Spanish Lessons and Pregnancy Culture

Here I am in Machala, Ecuador. What I'm supposed to be doing is MPH courses, designing a grant and writing a publication for my most recent work in Uganda. What I mostly do is go to spinning class, sit around and sweat while I listen to lectures, go running in the early morning, swim on occasional evenings, sweat some more, do dishes, hand wash clothes, sweat, and create fabulous dishes to cook without the use of an oven. Did I mention the sweating?

Trying to make the most of this unique opportunity of living in a rather idyllic mosquito infested swamp I'm taking some Spanish lessons to brush up on vocabulary and grammer. My teacher, Marcelo, used to be a high school chemistry teacher. Before that he studied medicine but had to stop because his wife left him with his two young daughters to take care of and well...studying medicine is expensive. Now he works in mosquito control, spraying for Dengue mosquitoes. He's a nice guy. Mostly we talk about how to describe vaginal discharge, religion, birth control, pregnancy complications and Ecuadorian culture. Its good he's not squeamish about these things.

Today was a contraceptive day and I listed off types birth control which he translated and made cultural comments on. My favourite: "Yeah, mostly its just the pill, the injection and the Copper-T that people use...well, there's also vaginal douches, but only prostitutes use those."

Good to know...

Before my Spanish class I was at one of the local health centers doing what they call 'psycho-prophylaxis' with pregnant women. It appears to be generic women's health education, so I don't know if the 'psycho' is related to the teacher or the patients, anyway... I was told to talk about nutrition in pregnancy, which I did with flare of course (with no preparation...I hadn't gone over that topic with Marcelo yet!) The health center is packed with patients and family members lining up with a garden variety of complaints. A cute, scruffy haired, ripe-smelling 2-year old screamed for most of my talk, and then happily played with my cell phone as he sat his ripe little diapered bottom on my foot. At one point the nurse wanted to emphasize a point I made about the complications of diabetes in pregnancy and having a baby that is larger than normal, she said "See what the doctor is saying? If you eat too much sugar you are condemning your baby to a life of obesity, diabetes, high cholesterol, heart attacks and early death!"

Perhaps not exactly how I would have worded it to a Canadian population...ah, I have much to learn, both language and culture.

A Hint of an Existential Crisis

The final hint of tropical moisture was removed from the air with a fine chemical mist as the flight attendants emptied their aerosol cans into the air to sterilize any hitchhiking mosquitoes. As the air-conditioned plane lifted off from the Entebbe airport I felt a mixture of relief, nostalgia and regret. I couldn’t help but feel just a hint of an existential crisis in the residual mixture of emotions left behind after spending August to December in Kampala. Although my expectations may have been unrealistic, on many levels, both personal and professional I question if there was any point to the exercise and whether the balance of good and bad, frustration and hope leveled out to a positive balance. The truth as, looking at the history of ASPIRE, a huge amount of progress has been made this year despite my questions as to the sustainability and local investment. Perhaps my goals for my time in Kisenyi were somewhat unrealistic.

After a few weeks in Europe for some much needed rumination and healing I found myself back at Hopkins, trying to drink in some knowledge from the Public Health fire hydrant. Its always an intense and exhausting experience but I found myself searching for mentors and perspective on how to direct my vocation in a way that will both be personally rewarding but actually contribute in a way other that just catching individual babies. Don’t get me wrong, I don’t need to save live ‘a million at a time’ like Hopkins claims to. As my wise spouse often quotes, “its not important to be important, its important to be useful.”