Monday, February 22, 2010

The 5 Senses of Lesotho

This weekend I hiked up to one of the tall mountain peaks here in Mokhotlong with one of TTL's night security guards, Bokang, who arrived a few hours early for his shift so we could set off into the hills together under the hot afternoon sun.

Mokhotlong sits cradled among the mountain slopes, dotting a relatively flat stretch of land in an otherwise vertical landscape. The air is thin here -- even the country's lowest points are above 3,200 ft., and some of the mountains around Mokhotlong are closer to 10,000 ft. -- and the hike was pretty intense.

Looking back on my first week in Mokhotlong is a bit intense as well -- and in a good way, sort of causes sensory overload. The differences between this country and the United States seem too many to take in. Things here look different, sound different, smell different, taste different, feel different and even seem to produce a different intellectual response.

In an effort to convey those differences, I offer my take on The 5 Senses in Lesotho.


Naturally, I think the visual differences here are the first to catch one's eye, so to speak.

Especially once you leave Maseru, you start to see the stark physicality of poverty. At points, you see skinny, dusty and partially-clothed children who mill about lethargically in their yards and stare blankly at the dust clouds rising away from your car's tires. Even the dogs' clearly visible ribs seem to jut out into your consciousness. When old men along the road hold out their hands and yell for "sweets" as you pass them by, you wonder if your sense of dignity is inappropriate or misapplied here and if you shouldn't be so quick to consider their dignity being lost a bit because of their simple requests for candy. You wonder if poverty kills the importance of dignity, or if it simply redefines it and allows it more leeway.

But there are also plenty of things that instill an abiding respect for the human spirit and people's ingenuity in the face of relatively few resources. Everything here seems raw and earned and sweated through. Most homes in the countryside are made of local stones piled together and topped with thatched roofs. The underlying poverty means many of these homes are smokey, windowless, suffocatingly dark and devoid of anything but a few random dishes on a mud-made shelf, but it also means they lack the neutered, synthetic feel of the increasingly common aluminum-sided cookie-cutter neighborhoods of the American countryside, and there is a beauty in their simplicity.

What's more, their organic feel seems to blend naturally into the constantly looming African countryside.

Mountains cascade into mountains, the sky is huge and you can see rain storms coming from miles away over the sloping horizon. You can watch lightning illuminate the neighboring mountain range while under a clear sky yourself. As each day wains, distant slopes take a darker blue color against the evening sky, clouds sometimes billow in and cluster around the highest peaks, and at night, when all begins to get quiet and the darkness truly sets in, thousands and thousands of stars dot the black world above you amidst a purplish haze that is the visible Milky Way.

During the day, the main road and the many dusty side streets are dotted with people walking against the light traffic. Men hold each other's hands in a platonic way unseen in the U.S., and women effortlessly balance massive bundles on top of their heads. Children walk to and from school in brightly colored school uniforms and politely say, "Good morning!," and "How are you?" in their best English. Adults and babies alike sometimes wear heavy winter coats during the hottest parts of the summer days. Everyone keeps an eye on cars and trucks that pass, whose drivers will veer dangerously close to pedestrians in order to avoid a pothole. Thrown into the mix is a steady stream of animals on and off the road. Depending on the shepherd, many of whom wear traditional blankets overtop pants and tall boots, the mix of animals can take almost any form. Donkeys, horses, cattle, dogs, sheep, ponies and the occasional pig make their way through unfenced fields and sometimes play chicken with oncoming traffic.

Here at TTL, our main building has a few small offices, two small bedrooms full of cribs, a bathing room and a bathroom that all sit on the outside of a long hallway that makes a right angle around the central play room for the babies. There is another small kitchen attached to the back of the building, and a guard house at the building's front near the gated entrance to the property. There is a small play set in the backyard, beyond which are two more buildings. One houses the fellows' bathroom and kitchen and a few small guest rooms. The other building, which is large and still under construction, will eventually hold new office space, some of which we will rent out. There is a small concrete sidewalk between the two buildings, and it leads back to where three rondavals stand. These serve as my bedroom, Kirsten's bedroom and our shared living and dining space, which happily has a well-stocked library of English books and DVDs.

We are in the process of having a landscaper come in to plant some greenery and create more established paths between the rondavals and buildings. He is also going to plant a memorial garden for some of our little babies who didn't make it, and plant some good-looking plants near the entrance and around the property to give off a more welcoming vibe. While landscaping may seem a luxury in a place like Mokhotlong, I think it will serve an important role in establishing a healthy institutional appearance in town. TTL has a substantial impact in Mokhotlong, and is one of the institutional pillars of the community. Our physical presence in town is important. In many ways, our positive reputation is what allows us to do what we do.

Here in the safe house, we currently have 8 babies, who range from three months to almost three years old. They are adorable. Big, curious eyes, tiny fingers, happy smiles and crunched up, pouty faces are all daily sights. So are yellow Bukana health booklets, toys, bottles and medicines.

During slow moments this past week, I've slipped into the play room to spend an hour or so with the babies. It's a strange perk in an office environment, one that can instantly remind you of the real mission behind the paperwork and the 8-to-5 days.

Those little faces are perhaps the best sight Lesotho has to offer.


All the bird calls are different here, which takes some getting used to. They start pretty early in the morning. There are also roosters who overlap in what seems to be a contest of cock-a-doodle-dos at around 4:15 a.m.

I routinely wake up to them and then later to horses neighing, cows mooing and children chattering along the road. I also hear music from far off and the occasional scream from a baby down the hill in the play room.

The construction workers putting the finishing touches on our new building chat to each other in Sesotho outside our kitchen at lunch time, and sometimes whoop as part of their chiding laughter.

During the day, the TTL offices operate to the constant soundtrack of baby sounds. The laughs are playful, the cries are demanding and the short bursts of vocalizations are always endearing. The soft coos and even the sharp corrections of the caregivers are comforting, and signify the high level of care TTL provides these kids -- some of whom were neglected before getting here.

I am still learning the series of greetings people give each other on the street, which basically amount to, "Hello, Sir/M'am. How are you? I'm fine, thanks." In Sesotho, these greetings are often given in an almost inaudible and slowly drawn-out intonation. I'm also working to expand my Sesotho vocabulary, but it will take some time. I'm hopeless on the words that involve a click of the tongue.

The radio is blasted outside of all of the larger stores in town, and in most of the cars that pass along the road. Much of the time, American music is playing in a random mix that will jump from Johnny Cash to Mariah Carey to The Backstreet Boys. At other times, news and other talk radio plays in Sesotho. Occasionally, there is local music on the radio, much of which involves talkative chatter.

Some of the larger stores here are owned by Chinese families, so occasionally Chinese can be heard amidst the Sesotho and the accented English.


Smells are really hard to describe, but I have definitely noticed them during my time here. The ones I notice most are the ones that are new to me, and they add to my feeling of being far from home. I think the best way to describe them is to list their causes:

Drooled-on baby bibs, milk and formula bottles, rubbery chewed-on toys and clean babies.

Dusty roads, close-by cattle, horses and sheep, and plenty of street-side droppings.

Fresh mountain air and fresh, rainy hillsides. Grass and stale agricultural scents.

The thatched roof of my rondaval, which has a smell that reminds me of a clean barn full of hay.

Suntan lotion.

Fruits and vegetables -- which have made up the majority of my diet -- and the great aromas of the dinners Kirsten and I have been making. (Kirsten is great, I'm getting better.)


Food is another example of the rawness of Lesotho, as most everything is homemade with fresh ingredients. So far we've made fajitas with homemade tortillas, pizza with homemade dough, and pasta with fresh pasta sauce.

Lots of times it's all about using what you have. This weekend I made an improvised dish that consisted of sliced potatoes, green beans, apples and peanuts sauteed with a bit of olive oil, pepper, garlic flakes, healthy amounts of red pepper and rosemary. This was officially the most randomly inspired thing I've ever made -- and it was good!

Lots of our fruits and veggies came from the Wednesday market that TTLF fellows here have taken to calling, simply, "Fruit and Veg." It's a once-a-week treat. I ate a mango I got there as part of my lunch the other day that was delicious. We also got really awesome nectarines there. Who knows if those things will be there next week. The selection is always random and different.

We also went recently to the Senqu Hotel -- the "q" is pronounced by the locals with a click of their tongue -- where Kirsten and I joined one of the American doctors here working with the Baylor International Pediatric AIDS Initiative, Dr. Amy, and her fiance at the hotel's restaurant. I ordered the Double Decker Burger. It came topped with two pieces of what seemed to be pork from a tube and two eggs. Also, there were fries -- or chips -- on the side. Lots of protein. A good burger. Worth the wait.

I'm still waiting to go to MP's, which is a small restaurant -- really a small shack made of corrugated metal -- in town that serves some more traditional meals.

Bridget, my sister-in-law and this blog's former author, made an awesome cook book while she was here that I've been eyeing as well. I already made her homemade chocolate chip cookies, using a chocolate bar I chopped up for the chocolate chips and a healthy scoop of the homemade brown sugar Bridget had kindly made before leaving. My mother's recipe for Ratatouille is in the cook book as well, and I might try it soon if I'm feeling particularly confident.


Holding little babies was never a regular thing for me. Now it is. They are squirmy and soft and playful, and seem to like staring at me as if I'm an alien as they feel my facial features. They bounce their tiny feet on my knees and push their foreheads against my chest. They sometimes fall asleep in my arms and their breathing feels like a tiny puttering motor inside my arms.

The sun here is super intense, as it's still summer here. It feels hot on your skin, and my first day out I got burned. Since then I've loaded up every morning with SPF 30, which seems to work well. I also bought a hat -- one of the things I forgot to bring -- at one of the local stores to shade my face. I've worn it every day since. It's tan and on the right side it has a picture of a soccer ball with the words "GOAL!" and "Let's play soccer." I can't be sure it's not a hat meant for a young boy, which I'm sure gives my Basotho co-workers a good laugh, but it fits my overly-large head, so it works.

The babies really like the hat as well. They also like ripping it off my head at odd, uncomfortable angles that they think are hilarious.

Some things here are strange and don't make much sense to me at all. A couple times the strangeness of everything has made me think about home and how far I am from everyone there. In a way, like I said, everything here creates a sort of sensory overload.

But all in all, I feel lucky to be here. Not often are people privileged enough to work in a place where the good their organization does confronts them on a daily basis. TTL is one of those places. If one week has brought all of this, I wonder what one year will do.

Thursday, February 18, 2010

Outreach to Safe House

Again today I went on outreach. Again today we found a little girl in desperate need of help.

This time around, two of TTL's outreach workers and I set out to the Linakaneng Clinic, which is about an hour outside of Mokhotlong.

We were delivering formula and food to almost a dozen clients. We also "graduated" one small boy, which means he's made it to a point where he is healthy and happy and doesn't need monthly support from us anymore. Graduation is the goal for every child.

Standing and sitting in the shade around the clinic were dozens of mothers with their young babies and children. Toddlers walked around holding hands, and I saw one adolescent girl carrying a younger girl on her back. It was obviously a communal experience, albeit one necessitated by the threat of illness.

We took lots of measurements of lots of babies -- most of whom were getting monthly check-ups -- and also performed a rapid HIV test on a small girl. Although her mother was positive, her test said she was negative. That gives hope that the more accurate DNA test will provide the same result.

Then, as we were just about to leave, an older woman approached us with the request that we look at her granddaughter.

The grandmother said the girl's unwed mother had "disappeared," leaving her daughter behind.

After we said we would look at the girl, the grandmother walked away and then returned with a child I first thought was little more than a year old.

I was wrong.

Looking at her Bukana, or health booklet, I saw that quiet little Seithati will be three years old in April. She only weighs 6 kg, or about 13 lbs. Her arms and legs are tiny, her swollen belly is large and distended.

We asked the grandmother if she and Seithati could come with us to the hospital. She said she couldn't, because she had other children to care for -- one of whom was on her back -- and no one to watch them. Still, we said, Seithati should see a doctor.

The outreach workers then spoke to the grandmother about TTL and the safe house and the help we wanted to get for her granddaughter. Eventually, the woman agreed to let us take Seithati with us, with the promise that we would of course be in touch.

On the way home, I rode in the front seat, and one of the TTL outreach workers rode in the back holding Seithati. We also gave a ride to another young mother and her baby, who needed to come to Mokhotlong because the Linakeneng Clinic didn't have the baby's prescription refill.

When we got to the hospital, one of the outreach workers and I took Seithati in and spoke with the nurses about her condition, giving them her age, weight and MUAC (middle upper-arm circumference) and handing them her Bukana.

About 20 minutes later, we walked out of the hospital with a fresh supply of plumpy nut packets -- which I carried in my shirt because the hospital had no plastic bags -- and a request that we bring Seithati back in a week so the nurses can check her weight again.

When we got back to TTL, Seithati -- who is old enough to talk -- said she was hungry. No wonder, I thought.

After the caregivers gave her a warm bath and dressed her in a freshly laundered shirt and dress, they went straight to feeding her one of the packets of plumpy nut. Some kids don't like the "plumpino," but Seithati happily gobbled up every spoonful. She also chugged a cup of water until it was empty, a funny sight that brought out happy laughs from the caregivers and me.

I don't know how long she will be one of our resident babies in the safe house, but for now its good to know she's being well taken care of.

I haven't seen her cry once since we picked her up at the clinic. As I write this, she's inside the playroom, playing with the other babies.

Thuso, who is our most gregarious 18-month-old boy, seems to have a crush on Seithati, and is also bigger than her even though she is a full year older.

But we'll see if that has changed after a good week of plumpino.

Wednesday, February 17, 2010

Finding Little Selloane

What a work day.

Yesterday morning, Kirsten and I decided to spend our day tagging along with one of TTL's outreach teams.

Here at TTL, outreach is the bulk of what we do. While the safe home in town is a vital safety line for the most vulnerable children we come across, outreach links us to the majority of our young clients who still live at home or with relatives in the rural countryside.

Every day, multiple cars leave TTL and embark on hours-long journeys up and down jaw-dropping and head-rocking unpaved roads in order to touch base with and deliver food to some of the youngest victims of the HIV/AIDS epidemic in the country. Each jolt on the road out to those clients is one step of progress toward our mission.

I was aware of all of this on our way out of town, and thought I had a pretty good sense of what I would encounter during the rest of the day. I just didn't imagine finding little Selloane.

The pavement ended not far outside town, when we turned off the main road. The rest of the 2.5 hour trip was made on a rock and dirt road that slithered along the long green slopes of the undulating mountains, about half-way between the gullies below and the rocky peaks above.

Most stretches of the road are only a sliver of leveled ground, made flat by stacked-rock walls on the downhill side and compacted dirt and rocks beneath the tires. (The tires, by the way, have life-spans of months here, not years.)

Our first stop was Moeketsane Clinic, a rural medical outpost where we stopped to see if there were any referrals to TTL. This day, there weren't.

Our next stop was in a small gathering of rondavals, or small round stone structures with thatched roofs, where one of TTL's young clients lives with his family. We were there to deliver "plumpy nut," or a peanut-buttery superfood for hungry babies.

After we measured the little boy's height, weight and MUAC, or middle upper-arm circumference -- three numbers that can be used to assess health and nourishment based on age -- we walked back to where the TTL car was parked to give his grandmother (and primary caregiver) the "plumpino."

It was then that the woman told us there was another sick baby, just a few rondavals away, who was also being taken care of by her grandmother. The tiny girl was not already a TTL client, so we decided to go check her health.

Shortly after walking into the dark, smoke-scented rondaval, we knew she needed our help. At two-and-a-half years old, little Selloane was only 6.7 kg, or just under 15 lbs. For her height and gender, that meant she was severely underweight. Seeing her spindly arms and legs was an emotional sight.

Selloane's yellow Bukana, or health booklet, showed the local clinic had suggested she be taken to the hospital a week or two prior, but the grandmother said transportation could not be arranged or afforded. (It was slightly frustrating that the clinic hadn't referred Selloane to TTL.)

Selloane's mother was gone, working somewhere in Maseru, and the grandparents did not know the mother's HIV status. Little Selloane had never been tested.

Kirsten and I conferred quickly with Matello, our lead outreach worker, and we all came to the same conclusion: The child should be taken to the hospital immediately -- by us.

After discussing this with the grandmother, we headed off to meet three other TTL clients and their mothers back at the clinic, where we distributed some more food and formula. Selloane's grandmother prepared herself for the long trip to Mokhotlong, then walked with her granddaughter to meet us at the clinic.

Not long after, we were all in the TTL car together. Little Selloane cried at first, then got tired and slept wrapped in a traditional blanket in her grandmother's lap. She occasionally woke again during some of the roughest parts of the road, and cried in an unsteady pattern of labored moans.

Last night, both Selloane and her grandmother stayed the night at the Mokhotlong hospital, which is next door to TTL.

I'm not sure how long their stay there will be. But it wouldn't have happened without TTL picking up the hospital and transport bills.

Perhaps equally important, little Selloane will now be a TTL client. Next time an outreach team finds her, it will be for a planned check up, and we'll likely have food or other resources in hand to give her grandmother.

Selloane will also be tested for HIV, so we'll know her status and can design a contact plan with it in mind.

This is TTL's work firsthand. What if we hadn't found her?

Sunday, February 14, 2010

Back in Business!

Greetings from Mokhotlong!

This is Kevin Rector, the newest TTLF Fellow in town, and here's the scoop: This blog is back in business!

As most of you probably know, my brother Reid and his wife Bridget started and authored the blog through much of last year, during their own TTLF fellowships. Now that I'm here -- I arrived two days ago -- I'm hoping to revive it, so you should all start checking in again!

I'm going to try to provide what Reid and Bridget did so well: a blend of personal anecdotes about rural Lesotho, news from the hustle and bustle of the safe home and updates on TTL's institutional progress.

I'll also try to continue some of their best ideas for posts, like staff profiles, updates on babies and video and photos.

My background is in journalism, so I'm hoping my itch to write will keep me posting quite often.

Now, in case you've been wondering since Reid wrote his last post almost six months ago:

The potholes on the ride out here from Maseru, Lesotho's capital, are still plentiful. The views of the mountains are still gorgeous. The people are still friendly, and the children are still adorable.

The safe house is still busy. I think there are seven little ones here now, and I got the pleasure of playing with them for the first time yesterday. I'm still trying to conquer the steep curve of learning everyone's names and how to spell them. But, I held one of the little guys -- walking around and showing him various things in the play room -- until he fell asleep sucking his thumb in my arms.

After months of preparing to come here and working through a long list of logistics, it was a really simple but no less awesome experience to have, one that reminded me again of the true mission and heart of TTL.

Hopefully I can post some pictures of the babies soon. They are certainly TTL's stars!

Tomorrow I will get to work, along with Kirsten, the other fellow, and I'll try to write soon about some projects we are working on. The potential for continuing progress here is palpable, and I'm going to do my best to convey that on a regular basis.

I hope you'll join me here, and point others to this blog as well. The more people who are part of the discussion, the better.

All best from Mokhotlong,