling with that happy sort of electricity that comes when you don’t want to be anywhere else, doing anything else. I’m totally buzzed.”

“But,” I continued. “At least as often, probably more often, I sit there and it’s hard, and I struggle, and I want to be almost anywhere else, and I hate it. Except I feel compelled to do it anyway.”

“That’s passion,” Mike said.

“Huh,” I said.

Why do I primarily associate vocational passion with the electric, positive, purposeful, buzz? Wishful thinking, maybe, or is it possible to have those joyous mountaintop moments without trudging through some valleys? Are mountaintop moments over-rated, anyway? Should we really be aiming for a nice picnic blanket halfway up a pretty green slope?

And, if what we were talking about really is passion, how can you live inside the circle of your passion without it consuming you?

That’s what we talked about for most of the evening, sipping our wine, staring at the river, tumbleweeding around. We didn’t come up with the right answer, because there isn’t one. But Mike and I wandered home through the dark streets feeling refreshed and ready to face the windstorms of tomorrow.

After the week we’ve just weathered, maybe that’s what we need this weekend – some tumbleweeding. Or maybe a river. Or friends. Or some wine? Looks like we have options.

What about you: Do you feel like you’re living inside the circle of your passion? How do you keep from being consumed?

P.S. I could practically see the parental eye rolling in Australia when I mentioned wine (again!!). So, my beloved mother, this picture’s for you. It’s Mike, weeks ago now, disposing of the last wine we had at home because it was simply wretched stuff. The bamboo, much to my surprise, has suffered no ill effects.

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Jesus wants you to build a toilet

Recently Alexis Grant mentioned on The Traveling Writer that someone had googled “best travel memoir’s by women” and landed on her blog. It made her day.

This piqued my curiosity. How were people (people other than my mother, that is) landing on my blog?

It took a while to figure out how to get this information, but a bit of my own googling eventually told me how to access the search terms on the blog stats page. So without further ado…

The number one search terms – lisa mckay and lisa mckay laos – made total sense to me.

The second most trafficked search terms – laos and laos writing – made less sense. I’m not quite sure how it’s possible to google an entire country and find my blog, but perhaps this is an unanticipated bonus to living in the least developed landlocked nation in Asia.

Then things started to get even weirder. The following search terms all showed up on the list:

  1. Lao snake
  2. giant snake Laos
  3. sneck in laos (no, I am not making these up)
  4. daaaaaate in asia.com
  5. pepsi from the fat of pig
  6. zozo spray India (pretty sure that one’s your fault, Jos)
  7. pebbles like girl scouts
  8. tropical waterfall
  9. honeymoon constipated
  10. poo laos existence
  11. males doing toilet on roads

If I were to take this as a guide to the sort of content my readers really want, I might conclude that my niche market is writing about toilets (or lack thereof) in Laos. That and snakes.

So for all you lovers of toilet stories, today I have a really good one for you. It was written by Mike a couple of years ago and published here by Reuters AlertNet. Enjoy.

Jesus wants you to build a toilet

by Mike Wolfe

“Jesus wants you to build a toilet for the women,” I told Pastor Barry in my best broken Tok Pisin. Normally I feel a bit annoyed when people make Jesus the poster child for their personal cause. I remember, for example, the billboard in Atlanta a few years ago that showed a picture of a cherubic Jesus and stated “Jesus was a vegetarian.” I laughed nearly every time I saw it.

But Pastor Barry wore a baseball cap that sported the phrase “Jesus is my boss”, so I figured I had his attention.

We were sitting on a bamboo bench on Petats Island in Papua New Guinea. A refreshing sea breeze rustled the coconut palms and mango trees. The bright red hibiscus flowers danced in the wind. It was a beautiful Pacific morning. A perfect day for conducting an evaluation of the water and sanitation project that World Vision is implementing in the region.

I had just inspected one of the new ventilated improved pit toilets built near the church. It’s a really well constructed toilet. And Pastor Barry keeps a lock on it. The women told me it’s only used on Sundays or special occasions. Apparently Pastor Barry doesn’t want people using it regularly. So most of the time people go in the bush or walk into the sea. But sometimes they get to use the nice new toilet.

I asked the women whether they liked it. They giggled, perhaps on account of my broken Tok Pisin, and perhaps because they were embarrassed that a white man with notebook, camera and funny GPS unit strung around his neck was asking them whether they like defecating in the lone toilet. After the initial embarrassment, the eyes of one of the women lit up. “Yes,” she told me. “We feel safe with the toilet.”

The United Nations has proclaimed 2008 the International Year of Sanitation. That may seem irrelevant for those of us who are able to flush and forget. But roughly one third of people on the planet don’t have access to improved sanitation. That more or less means 2 billion people relieve themselves in the bush.

Lack of improved sanitation has all sorts of negative effects on public health. Like dead children – diarrhea is still the leading cause of death for children under five. Like the additional burden for mothers who regularly have to take care of a sick child. Like cholera outbreaks – ever hear of cholera occurring in a place with improved sanitation? Nope.

Sanitation is a basic human need. If you look at the data from New York, London, and Paris before those cities built sewers, you’ll see their mortality rates were about the same as mortality rates today in Sub Saharan Africa.

On my first year in an overseas posting as a water and sanitation engineer, my focus was on improving access to clean water and sanitation. Women in displacement camps in northern Uganda would often wait in line for two hours to pump water, while some 1500 schoolchildren would have to share two toilets. So we drilled more wells and built more toilets.

I spent my second year in Sri Lanka where thousands of houses had been destroyed by the tsunami. In addition to rebuilding schools, health clinics, and homes, we installed hundreds of wells and built hundreds of toilets.

In Papua New Guinea I’ve begun focusing more on improving hygiene practices than building infrastructure. We can build lots of toilets, but what if people don’t actually use them? (Happens more often than you may think.) And if people don’t wash their hands after using the toilet, it’s likely there will be hardly any improvements in health.

So for the past year my focus has been on behavior change: improving hygiene practices that complement improvements in infrastructure. But while assessing this project, I’ve been particularly moved by something that isn’t directly related to safe water or improved sanitation.

Before our project, the women walked an hour or more to get water. To relieve themselves, they walked far into the bush or the mangroves. The women told us they used to get sexually assaulted by men hiding in the bush. Now that there are water taps and toilets close to their homes, they no longer get attacked on trips to fetch water or go to the loo.

Domestic and sexual violence against women is prevalent in the Pacific. I reckon that women tend to get the short end of the stick all around the world but it seems to me to be particularly bad here. In the Pacific, the women are damn lucky if they get any of the stick at all, because most of the time the men take the stick and beat them with it. Given a choice, I reckon I’d prefer to be a woman in Afghanistan than a woman in PNG.

On Petats the women told me that they felt safe when they used the new toilet.

“You know the Bible and I know the Bible,” I said to Pastor Barry. “You know that Jesus loved the mamas and he loved the weak and the vulnerable. I think Jesus wants you to build a toilet for the women.”

I hope he will.

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What price a child’s life?

This afternoon Mike and I sat upstairs on the deck at our place, looking out towards the trees. It was pouring rain. Water was sheeting off the tin roofs of the houses behind us and running down the big green leaves of the coconut trees – arcing off and dropping towards earth in one, unbroken, stream.

We were up there because Mike had quit the kitchen table, which was burdened by our two laptops and a stack of documents eight inches thick that he’d bought home to sign over the weekend. The stack was peppered with neon tags demanding his signature.

“Mr Michael,” the tags read, one after another.

Mr Michael. Mr Michael. Mr Michael…

On this quiet Sunday afternoon Mr Michael had worked through all these documents, not pausing until near the end, when he came across three requests for reimbursement. These were all related to cases where a sponsor child had gotten sick out in their village and the district health centers hadn’t been able to address their problems and had recommended transfer to the provincial health center in Luang Prabang.

It costs money to transfer sick children to the provincial hospital, and when three children get critically ill in one district within a month, it costs more money than has been budgeted for medical emergencies. Significantly more. As in, more than half the budget for the entire year.

“It’s not three cases,” Mike reminded me, when I went to see where he’d gone and found him sitting at the table on our deck, staring out at the rain. “It’s four. We also have little orphan girl.”

Ah, yes. Little orphan girl. Little orphan girl whose story began two weeks ago now, when Mr Michael received multiple phone calls on a Saturday requesting him to authorize the medical transfer of an eleven-year-old child from Luang Prabang to Vientiane. The doctors in Luang Prabang said they couldn’t treat her here, that she had a problem in her brain and that she would probably die if not flown to Vientiane for specialized medical care immediately.

Mr Michael authorized the medivac. At first, it seems, the doctors in Vientiane thought she had Japanese encephalitis – she could not even sit up, or swallow – but after a week of testing these results came back clear. So she does not have encephalitis, but no one is any the wiser yet on what she may have.

At least, this is what we think is going on. It’s very difficult to get accurate information. Whatever the doctors in Vientiane are saying gets filtered through at least two other Lao speaking staff before it reaches the office up here. To complicate matters further, little orphan girl herself doesn’t speak Lao, much less English. Little orphan girl is an ethnic minority child who is too poor to attend school, where she would learn Lao. So she only speaks Khmu, and the doctors only speak Lao.

I was speaking about this with the local staff member on the case during our house-warming party on Friday night.

“So, no one knows what is wrong with her brain,” I said, trying to make sure we were on the same page. “But now she needs help to get her muscles working again?”

“Yes,” the Iokina replied. “But the doctors say the problem will happen again. They say she will die.”

“But they don’t know what the problem is?” I said.

In summary: No. They don’t know what the problem is. They don’t know when “it” might happen again. They don’t know when she might die – it’s just that Iokina seems pretty certain that she will, at some point, especially if we send her back to the village with her fourteen-year-old sister and elderly grandmother.

“Do you think she should go back to the village?” I asked.

“Yes,” Iokina said, shrugging a little in that helpless way that needed no translating.

“We tried,” Iokina was saying, without words, “and there’s only so much you can do for one child.”

So Mike and I are left wondering. Is that really what the doctors have said? How do you weigh and filter this information that has come up to us across many miles and two significant language barriers? Would physiotherapy help her, or is the primary problem neurological? Are there any Khmu speaking physiotherapists in Luang Prabang that could coach her on exercises she could do at home? If so, how could we find them? How are her sister and her grandmother going to be able to help her when they need to be tending the rice fields so they can all eat? And, of course, how much is this all going to cost?

How do you put a price on the life of a child?

“The emergency medical fund is for emergencies,” Mike said today as we sat on the porch watching the rain. “This case is no longer an emergency. We don’t have the capacity to take on long-term rehabilitation cases. We cannot continue to pay for her treatment indefinitely when no one yet knows what may be wrong with her. She has to come back from Vientiane.”

“What then?” I asked.

“I don’t know,” Mike said. “I have to go in to the office early tomorrow before we head out to the field. I’ll see if I can get some more information.”

We sat and stared at the rain for a little while longer, and then we came inside and went back to work.

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