Madeline Uraneck: International Development Atop Lesotho’s Mountains
January 15, 2010
I was sitting in my cubicle in Wisconsin’s state education building, reading yet another e-mail about an over-50s friend who’d contracted a serious and unexpected illness. “Is there anything I still would like to do,” I mused, “that might involve being healthy, traveling, climbing mountains?”
Eleven months later, I sat on the front porch of my straw-thatched rondavel in Lesotho, Africa’s tiny and little-known “Mountain Kingdom”, wondering exactly what I’d gotten myself into. Both Peace Corps and I had arrived at a new idea at the same time – promote Peace Corps to the over – 50 – something’s. Utilize their experience, maturity, and once-youthful idealism.
Announcing after 16 years of steady state service, a good salary, and a creative, fulfilling job that I was joining the Peace Corps – not for retirement, but hoping for a late-in-life career change - virtually brought my work place to a halt. It’s one thing for young people to join up, another thing for people who have options for well-paid work. I was touched by how many people said, “I’ve always wanted to join the Peace Corps.” And “I’ll be at your side. Please write to me.”
Before I went into the Peace Corps, indeed, before I’d even thought of the idea, I enrolled in the Development Management Project Institute (DMPI) certificate course in January 2006 located in balmy Monterey, California. I was fascinated with every aspect of international development. I loved the textbook cases, and could easily picture myself beneath a tree with a group of women wanting to learn nutrition or childcare or literacy skills. Together we would start cooperatives, micro-financing efforts, and march in the streets to petition recalcitrant government offices.
None of that was to be. First of all, I never found women sitting under trees in Lesotho. What I did find was a dearth of adults, especially female, with even a minute of extra time to attend two consecutive meetings under a tree, much less to form a co-op. Lesotho is one of the countries in the world with the highest HIV infection rate – it’s number #3, together with near-by #1, Botswana and a geographical stone’s throw from #2, Swaziland. Poverty statistics and the need for men to find work in the gold and diamond mines out-of-country, away from home for 6-12 months at a time, exacerbate the infection rate. Health care has a wobbly infrastructure, and the men bring HIV infections home with them from their mistresses/wives at the mines. Other reasons push Lesotho’s HIV infections to high rates include gender inequality, the cultural practice of multiple concurrent partners, inconsistent and incorrect condom use, low rates of medical male circumcision, intergenerational sex, and transactional sex (women sell themselves for food for children, school fees, etc).
This means that any woman -- from even very young ones to very old females-- who is educated, skilled, and healthy, or any female described by even one of those adjectives, is already triple burdened. Women and girls care for sick relatives, take in orphaned children of neighbors and relatives, miss much work or school because of these demands, and experience significant stress from their relationships with men, for example, arguments about sex and marital affairs, physical abuse , bargaining for child support, and abandonment.
I loved Basotho culture and saw its strengths. Overall, despite the fact that I attended many funerals and suffered the death of one orphan I’d informally adopted, I felt immensely enriched. Basotho culture is alive with singing everywhere. Women’s work – including hauling water, gathering firewood, cooking outdoors, washing clothes at the riverside, walking long distances to jobs, bringing groceries home in a wheelbarrow or on a donkey’s back – was done at a measured pace, always with time to greet a neighbor, inquire about a sick child, promise to send a bit of money or a sack of maize meal to a person in need.
I replaced time spent answering 100 e-mails a day at my Wisconsin job with several hours a day exchanging greetings in my new village. Thank goodness for repetition of “Lumela. U phela joang?” (“Hello. How are you?”) Thank goodness people in the crowded busses asked me the same five questions over and over again. I plunged into Sesotho, and took lessons right up to the day I left.
The Development Project Management Institute gave me tools I used every day, and investing in it was one of the best decisions I’d ever made. The certificate course was short and intense, and I was a ready, grateful learner. DMPI gives a person skills to focus on the big picture. In Lesotho, the big question was how do people work together to lower the HIV/AIDS infection rates. A large number of Government Ministries and NGO’s in Lesotho were dedicating resources to this project. Each one had a strategic plan; they attempted to do strategic partnering; attempts to monitor and assess data were everywhere around us. My vocabulary and skills from DMPI enabled me to see how I was a tiny part of a huge effort.
Lesotho’s Peace Corps Medical Officer Fatokun Johnson told us Volunteers that if HIV/AIDS work wasn’t foremost in our service that we were wasting a valuable opportunity. For those of us teaching high school English, doing library development and school construction – i.e., not primarily health work – this was a tough challenge. Most of us re-directed our projects to contribute to the fight against AIDS. We came to understand that he work fighting HIV will not be successful if is left to health care workers . Because HIV/AIDS touches every aspect of life in Lesotho, all Volunteers needed to integrate HIV work into their daily efforts.
For me this entailed talking to the 160 elementary teachers I worked with about why they were reluctant to get an HIV test. Appreciative inquiry skills learned at DMPI were my entry. Conversations revealed many reasons – all cultural – and the damning estimate that probably as many as 80% of them, in the very group most likely to get infected – i.e., women 25-40, hadn’t yet tested. Fear of a divorce, physical abuse by husbands, loss of respect from students and community, and despair at the impossibility of medical privacy in a village setting topped their list of reasons to decline.
Two thousand teachers attended the summer and winter vacation sessions at the main campus. What an opportunity to reach women, I thought. With a group of local teachers as key participants plus US Government PEPFAR funding, I put DMPI skills to use. In facilitated sessions, it became clear that it wouldn’t be MY solutions, but theirs, that were essential to reach fellow teachers. Never would I have thought of a SINGING CONTEST to reach teachers, but for Basotho teachers this was an early first idea. If they were to tell fellow teachers about HIV prevention, challenges, and solutions, they wanted to do it in song.
The outstanding reception to the singing contest wasn’t the only thing we tried. We did drama, disk jockeyed music events, performed at college-wide assemblies, and initiated Life Skills workshops and certification. Throughout, we kept making HIV testing available and private. Appealing to the LOGIC of why one should test – that a teacher is a leader; that teachers had a mandate to educate students about HIV; that living 14 healthy years was better than living four unhealthy ones; that one’s own children didn’t deserve to become orphans – got me nowhere. These were appeals out of my culture. Basotho teachers needed to find appeals out of their own culture.
The Basotho advisory committee and I engaged other partners, modified our plan, repeated good efforts and ditched ones that didn’t work, collected data, recognized and celebrated the efforts of one another. In the process, I became more interested in and admiring of the work of other players in Lesotho – including Clinton Foundation, PIH, Baylor University, GTZ and the Ministry of Local Government. Following a collaborative model, they had organized a monthly work group whose meetings clarified both the enormity of the problem and the potential power of people working together.
Throughout my time in Lesotho, I often remembered one of Beryl Levinger’s statements, “Isn’t it a crime that poorly-designed projects give back so little to the communities that deserve more.”
The DICE model of change management – duration, integrity, commitment, and effort – bodes well for the future of HIV reduction in southern Africa. On the other hand, the continuing devastating statistics show that the right formula hasn’t been found yet. The medical / clinical solutions are easier to bring to a poor country than the cultural ones. Organizations doing the best work combine both – and are invested for the long term, not a few months or even a few years. People who speak the language, who live within in the rural villages, who know the songs, who walk the mountain paths and haul the water need to be drawn further into the conversation.
DMPI gave me tools to understand lack of change that surrounded me, as well as gave me tools for good project development and change management. Peace Corps allowed me to see deep commitment needed to become a real part of a community’s change efforts – learning a language, participating in weddings, funerals and dances, falling in love with orphans and neighbors was just a start. Together, DMPI and Peace Corps provided a powerful combination for learning how to be a perceptive and effective global citizen.