Family Planning is Not the Ugly Stepchild—It is a Lifeline for DRC

We traveled Manika health zone today, about 30 minutes from our home base in Kolwezi.

Jimmy, the director of the health zone told us, yes, your project is making a difference. “Men have learned that women are not just an instrument of men.” He said men have started to help out around the household, cooking on the weekends, and “cultivating” with their wives.

I want to believe him, but our project has been in true operation for just under a year. I am sure there are seldom cases where a man decides to dedicate his weekend to cooking for his 7, 8, 14 children, but I just don’t buy it that that is the norm—just yet.

But Jimmy, like we do, wants to show the project is successful. He wants the funds to continue with the good work.

That is the problem with these short-lived projects like ours. We come, we make a difference, sometimes a phenomenal difference in a short amount of time, but usually for a very small population, or with an approach that the government won’t support on its own.

Governments have their priorities, and family planning is often the ugly step child.

If they can do it, they will, but they will do other things first: things that are more acceptable, maybe a bit easier—fighting malaria, vaccines, offering sustainable water sources, even making deliveries safe for women.

Sexual and reproductive health—of which family planning is a part—is not always so popular. But in reality family planning affects EVERYTHING else. Without contraception, families will continue to procreate and suffer, without enough resources to support the children they love. Often, their children will die young, and sometimes they will too: working in hazardous conditions to make enough money to have a meal each day, or giving birth at age 14, and then year after year after year. Many of the kids that do survive will not have the chance to be educated, and without that, they will live in a cycle of endless poverty. The country will suffer too. Without an educated population, how will DRC ever prosper, grow, and move toward democracy and human rights?

Today, a lady nurse told me one of her clients she saw the other day was just 3 years younger than myself, 33, and she had 9 children. 9 children! She never knew that contraceptives were even an option before her husband heard about them from one of our community-based distributors. He went home to his wife and demanded that she stop having kids (like it was her fault) and get something called an implant. She rushed off to the health center the next day, and voila—perhaps she will be a mother of 9 and not 14—perhaps.

Two of the older lady community-based distributors I chatted with today had 14 children. The other 5 had no less than 5 children, but most had closer to 10. Long before contraceptives became available in their communities, they didn’t have a choice.

I feel very strongly about the work we are doing here and I want it to continue long after I step back on that plane to Washington, DC. I want it to continue for the 14 children of Marie Jeanne and Kashala and for the DR Congo as a whole.

I want there to be more women in DR Congo like Dr. Jacquie Bapura, a beautiful elegant pediatrician who joined our project in Katanga as a provincial coordinator because NGOs pay more money than working at public-sector hospitals. She lives away from her two children, who reside in Kinshasa (a 2-hour plane ride), to make the money she needs to have a respectable life. She lives with her sister, who cooked us dinner every night—a necessary and silent partner on our trip here in DR Congo. But there is little chance that women with 5, 7, 8, 14 children will ever become DR Congo’s next set of Dr. Jacquie Bapuras.

Mining for Life

The first thing we saw when we walked into the Director of Health’s Office in Fungurume Zone, Katanga Province, DRC, was one photo on a barren cement wall: it was of a newborn baby, its face deformed, and lying in its own pool of blood. The photo was hung in a cheap tin frame. The whole team of us, even the doctors and the public health professionals who had worked in some of the most desperate conditions—IDP camps on the Congolese border with Rwanda and Uganda—were staring. One of our senior advisors finally got up the nerve to ask: What is photographed there?

The director told us “this is the result of copper and cobalt mining in Fungurume.”

I couldn’t focus on whatever else the Health Director said for the next few minutes, probably several formalities of the many since we have engaged in since arriving in DRC . All that I could focus on was the horror.

The only other photo on his wall was the mandatory one: of President Kabila. As far as I can surmise, that photo is seen hanging in every public office. Kabila’s face is so familiar to me now. It covers billboards on the roads leading to Kolwezi with the slogan “Mon Congo”  - My Congo. 

Along with the billboards, when you drive through Katanga Province, one of the biggest mining destinations on the planet—copper and cobalt, uranium and gold—you see the beautiful mountain-scape punctuated by depots where the mined resources are bought and sold. You see long roads up to the mountains, sometimes behind huge chain-linked fences, where dump trucks enter and exit on a continuous basis. You see barracks where some of the hired miners live. They look like prisons.

On the other side of the road from the natural treasure chests are squatter camps where artisanal miners have set up camp to trek into and out of the mines. They are like freelance miners. They do not work for a company, but for themselves. They scrape what they can together to sell to the big companies that control the exports—most of them Chinese. I’ve heard the big companies pay them scraps compared to what these minerals, and the products that come from them, go for on an international market. I believe them. They are living in squalor.  

You will see large plastic bags loaded to the top with the minerals, stacked in minivans, on motorcycles, and on people’s backs, until they can reach the nearest depot and sell them for a small fraction of what they are worth.

The men under the mountains picking away at their living and carting around the heavy sacks need to do it. They are often supporting 6, 7, 8, 10, and 12 children.

That’s why the work we are doing here is EXCITING. It is IMPORTANT.

We went to the central market today to witness an outreach event organized by our project. At these events, bands of trained health volunteers, called community-based distributors, tell the community about all the family planning methods that are now available to them and refer them to a makeshift “clinic” at the back of the market where women can receive counseling from a trained health provider, and if they wish, the contraceptive of their choice.

And many do wish. When the community-based distributors took out their megaphones and started announcing their presence to the market, flocks of women—and men—arrived at their tables. They wanted to know about this thing called family planning, in the hopes they could make things for their families just a little bit easier.

So, we are addressing one tiny slice of what these populations need for one small slice of time.

Welcome to the Heart of Africa

I’d missed Africa. After I landed in Kinshasa yesterday and left the air conditioned airport, I stepped out into the thick, humid air.  It was almost as if I carried a cloud down from the sky with me. Following a recently departed winter back home, that humid air felt like a gift.

After my colleague who is traveling with me left one of his bags mistakenly inside and ran like a bolt of lightning back into the airport, I waited there on the sidewalk with the throngs of Congolese. They wore Western dress and African dress and many held signs with Western names on them—Congolese there to safely transport foreigners within what are notoriously known as unsafe borders.

To my left was a raucous gathering of people my age or slightly younger. When they saw their friends and family members arrive from inside, they let out cries of pure joy—a kind of joy that seeps into you and rests there for a while: another gift. They embraced their loved ones with such force that couples of them almost of fell to the ground. It was unbridled emotion, not something you see often in the US. Or, even if you see something akin, you certainly aren’t gifted the same feeling very often: that feeling of not really being all alone this world, of communion, of solace with other human beings. It is something we search for all of the time, but rarely find.

So, my first thank you to DRC came at that very moment. 

The warm, fuzzy feeling, of course, comes along with quite the opposite. After all, it is Africa’s heart, my love, my continent of paradox.

I’m reading a book while I’m here, Dancing in the Glory of Monsters, which is bound to pepper my blog posts from here forward. As the title suggests, the book chronicles la catastrophe that is Congo’s history and politics. “The Congo has always defied the idealists,” writes the author.

My idealism, my captured joy, took a strong hit the next morning when we returned to the airport to take an in-country flight to Lumumbashi, one of the largest cities in DRC outside of Kinshasa, far to the East and known for the province in which it is located—Katanga—one of the most mineral-rich places on the planet. I returned with my colleague, a Nigerian doctor, to the airport and it didn’t take long for DRC‘s politics to start to seep in. Because he is Nigerian, the immigration officials said he could not travel outside of the capital due to a sour political relationship between West African countries and DRC. 

I was quickly ushered into the immigration office (because my colleague does not speak French), where I had to argue, in my very mediocre French, for 45 minutes about how he is a respectable doctor, how we have visas for the travel, how our work is important to people in the rural provinces of Katanga, how we are supported by their friend, the US Government. It was only after I softened my tone with the two men (one who was asleep for the first half of my arguments) that they softened as well. I stopped trying to strong-arm them and instead smiled politely, maybe even slightly flirtatiously, to win the favor. The only thing left to do after winning my argument was to have a lady security guard make some photocopies of our documents for us. I followed her through the airport to the photocopy machine, where she paused, stood with her arms folded, stared at me for a good 15 seconds with a disapproving face, and rubbed her two fingers together.

“L’argent!” Bien sur, l’argent.

I handed her 5 $1 bills out of the stack of 200 singles I was told to bring for just such situations. She held out for more, but when I stood my ground, transforming from soft to hard again, she slowly moved toward the window where the photocopies were made.

In my two weeks here, I have no doubt that I will capture at least a few more palpable joys, and, at the same time, I will lose just a little more faith in humanity.

Wanderlusting to Home

I have always been a wanderer, a nomad. Although I have settled in one place or another for relatively long stretches of time, my heart has always ached to wander. Perhaps this is because I have never really felt at home in the various places I have lived: in between the rock gorges of Ithaca New York, at the precipice of the main line and White Anglo Saxon Protestant America, in our nation’s capital for more than a decade.  Perhaps it is the ever addictive pull of perspective.

But now I do, have a home. This farm, its hills, that magical breeze, the forest of trees, the gravel driveway underneath my feet, the long winters and the preciously short summers, the Technicolor dream coat of leaves that masks our perimeter in the fall, the sheets of rain that pour heavily on the tin roof, my horses as they run and chew and gnaw on the wooden fence boards, my dogs as they sleep and awake me each day just a little too early for my comfort. I call it home.

As much as I had always yearned to see Ethiopia, and, in fact, every single one of Africa’s 54 countries, on this last trip abroad, what gave me solace was home. The world is chaotic and its problems are infinite and of overwhelming magnitude. I now, after my 35 years here, finally see the value of home.

Life, of course, is showing me the danger of finding a home. This year has been unpredictable at best. Impermanence is shining its blinding light. The bedrock of my existence has been pulled from underneath me, first with the death of my mother and then with the dissolution of my marriage.

It’s no one’s fault but my own and the way fate has willed it, if fault can be declared at all. 

As life would have it, my home may now cease to be. It is dangerous, I think, to find our home in physical sense. I would imagine that the most happy of us all have that sense of home right there inside. They can find it there, where they live, or 10,000 miles away, on the other side of the world. It isn’t affected by a difference in smell, taste, and a sense of security. It is owning what is you.

In my wanderlust, I hope I can eventually travel to, grab, wrap myself around, and never let go of that elusive place I can call home. 

The Road to Nekemte

Boom. Flash. We were eating dinner at what is known as the nicest hotel in Nekemte and the rainy season had finally made its exuberant debut.

I will admit: my colleague and I definitely jumped. Nekemte, a vibrant city, 350 km to the West of Addis, is true Africa. It is the open markets and the dirt. It is the young and old and people moving, walking anywhere and everywhere. It rises out of nowhere, from the mountains and the lush green fields of teff, maize and sorghum. It is jumping and bustling, a sharp descent from another trip through God’s country.

Unlike my colleague who has traveled through Rwanda and Uganda and professes the road West of Addis to resemble her previous trips, I, myself, had never known such a journey. If I had to compare what I have seen in Ethiopia, Lalibela would be the dry peaks of the American southwest, while the mountain road West of Addis is the lush, green mountains I’d seen in parts of South Africa. But I hate to make a comparison that isn’t comparable.

The dirt is the perfect red-brown, and the people are poised to traverse the steep cliffs above and the muddy rivers below. They are tall and lean, with skin made to absorb the sun, the rain, and the dirt that only makes them seem more a part of the Earth. The green is tremendous and overwhelming. It feels as if the Earth has to be endlessly fertile and that the space around you will never end. It calms those aching, compulsive anxieties, and allows you to imagine a place where humankind could be born. This green universe could give birth to anything and everything, forever. It is only logical that the fertility rate remains high and many Ethiopians, despite their circumstance, continue and continue to procreate.

This natural wonder is punctuated, for the better and for the worse, by development. The road, the entire way from Addis to Nekemte is paved, which made the drive more pleasant, but also allowed for the easy passage of large trucks. They carry goods and materials, maybe to further the development of Addis. They dash precariously past, sometimes on the correct side of the road and sometimes almost not, their fumes lingering long after their descent down the mountain. Small- and medium-size villages arise every now and again, with the open-front storefronts and the same types of scenes that tend to characterize developing countries: animals wandering aimlessly; the shoeless, the shirtless, and the extraordinarily thin coupled with the young men and women in Western clothes who could be meandering down a street in Washington, DC. Many of them look at you in your ominous white SUV and you feel like a big gaping sore thumb invading what isn’t yours. At the same time, pastoralists with their herds block the road, some more accustomed to the passing traffic than others.

It was the new with the old: the heart of Africa, of the Earth, being pulled very slowly from itself.

When we finally arrived in Nekemte, seven hours later, we were ready to rest and eat. We walked into the hotel and were greeted by a strange smell. It was the mix of the ancient sauna on the lower levels (and the sweaty men using it), the Ethiopian meat being broiled in the restaurant, and the wet, humid air quickly moving in. Always sensitive to smells and still suffering from the nausea acquired in Lalibela, I shamelessly breathed conscious, shallow breaths.  When I got to my room on the third floor, I was met with at least 50 huge black moths that had entered the open window above the shower. Horrified at the sight of the insect tsunami, I asked for a room change.

I now sit at the penthouse level (floor 4) and I realize how sheltered I had let myself become since my hiatus in Niger and my trips abroad more than five years ago. Farmland Hotel has running water, a Western toilet, toilet paper, a real bed with linens, and even a television with four channels. I am staying in a country where the majority of people still live in abject poverty, female genital cutting persists, and girls are still forced to marry at an age when I was buying my first bra. I’ve become spoiled.

God's Country

After five days of hotel hopping in Addis, I finally found God’s country. I awoke at 5:15 am on Friday, the Ethiopian day of fasting, to jet to the airport. I was going to go at the trip alone, but I met a nice travel companion during my hotel hopping and conference managing to accompany. We boarded an early morning flight from Addis, touching down in Gondar, and quickly kissing the sky again above Lalibela. I closed my eyes on the tarmac in Gondar for a quick power nap and awoke just below the clouds and just above the towering mountain-scape for which Lalibela is known. The Lalibela airport is just a pinprick in the infinite space of its surrounding universe. Two floors and three rooms, we easily saw our names written in red marker, held by the drivers sent to pick us up and drive us through mountains to the historic city of Lalibela.

The drive is 35 kilometers, but can feel a bit longer because of the winding mountain roads, and because of the pastoralists and their animals: unaccustomed to vehicles and the necessity to hop out of the way upon their approach. There in that van, I definitely felt like I was invading a sacred space, one in which people are still unified with nature under God’s sky. People who look to be 70, 80 years old climb the mountains with loads of timber strapped to their backs. Men with long sticks steer their oxen, goats and donkeys up the long mountain pass. They are often almost shirtless, threadbare, and seem unequipped without water and sometimes without shoes. The women wear their long syrongs and worn sandals. They look as if they have climbed the entire mountain range, or have been dropped straight from the sky, their sharp features and lean figures an ideal for tackling life here on Earth. 

I reference God, here, not because I am a Christian, but because a trip to Lalibela will make you want to believe. Lalibela is famous for its ancient churches, built in the 12^th Century by King Lalibela and his army of angels. With a small pick ax and chisel, along with his angels, it is said that the 11 churches were built in just 23 years. Today, this may not seem remarkable, but when you see the tools and feel the density of the rock underneath your feet, you could almost believe an army of angels was indeed present. Lalibela was created as a second Jerusalem. King Lalibela made the Holy Land a more convenient place of worship for his chosen people by moving it to Ethiopia.

The Ethiopians are true believers. They believe in willing their lives to chance under the promise that God will inevitably have their backs. They still have many children with little resources and walk for miles in the name of God with little food in their stomachs. They believe in priests that extricate demons. The most devout believe that by bathing a barren woman in a fertility bath, she could become the next Virgin Mary. Living among the luminous mountains, the eternal sun,  the dry mountain air, the rain that falls just enough to allow the crops to flourish, and the forgiving clouds that often leave a sliver of sky open to the wandering eye, it is no wonder these people are believers. Ethiopians, the most exquisitely and structurally beautiful people I have ever seen, are living in God’s country.

That day in Lalibela, as we trekked through the rock face caves and gullies which connect the 11 churches through the mountains, we walked among the most devout. We happened to arrive on the Day of Michael, one of many religious holidays on the Ethiopian Orthodox calendar. Thousands of Pilgrims had also arrived to worship, to pray, to chant and to sing. They had come from across Ethiopia to celebrate their saint, young and old, but mostly old. Their faces told stories, but their feet told many more. Some of the oldest wore sandals worn to the dirt, and some of the youngest, sneakers and socks.

They prayed and kissed the rock-face churches. They fell to the feet of Jesus, as he was depicted 900 years ago. Some of them, they walked hundreds of miles to stand and kneel on the old carpets that cover the rocky church floors. A priest sits all day in each church. My mind wandered to how the priest is filled, his thoughts and his journeys as he keeps watch and leads prayer. His mind must wander so differently from mine, as the concept of being sedentary for long stretches of time, in the name of God, is about as foreign as Lalibela itself.

Over five years since I had stepped outside the confines of North America, Lalibela did feel infinitely foreign. Only there for 24 hours, there was no time to adjust to uneven rock, the high altitude, the smell of open fire, the sound of chanting prayers. A pack of mating dogs kept me up all night and I awoke in nausea from my ambitious lunch that included raw jalapenos. Even God’s country is still developing.

The Buoyancy of Travel

It has been almost five years since I took the sky and crossed space and time. I don't count a small jaunt to a luxury resort in Mexico  and I discount any journeys  constrained by my own national borders. I am including the kind of travel that makes you so weary without sleep you feel high and completely disconnected from time and space. It had been half a decade since I engaged in this type of travel - since I stepped off of a plane from Sana'a Yemen and arrived back in Virginia. I carried with me a taste of honey perfume that I have used so sparingly that I still enjoy a small touch of it now and again. It brings me right back into the hustle of Sana'a and the bustle of men and little children taking inconspicuous glimpses of the Western tourist in the black turtle neck, standing enamored in the perfumery. 

This time, Ethiopia. Since I moved to the small farm in rural Pennsylvania, a place like Ethiopia seemed only another planet. I'd sewn myself into the fields and the trees and the grass and the enormous weight of care that comes with owning a farm and two horses. I'd dedicated myself, my entire being to that farm; its rolling hills, its long gravel driveway, the gift of its breeze, and the destitution of its February days. My days had become a swirl of  maintaining a regular job, and a well-kept home. I had always innately been tied at the soul to my horses, and this was no different. I had these magical creatures there with me, every day, and I owed them, and some ways sacrificed what I always knew was the beautiful unique lightness - buoyancy - of world travel.

Once those large international jets lift to the sky, you are helpless. You are helpless to your daily procedure, to getting distracted from your path, to veering here and there trying to keep up with life's dust. You are given a seat and besides a small walk down the aisle to stretch your cramping limbs, that is where you stay, floating buoyantly above the earthly pull of gravity. As I slept and woke fitfully during my the first leg of my flight from Baltimore to the UK, I did feel buoyant. It was the most buoyant I had felt in a very long time, maybe since I packed the small vile of honey perfume in my suitcase before taking to Sana'a's sky.

For 12 hours, I was stowed away in London. Few people knew the time and space I was occupying, and there was something magical about that too - occupying a space where nothing can be demanded of you, where no one has too many assumptions about you, yet; where you haven't yet tasted the air before a heavy rain or watched the sun as it folds in and out of the clouds, or been trapped in the corners of disappointment and despair. During my short hiatus in London, I took a trip on the tube to Covent Garden, a place that was a little too upscale for my comfort, yet alive enough to awaken in me a yearning to go back and spend more time.

Again, up, up and away, another night I spent buoyantly floating up there in the sky. This leg of the flight was entirely more lively than the last. Ethiopia had infused the walls of that big jet. The smell of the food, the aroma of the women as they sifted by in their soft white dresses and colorful head scarves and the little children, sounds which might have otherwise aggravated me trapped in some room or small restaurant, placated me.

Like many of us spoiled NGO workers are some times, I am now in my ironically nice, comfortable hotel room. Like them all before, these hotels have big walls and gates that only give us glimpses of the real city behind our walls. The tall buildings of Addis Ababa are calling out to me. I can see them, there, but they are still out of reach. I floated buoyantly in the hotel pool behind those walls and could have been up there in the sky again. I could have be anywhere, an entirely different person, as the water gifted me another moment of silence and solace that had been absent for far too long. Water, travel, flying through the sky heals.

I do good work, we all try to, but these places we travel to, these moments, and many of the people we meet along the way undoubtedly give us far, far more than they could possibly take from us. Ethiopia, thank you for taking me in, if only for a few days. I already know I will take you with me when I am back in the sky and inevitably when I land at the hooves of my horses.