It was easy enough not to think about during the first half of training. We were all busy adjusting to the new culture, getting to know each other, our teachers and our host families, and galvanizing our stomachs against the new food. But by the time the second half of training rolled around, it became the question on everyone’s mind: where on earth am I getting sent for the next two years?
To be fair, we did get some say in where we went. During the summer we had placement meetings where we got to express our site preferences. Like any selfless Peace Corps volunteer with a mild savior complex, my top priority was of course to be at the site where they felt I could do the most good. Then, all other things being equal, I wanted to go somewhere with other PCVs I could collaborate with (and hangout with, and commiserate with…), especially a business volunteer since I want to get more into the economic development side of things after I finish here. And just in case the powers that be were feeling especially generous, I’d also take some nice mountains and rivers if it wasn’t too much to ask. That’s good, they said, usually if you can come up with a few different things you want we can probably give you at least one of them—but of course it’s good not to get your hopes up too much.
Then as the diabolical and prolific Peace Corps rumor mill got spinning, there of course were hints. Rumor had it most of my language class was getting sent to the East. East, I thought, well not much in the way of mountains or rivers, but hey, who doesn’t enjoy a vast, featureless steppe? We had been told there also weren’t any health sites in UB, the capital, or in Bayan Olgii, the far western province that was almost entirely Kazak and required switching language training at the end of the summer. This again seemed to confirm my going east.
And there was also what we could deduce through reason. As one of the few health volunteers, I knew I had a pretty high chance of being placed in an aimag center, i.e. a provincial capital, and hence I would probably live in an apartment. At first I found this a little disappointing since a part of me was looking forward to the experience of life in a ger—not to mention the extra hardcore points you rack up living in a felt tent during a -40 F winter. Though in time I came to realize, as much as I wanted that experience, more so I wanted to be as effective a volunteer as I could, and that probably wasn’t going to be the case if I had to spend a huge fraction of my time and energy shoveling coal, building dung fires, and thawing my toothpaste every morning.
It wasn’t until our second site placement interview though that things really started to get interesting. Have you ever heard the expression, “Don’t do something well because you’ll probably get asked to do it again?” Because I’m pretty sure the Mongolia site placement staff certainly have. Our meeting started out with some unsolicited praise of my resume, which I appropriately took as a sign to brace myself.
We see here you’ve volunteered in quite a few developing countries… (nod) …And that your undergraduate studies were also very relevant for the type of public health work Peace Corps focuses on… (nod) …Which is why we’ve decided to almost certainly send you to a “fix-it” site. (quizzical single eyebrow raise)
Now there are basically three types of Peace Corps sites a volunteer can go to: a new site whose host agency has never had a previous volunteer, a site whose host agency had a good relationship with its previous volunteer, or a site whose previous volunteer is making the host agency consider never speaking to Peace Corps again. I’ll let you guess which one a “fix-it” site is.
Now don’t worry, they said, of course it’s hard to know how much the problem stemmed from the volunteer or the host agency, but we’re sure you’ll do fine. Oh, and by the way, no one at your health department speaks any English. Good luck on your language proficiency exam!
Marvelous, I thought. Good thing my evening study time has been replaced by practicing the Jalam Har till my lungs collapse every night.
Then as the summer wound down everyone, including myself, became increasing ambivalent of the prospects of shipping out to site. On the one hand, by the end of training, each day seemed more of an exercise in patience than language, culture or technical knowledge. Yet at the same time we had all come to recognize the cruel joke that all the people you had trained with, and grown closest to over the summer, composed the only small group of people you were guaranteed not to get placed with at site.
Like it or not though, site placement day finally rolled around, and when they unfolded the giant map of Mongolia that covered about half the gym floor, it quickly got a lot more tangible. And then when someone said if you’re within arm’s length of the person next to you, that’s about a five hour commute, it started making sense why we’re one of the few Peace Corps countries that gives out cell phones for emergencies and our sanity.
Well, East, I thought as I waited to hear my name called, the longest site that way is only about 12 hours by bus. Not terrible considering some of the western fly-sites are about three straight days on a bus when Peace Corps won’t pay for a flight. At least this way I can afford to meet up with people in UB every so often.
Then, to my surprise, I was one of the first people called. I looked at where the other people at my site who had already been called were standing—about two feet away from the western tip of the country. I started reading my info packet. It began: “***** is remote, even by Mongolian standards.” Fly-site, approximately three straight days drive from the capital, under good weather conditions, if the bus doesn’t breakdown. About as far west as you can go before everyone starts speaking Kazak. I looked across the map at my friends as they slowly got called. I couldn’t have even hit any of them with my six foot lacrosse stick, let alone touch them. So much for that.
Disappointing as it was at the time though, I’ve since come to realize I’ve actually probably got one of the best sites in Peace Corps. Firstly this aimag center is in many ways the capital of western Mongolia so to speak. It’s fairly large at about 30,000 people, gets a decent amount of amenities from trade with Russia and China, and has a beautiful, mountainous, desert landscape with a nearby pair of parallel rivers. It’s also a secondary head quarters for many NGOs outside of Ulaanbaatar, which means lots of people to work with and good potential sources of funding. It also means there are several other foreign researchers and volunteers (Swiss, Russian and Danish), which on top of the other 6 PCVs living here, means we are some of the few volunteers who have something resembling a normal social life. Plus we’re on the standard Central Asia travel route so we even get the occasional couch surfers as well—such as the French Canadian, self-proclaimed gypsy couple that played the accordion for tips to fund their adventure across Asia.
After the ominous foretelling of a fix-it site, work has also been surprisingly smooth—though I can’t say as much for my introduction with my director, Dr. Jamsran. Having missed the formal introduction ceremony and luncheon due to flight trouble, the only time I spent with him before coming to Khovd was a brief afternoon of mildly awkward Peace Corps group workshops, usually sans translator. Then before parting ways we agreed on when I would meet him to take our taxi to the airport. “Margash bid nar heden tsag yawen we?” (“Tomorrow we what time go?”), I asked in my broken Mongolian. “Dzorgan tsag,” (“Six o’clock”) he answered. Just to be sure, I rephrased my question and asked again, after all I certainly didn’t want to start my relationship with my boss for the next two years on the wrong foot. Same response: six o’clock.
After far too short a night’s rest, I woke up at 4:30 am to give myself plenty of time to shower, eat, and hit the ATM before we left. Not a minute after my alarm went off I heard a knock at my door. Must be one of my friends with an earlier flight wanting to say good-bye, I thought to myself, or maybe just someone with the wrong room. So I stumble to the door half-wake, disheveled from the previous night’s revelries and wearing only my boxers. As I open the door, the only thing that keeps my jaw from hitting the floor is the surge of adrenaline that hits me as I discover not only my director, but his daughter and toddler grandchild patiently waiting for me in the hall. Apparently six was when we're supposed to be at the airport.
My brain instantly starts reeling as it leaves my body paralyzed in the doorway. No call, no text. How did he even know where my room was in this enormous dormitory?! I stammer out an “uchlaarai” (“sorry”), as I swiftly close the door on him, his daughter and his grandchild, and begin furiously dressing and trying to get my hair to not look like I’m impersonating a homeless Conan O’Brien. Having broken several land speed records packing and hauling my immense amount of luggage downstairs, I then got to suffer the further embarrassment of having to ask to stop at an ATM on our way to the airport.
Despite that possibly being the most embarrassing moment of my life, you'll all be happy to know I’ve made a full recovery, and surprisingly I don’t think my relationship with my director actually suffered much because of it. At the time he really took it in stride, and since then I’ve learned that since Mongolians have traditionally been housing entire families in gers the size of large camping tents, privacy is something that is virtually non-existent in Mongolia. And then on top of that, since during our New Year’s Party several men in our health department sacrificed their pants during a women's cross-dressing competition, I’d say my own faux pas wasn’t in fact too big a deal.
As I’ve worked here, my relationship with my director and coworkers has been very amicable. From what I’ve gathered, the tensions with the last volunteer a few years ago came from the fact that she felt underutilized since the Health Department never gave her much to do, and the Health Department thought she was lazy since she never did very much. Fortunately however, though it may not be as easy or efficient as getting a specific assignment, I’m quite ok with finding my own work to do. So far, aside from my requested English and computer classes, that’s included iodine deficiency education, helping children with disabilities, sex education, alcohol seminars and installing enough free anti-virus software to make Norton rollover in his grave. Unlike the TEFL volunteers who make more of a measured impact everyday with their classes, I feel like my most lasting impacts will come from projects that I do that are more high risk, high reward. I’m sure most of my pursuits will be dead ends, but I think if I can get a few projects to stick, I’ll feel like I did my part.
Like my work, my apartment was also pleasantly surprising—even despite the occasional sheep slaughter on the sidewalk outside. It’s quite large, four rooms, about 700 sq feet—pretty much the size of my old host family’s actually. It was fairly well furnished, aside from the kitchen, which more or less consisted of a sink, rice cooker, hot plate, uneven card table, and a duct tape patched pot, which created some excitement the first time I tried to cook with it. Despite the separate living room and bed room, I moved everything into one room to conserve heat, an indispensable strategy in winter I’ve heard, especially when the electricity and/or hot water goes out, as it briefly does a few times a week. I figure the smaller bedroom can serve as a walk-in fridge. I also have a TV, with cable, which means I get all the fuzzy Mongolian television I can watch. Aesthetically the apartment is pretty nice too, though the wavy, light blue and white wallpaper makes you feel like you’re in a glacier, which I fear may be a little too prophetic. However, it still beats my friend’s place which literally has shining gold leafed walls, and a golden shag futon. It pretty much feels like you’re in 70’s version of King Tut’s tomb.
The town itself here also has quite a lot of character. Like most areas of Mongolia there are occasional, scattered animal remnants, and the packs of stray dogs perennially battle the cows for the scraps around the garbage pyres. The local outdoor market is enormous and constantly bustling year-round with people selling everything from sheep heads to camel-wool vests to Pantene Pro-V. The dual rivers on the edge of town are beautiful and make for a wide, lush plain where people go to play, picnic and do laundry when the weather allows it. Though what I’m sure I’ll always remember the most about Khovd is Red Mountain, a craggy, crumbling mountain on the edge of town that looks different every hour of everyday, and which cradles the sun and the moon as they rise each day and night.
Though perhaps less than glamorous, I could still certainly think of much worse places to live for two years.
Thursday, December 30, 2010
Tuesday, October 12, 2010
At Long Last, Pictures
So I've finally got around to uploading my first album of pictures from Mongolia. These start at the beginning of training and go up through swearing-in and my various adventures here at site. You can download any of the pictures using the "download" tab in the upper left above the pictures. Hope you enjoy them.
http://picasaweb.google.com/ned.lederer/Mongolia#
http://picasaweb.google.com/ned.lederer/Mongolia#
Thursday, September 16, 2010
End of the Beginning
First off, my apologies for taking so long to get the word out on what I’ve been up to. The second half of our training this summer was far busier than the first, and it’s only now that I’ve settle in at my new site that I’ve gotten the chance to catch up with myself. However, before I get too far ahead of myself let me begin where I left off.
The second half of our summer began with Nadaam, the festival of the Three Manly Sports, which is the second biggest Mongolian holiday after Tsagaan Sar, the New Year’s festival, in the winter. Most aimag (“eye-mag”) centers (10-30,000 people) and soums (1-10,000) have their own local Nadaams consisting of a few days of wrestling, horseracing and archery competitions. Though a little dull to watch since you can only see the beginning and end of the several kilometer long courses, the horse races are never the less quite the spectacles to observe since the horses often collapse from sheer exhaustion during or after the lengthy races, and the jockeys are almost universally children, some as young as 3, chosen for their light weight. Not surprisingly, the practice has recently been under a lot of criticism as a human rights violation since almost every year a few children are seriously injured or even killed during the races throughout the country.
The wrestling is also quite a spectacle in its own right. The rules are unique in that the object is simply to get your opponent to hit the ground before you do; there are no boundaries or weight classes; and several matches are usually held simultaneously in a large arena. Probably most notably of all, however, are the wrestling outfits they wear. By Western standards, I would wager almost any amount of money that you couldn’t find a more herculean group of men out there, taking themselves so seriously, in such contrastingly emasculative clothing. But rather than try—and undoubtedly fail—to adequately describe the wrestling uniforms, I will simply refer you here.
The story behind these exceptional outfits is that years ago a woman entered and won the preeminent wrestling competition by wearing a man’s deel (the large traditional robes) to hide her gender. This, of course, was an intolerable affront to the male dominated sport, and Mongolian culture at large, so they in turn designed these outfits to universally bar women from participating in the sport, thereby reclaiming the dignity of the rightful male participants. On an unrelated note, no, irony is not a prominently featured topic in Mongolian literature. (My preemptive apologies for the ethnocentric jokes. I just couldn't help myself, and I'm well the US is guilty of far worse fashion movements.)
It was also during Nadaam that I first tried the infamous Mongolian Airag, i.e. the traditional drink of fermented mare’s milk. I was surprised in that it didn’t live up to my expectations of being as formidable as one might imagine, though I was equally surprised by how long the aftertaste lingers in one’s mouth. The best I can describe it is it’s like drinking a milk based wine that hits you with a strong, but tolerable, initial sour punch, followed by a lingering, unsettling milk-like flavor that nature hadn’t ever intended man to drink.
Our Mid-Center Days training was also a lot of fun since it was the first time we all got to see each other again since our first few days in country. Aside from another great middle school style dance party with our trainers and Mongolian teachers, I think my favorite part had to be getting to swap our stories of the quintessentially Mongolian, and otherwise just generally farcical, moments we had all gone through. For instance, one of my good friend’s host family was kind enough to get him a Mongolian horseback riding lesson …and then serve him the same horse for dinner the following evening. People from several different training sites had stories of getting shocked by their local ATMs, and on two separate occasions, it turned out a PCV’s host family had been squatting on their property. One of the times resulting in all of the volunteer’s stuff getting strewn out on the lawn when the family disassembled her ger to move without telling her. A friend of mine was served a sealed beer filled with water, and another volunteer spent the night in a five person car with her host family of seven and two goats because they got lost on the way back from their trip to the hudoo (i.e. the rural countryside).
My own best story was the night I wound up sleep walking into the room where my host brother, 22, and sister, 20, were sleeping. I apparently woke them by tugging on their blankets, mumbling something along the lines of, “It’s like fun…” (which has since become something of our tag line of our training this summer), before my host siblings somehow finally got me to go back to bed without waking me. The next day then played out like the amnesia-driven plot of a B-list movie as I tried to figure out why my family is acting so weird towards me, followed by me trying to profusely apologize and explain the concept of sleepwalking in my broken Mongolian.
However, there have also been some stories that crossed the line from the comically frustrating and uncomfortable into the seriously regrettable. Domestic violence is a huge, and largely unaddressed, problem in Mongolia. Most Mongolians consider it within the rights of each family to resolve internal conflicts, and therefore there is little outside intervention from neighbors, the authorities or anyone else. Out of the 15 volunteers in our town during training, at least three of them observed some form of domestic violence within, or involving, their host family, creating no small amount of tension within their living situations. During our final days in the capital before shipping out, I also witnessed an incredibly violent fight between two women on the steps of a bank, during which the guard standing ten feet away did nothing but stand there and watch. Even from across the street it was hard to stop myself from intervening, but as the Peace Corps warned us, to do so would expose us not only to physical danger, but a Kafkaesque legal system where we would receive little sympathy for having interfered where we didn’t belong. Understandably domestic violence has become an area of focus for many volunteers, and encouragingly the classes they have held seem to have so far been met receptively.
Fortunately though, those experiences have certainly been in the minority, and the second half of our training was overwhelmingly positive. Our first major event was having a Peace Corps sponsored traditional Mongolian horhug with our host families and language teachers. Now a horhug is like a big US barbeque in many respects: you go to a nice outdoor space, play games, and eat meat with your hands. The differences though are quite notable. First, instead of putting the meat in the grill, you put the grill in the meat, by which I mean you literally cook a goat/sheep/whatever by stuffing it full of searing hot rocks about the size of your hand. You then dismember the animal and put the meat in a giant, covered pot with some vegetables and the still hot rocks to cook some more. Then before eating, you remove the rocks and hand them to people to juggle until they are cool enough to hold—for absolutely no apparent reason. And, of course, you just can’t really compare nibbling on a chicken wing to ripping the meat off a goat’s scapula—though I have to admit the lack of A1 or BBQ sauce is a glaring detractor.
However, because our gratitude towards our host families could not be expressed in a single event (and because Peace Corps gave us more money), we had another Host Family Appreciation Day later in the summer. This time though the tables were turned, and the 15 of us volunteers spent the morning sharing an industrial sized kitchen with the staff of a Korean summer camp as we prepared pizza, onion rings, lemonade, brownies, apple cinnamon hoshurs (think small calzones), and pasta salad—which I made, and hence unsurprisingly later primarily served as dog food—all the while listening to the Korean kids and their full-sized, yellow, teddy bear mascot sing camp songs in the adjoining room. The party then consisted of us feasting in the school auditorium, performing via karaoke our limited Mongolian repertoire, as well a few American songs, and then having those of us who were learning dance pieces for our swearing-in ceremony perform those as well. And yes, there is going to be another post covering that whole dancing saga.
The second half of training also held our first community outreaches in conjunction with our family clinics. As much as the projects were designed to benefit the communities we were serving in, they were also designed to familiarize us with the challenges of working in a less results-oriented culture. And did they ever. Despite getting along very well with the counterparts in our clinic, it was quite the challenge to ever actually meet with them to work on our project or hold English classes for them. On the whole, about three times out of four, despite them choosing the time and location of our meetings, they wouldn’t make it for some reason. In fact, one of the most productive meetings we had was when our group of PCVs caught them during a break at a medical training seminar, and we just had an impromptu meeting on the spot.
The real kicker though was the day of our final anti-smoking presentation that we been building up towards for a few weeks. We went to the clinic and not only had we lost our venue, which was previously the poorly lit hallway of a kindergarten next door, but because it was about 50° F with a little wind and drizzle, they thought too few of the 30-40 doctors and nurses we were supposed to present to would come due to the bad weather. That’s right, a little drizzle and light wind at 50 degrees Fahrenheit is insurmountable weather—in Mongolia. However, after a few remarks from our training coordinators behind closed doors—or at least behind a pretty sizable language barrier—and the presentation was back on. We just didn’t quite know where and for whom quite yet…
This led us to another clinic across town where we quickly scrambled to find power outlets, chairs and participants for our hastily rescheduled presentation. Slowly Mongolians of all ages start trickling in as we realize our clinic doctors are simply calling everyone on their contact lists to try to boost attendance. We now faced a couple dozen Mongolians, age 5-75, without the hour of preparation we had expected, in a new, overly crowded venue, with a presentation designed for medical professionals. Wonderful.
Quickly our well planned concert of educational lectures, interactive games and group competitions, devolved into an exercise in improvisation and damage control as we tried to adapt our materials to the new circumstances sans translator. As we floundered to explain our objectives to our clinic’s head doctor who was doing most of the actual talking, we passed around candy to try to placate our audience, while also realizing we don’t have a way to make hot drinks, a transgression no doubt akin to a personal betrayal given Mongolian culture and the “awful” weather.
After an about an hour or so of awkwardly interrupting ourselves as we stumbled through our presentation, we start to feel the relief that only the end of such a prolonged debacle could bring. Then, entirely unexpectedly, one of the oldest gentlemen in the room stood up, and though we couldn’t understand his exact words, it’s clear he is giving us the most heartfelt expression of appreciation you could ever imagine an anti-smoking presentation receiving. Needless to say, we were stunned. And as the session ended and we started to get feedback from our trainers and our fellow PCVs, we were pleasantly surprised to find that despite the setbacks, they felt we handled it well, and the staff at our clinic were truly impressed with, and very grateful for, the effort we put into the presentation and educational materials we made for them. Then, when a few days later when we went to the clinic to say our final good-byes, the staff each gave us a Chingis Khan key chain, a miniature morinkhuur (the traditional horse-head fiddle), and a lovely card teaching us how to write our names in traditional Mongolian script, which currently resides on the wall of my new apartment.
Then as training wound down, we had our final days all together at site where we received even more warnings about STIs, the Mongolian drinking culture, and our inevitable gastrointestinal ailments—which in fact a few of my site mates and I are suffering from as I write. And, of course, we had a final dance party with our language teachers, PCV trainers and all. Finally the 75 of us packed up our bags, said our tearful good-byes to our host families, and loaded up the buses for our final stretch together in Ulaanbaatar before being flung to the far corners of the steppe.
Once in UB, as one might expect, our group of young twenty-somethings responsibly saved all of our substantial moving-in allowance, and celebrated our last few evenings together modestly, while enjoying the various historical and cultural monuments the world’s coldest capital has to offer…or something like that. I, for one, especially enjoyed my first joint Mexican/Indian food restaurant, and finally got to try the infamous American Burger and Fries, which after two and half months of mutton, did not disappoint. Our days in UB ultimately peaked with our spectacular swearing-in ceremony, which as I hinted at before, will be covered in detail in another update. Though I think it’s very interesting, and worth mentioning here, that Peace Corps Volunteers in fact take the US Oath for Federal employees, i.e. the one you usually associate with military service about protecting the Constitution from all enemies foreign and domestic, etc. If you’re interested, you can find it in its entirety here.
Anyways, our final days together went by far too quickly, and even our final hurrah at a grungy roller rink-disco hybrid with an enormous Scrooge McDuck spray painted on the wall, couldn’t entirely make up for the knowledge that we would soon part ways for several long months with the great friends we made that summer. Fortunately though, as I believe we are the sparsest active Peace Corps country, we are among a small subset of volunteers worldwide that get PC issued cell phones, and with increasingly available internet access, we will at least be able to keep in touch, if not in sight.
The second half of our summer began with Nadaam, the festival of the Three Manly Sports, which is the second biggest Mongolian holiday after Tsagaan Sar, the New Year’s festival, in the winter. Most aimag (“eye-mag”) centers (10-30,000 people) and soums (1-10,000) have their own local Nadaams consisting of a few days of wrestling, horseracing and archery competitions. Though a little dull to watch since you can only see the beginning and end of the several kilometer long courses, the horse races are never the less quite the spectacles to observe since the horses often collapse from sheer exhaustion during or after the lengthy races, and the jockeys are almost universally children, some as young as 3, chosen for their light weight. Not surprisingly, the practice has recently been under a lot of criticism as a human rights violation since almost every year a few children are seriously injured or even killed during the races throughout the country.
The wrestling is also quite a spectacle in its own right. The rules are unique in that the object is simply to get your opponent to hit the ground before you do; there are no boundaries or weight classes; and several matches are usually held simultaneously in a large arena. Probably most notably of all, however, are the wrestling outfits they wear. By Western standards, I would wager almost any amount of money that you couldn’t find a more herculean group of men out there, taking themselves so seriously, in such contrastingly emasculative clothing. But rather than try—and undoubtedly fail—to adequately describe the wrestling uniforms, I will simply refer you here.
The story behind these exceptional outfits is that years ago a woman entered and won the preeminent wrestling competition by wearing a man’s deel (the large traditional robes) to hide her gender. This, of course, was an intolerable affront to the male dominated sport, and Mongolian culture at large, so they in turn designed these outfits to universally bar women from participating in the sport, thereby reclaiming the dignity of the rightful male participants. On an unrelated note, no, irony is not a prominently featured topic in Mongolian literature. (My preemptive apologies for the ethnocentric jokes. I just couldn't help myself, and I'm well the US is guilty of far worse fashion movements.)
It was also during Nadaam that I first tried the infamous Mongolian Airag, i.e. the traditional drink of fermented mare’s milk. I was surprised in that it didn’t live up to my expectations of being as formidable as one might imagine, though I was equally surprised by how long the aftertaste lingers in one’s mouth. The best I can describe it is it’s like drinking a milk based wine that hits you with a strong, but tolerable, initial sour punch, followed by a lingering, unsettling milk-like flavor that nature hadn’t ever intended man to drink.
Our Mid-Center Days training was also a lot of fun since it was the first time we all got to see each other again since our first few days in country. Aside from another great middle school style dance party with our trainers and Mongolian teachers, I think my favorite part had to be getting to swap our stories of the quintessentially Mongolian, and otherwise just generally farcical, moments we had all gone through. For instance, one of my good friend’s host family was kind enough to get him a Mongolian horseback riding lesson …and then serve him the same horse for dinner the following evening. People from several different training sites had stories of getting shocked by their local ATMs, and on two separate occasions, it turned out a PCV’s host family had been squatting on their property. One of the times resulting in all of the volunteer’s stuff getting strewn out on the lawn when the family disassembled her ger to move without telling her. A friend of mine was served a sealed beer filled with water, and another volunteer spent the night in a five person car with her host family of seven and two goats because they got lost on the way back from their trip to the hudoo (i.e. the rural countryside).
My own best story was the night I wound up sleep walking into the room where my host brother, 22, and sister, 20, were sleeping. I apparently woke them by tugging on their blankets, mumbling something along the lines of, “It’s like fun…” (which has since become something of our tag line of our training this summer), before my host siblings somehow finally got me to go back to bed without waking me. The next day then played out like the amnesia-driven plot of a B-list movie as I tried to figure out why my family is acting so weird towards me, followed by me trying to profusely apologize and explain the concept of sleepwalking in my broken Mongolian.
However, there have also been some stories that crossed the line from the comically frustrating and uncomfortable into the seriously regrettable. Domestic violence is a huge, and largely unaddressed, problem in Mongolia. Most Mongolians consider it within the rights of each family to resolve internal conflicts, and therefore there is little outside intervention from neighbors, the authorities or anyone else. Out of the 15 volunteers in our town during training, at least three of them observed some form of domestic violence within, or involving, their host family, creating no small amount of tension within their living situations. During our final days in the capital before shipping out, I also witnessed an incredibly violent fight between two women on the steps of a bank, during which the guard standing ten feet away did nothing but stand there and watch. Even from across the street it was hard to stop myself from intervening, but as the Peace Corps warned us, to do so would expose us not only to physical danger, but a Kafkaesque legal system where we would receive little sympathy for having interfered where we didn’t belong. Understandably domestic violence has become an area of focus for many volunteers, and encouragingly the classes they have held seem to have so far been met receptively.
Fortunately though, those experiences have certainly been in the minority, and the second half of our training was overwhelmingly positive. Our first major event was having a Peace Corps sponsored traditional Mongolian horhug with our host families and language teachers. Now a horhug is like a big US barbeque in many respects: you go to a nice outdoor space, play games, and eat meat with your hands. The differences though are quite notable. First, instead of putting the meat in the grill, you put the grill in the meat, by which I mean you literally cook a goat/sheep/whatever by stuffing it full of searing hot rocks about the size of your hand. You then dismember the animal and put the meat in a giant, covered pot with some vegetables and the still hot rocks to cook some more. Then before eating, you remove the rocks and hand them to people to juggle until they are cool enough to hold—for absolutely no apparent reason. And, of course, you just can’t really compare nibbling on a chicken wing to ripping the meat off a goat’s scapula—though I have to admit the lack of A1 or BBQ sauce is a glaring detractor.
However, because our gratitude towards our host families could not be expressed in a single event (and because Peace Corps gave us more money), we had another Host Family Appreciation Day later in the summer. This time though the tables were turned, and the 15 of us volunteers spent the morning sharing an industrial sized kitchen with the staff of a Korean summer camp as we prepared pizza, onion rings, lemonade, brownies, apple cinnamon hoshurs (think small calzones), and pasta salad—which I made, and hence unsurprisingly later primarily served as dog food—all the while listening to the Korean kids and their full-sized, yellow, teddy bear mascot sing camp songs in the adjoining room. The party then consisted of us feasting in the school auditorium, performing via karaoke our limited Mongolian repertoire, as well a few American songs, and then having those of us who were learning dance pieces for our swearing-in ceremony perform those as well. And yes, there is going to be another post covering that whole dancing saga.
The second half of training also held our first community outreaches in conjunction with our family clinics. As much as the projects were designed to benefit the communities we were serving in, they were also designed to familiarize us with the challenges of working in a less results-oriented culture. And did they ever. Despite getting along very well with the counterparts in our clinic, it was quite the challenge to ever actually meet with them to work on our project or hold English classes for them. On the whole, about three times out of four, despite them choosing the time and location of our meetings, they wouldn’t make it for some reason. In fact, one of the most productive meetings we had was when our group of PCVs caught them during a break at a medical training seminar, and we just had an impromptu meeting on the spot.
The real kicker though was the day of our final anti-smoking presentation that we been building up towards for a few weeks. We went to the clinic and not only had we lost our venue, which was previously the poorly lit hallway of a kindergarten next door, but because it was about 50° F with a little wind and drizzle, they thought too few of the 30-40 doctors and nurses we were supposed to present to would come due to the bad weather. That’s right, a little drizzle and light wind at 50 degrees Fahrenheit is insurmountable weather—in Mongolia. However, after a few remarks from our training coordinators behind closed doors—or at least behind a pretty sizable language barrier—and the presentation was back on. We just didn’t quite know where and for whom quite yet…
This led us to another clinic across town where we quickly scrambled to find power outlets, chairs and participants for our hastily rescheduled presentation. Slowly Mongolians of all ages start trickling in as we realize our clinic doctors are simply calling everyone on their contact lists to try to boost attendance. We now faced a couple dozen Mongolians, age 5-75, without the hour of preparation we had expected, in a new, overly crowded venue, with a presentation designed for medical professionals. Wonderful.
Quickly our well planned concert of educational lectures, interactive games and group competitions, devolved into an exercise in improvisation and damage control as we tried to adapt our materials to the new circumstances sans translator. As we floundered to explain our objectives to our clinic’s head doctor who was doing most of the actual talking, we passed around candy to try to placate our audience, while also realizing we don’t have a way to make hot drinks, a transgression no doubt akin to a personal betrayal given Mongolian culture and the “awful” weather.
After an about an hour or so of awkwardly interrupting ourselves as we stumbled through our presentation, we start to feel the relief that only the end of such a prolonged debacle could bring. Then, entirely unexpectedly, one of the oldest gentlemen in the room stood up, and though we couldn’t understand his exact words, it’s clear he is giving us the most heartfelt expression of appreciation you could ever imagine an anti-smoking presentation receiving. Needless to say, we were stunned. And as the session ended and we started to get feedback from our trainers and our fellow PCVs, we were pleasantly surprised to find that despite the setbacks, they felt we handled it well, and the staff at our clinic were truly impressed with, and very grateful for, the effort we put into the presentation and educational materials we made for them. Then, when a few days later when we went to the clinic to say our final good-byes, the staff each gave us a Chingis Khan key chain, a miniature morinkhuur (the traditional horse-head fiddle), and a lovely card teaching us how to write our names in traditional Mongolian script, which currently resides on the wall of my new apartment.
Then as training wound down, we had our final days all together at site where we received even more warnings about STIs, the Mongolian drinking culture, and our inevitable gastrointestinal ailments—which in fact a few of my site mates and I are suffering from as I write. And, of course, we had a final dance party with our language teachers, PCV trainers and all. Finally the 75 of us packed up our bags, said our tearful good-byes to our host families, and loaded up the buses for our final stretch together in Ulaanbaatar before being flung to the far corners of the steppe.
Once in UB, as one might expect, our group of young twenty-somethings responsibly saved all of our substantial moving-in allowance, and celebrated our last few evenings together modestly, while enjoying the various historical and cultural monuments the world’s coldest capital has to offer…or something like that. I, for one, especially enjoyed my first joint Mexican/Indian food restaurant, and finally got to try the infamous American Burger and Fries, which after two and half months of mutton, did not disappoint. Our days in UB ultimately peaked with our spectacular swearing-in ceremony, which as I hinted at before, will be covered in detail in another update. Though I think it’s very interesting, and worth mentioning here, that Peace Corps Volunteers in fact take the US Oath for Federal employees, i.e. the one you usually associate with military service about protecting the Constitution from all enemies foreign and domestic, etc. If you’re interested, you can find it in its entirety here.
Anyways, our final days together went by far too quickly, and even our final hurrah at a grungy roller rink-disco hybrid with an enormous Scrooge McDuck spray painted on the wall, couldn’t entirely make up for the knowledge that we would soon part ways for several long months with the great friends we made that summer. Fortunately though, as I believe we are the sparsest active Peace Corps country, we are among a small subset of volunteers worldwide that get PC issued cell phones, and with increasingly available internet access, we will at least be able to keep in touch, if not in sight.
Tuesday, July 6, 2010
Life on the Steppe
Another couple weeks in and time has continued to fly. We’ve definitely found our rhythm of Mongolian class for 4 hours in the mornings, a break for lunch, and then another 3 hours of technical and/or cross-cultural training in the afternoons. On the whole, I think the classes have been as good as one could reasonably expect—especially the language training which I’ve been especially impressed with—though they certainly aren’t without their trying moments. For instance I’ve got a packet on the Mongolian health insurance system that could cure insomnia, and some of the advice we get on how to take of care of ourselves can get a little patronizing, but overall I think it’s been quite well run.
After class we all head back for dinner with our host families, who are in charge of all of our meals, and we’re supposed to be working on list of cultural and domestic activities meant to prepare us living on our own. Most are fairly inane or banal like learning games and cooking Mongolian food, but we’ve also got a few along the lines of herding sheep, observing an animal being slaughtered and learning the Mongolian waltz, which are going to be interesting to say the least (especially for those of you who know how well I can dance).
We’ve also started getting a few good stories under our belts from the last couple weekends. The first was the 13 mile hike that a group of did last week. It started with a hike to the nearby ruins and temples tucked into the hills, and ended with a trail-less ascent of the highest peak we could see from our town. Aside from the fantastic view from the top, my favorite highlight was the boulder fields we crossed that were littered with spiders the size of a silver dollar that would spin webs over every other crevasse.
A couple days ago we also had our first Mongolian karaoke session at the same place I went for my host sister’s 21st birthday—which, it turns out, is because it’s more or less the only night club in town. The main area is also exclusively decorated in red and green, including the lasers, which more or less makes it feel like a perennial disco Christmas party, though aside from that it’s actually surprisingly nice, all things considered. A group of the volunteers here in town all got together with our Mongolian teacher, Oogii, “Aw-gi”, (who I’ve actually gotten to know quite well since she is also a close friend of my host family), and a few of our host family siblings and parents, who we got to tag along for some dancing before moving upstairs to our own karaoke room. Unfortunately only a few songs in the power for the whole town went out, but we still had a great time hanging out by candle light waiting for the power to go back on before the police finally came and told us we should probably go. Undeterred however, we managed to pull some strings and have one of the volunteer’s host mothers open up her ДЭЛГYYP (“delguur”)—i.e. convenience store—for some snacks and drinks before migrating to one of the volunteer’s gers for the remainder of the evening.
We also got some mozzarella brought in from UB (Ulaanbaatar) the other day, so a bunch of the volunteers got together to make some pizza. We only got a couple slices each, but thanks to a good friend of mine who provided me with some last minute Italian seasoning and garlic powder they were still absolutely delicious.
Of course it hasn’t all been smooth sailing, however. On Saturday we played a few games of basketball against the business volunteers in almost 100° F heat, which left me with a skinned elbow, a bloody nose and a good case of dehydration despite drinking almost 3 liters of water while we were out there. More so than anything else though, it left me in desperate need of a shower—a real shower (i.e. the kind that doesn’t come from my lime green, plastic tumpen). However, I still had yet to activate my ATM card so that meant a trip to the bank in my sweaty athletic gear, towel in hand, to withdraw the fee I needed for the local bathhouse. Two banks, three attendants and 45 minutes later, I’m walking home in the midday heat, dirty as ever, because “activate an ATM card” never came up in any of the games of charades I’ve ever played.
There were also a few aesthetic details about Mongolia that I’ve realized I failed to mention in my last post. The first comes from the fact that until only a handful of decades ago, Mongolians never used to have anything that wouldn’t get eaten or biodegrade if they just threw it on the ground. This in turn has meant that it’s about as easy to find a public trashcan here as it is to find a blonde Mongolian. Consequently, my first morning here, I awoke from jetlag at about 4:00 am and decided to watch the sunrise. And as I looked across the field outside our dormitory, I noticed the ground was literally sparkling, giving this already picturesque scene a truly fantastic quality. That was of course until I realized they were the shards of countless broken vodka bottles… However, you would be surprised how quickly you get used to the broken glass. What takes a little longer is acclimating to the partially decayed quadruped jawbones and vertebrae speckled amongst the rest of the litter. And what almost certainly takes the longest of all is getting used to the post-slaughter piles of evacuated sheep-bowel contents that occasionally get wrung out along the side of the road. My apologies if you were planning on eating any time soon.
Rumor has it we’ve also had the first member of our M-21 group early terminate (ET). Most of us only knew him for a few days, but he was a cool guy, and hardly one that we would have expected to leave so early. Apparently though he was quite unhappy with the level of English he would be teaching and decided to leave before he got too far into things. I guess you just never know.
The weather has also gotten impressively volatile as of late as well. Contrasted with the early morning frost we had when I wrote my last post, we’ve recently been going through a bone-dry heat wave that regularly gets up to nearly 100° F as I mentioned before. It also comes with pretty spectacular, tree-bending wind, which I’ve heard is usually more characteristic of the spring here. Especially in the afternoons, you can sometimes watch small sandstorms blow in across the town stirring up a sandy haze and generating little dust devils on the corners of buildings. However today the wind finally blew in another cold front, and with it a mild thunderstorm that left us less than dry even after only the few minute walk back from playing frisbee in the park.
Overall though I’d say everyone’s been having a really enjoyable time, and we’ve got a few things coming up to look forward too. We’re about to have our summer holiday for Nadaam, the festival of the three manly sports, and the other volunteers are all coming back to our site for a view days so we can all spend some time together. I have no doubt it will provide some more stories worth sharing.
After class we all head back for dinner with our host families, who are in charge of all of our meals, and we’re supposed to be working on list of cultural and domestic activities meant to prepare us living on our own. Most are fairly inane or banal like learning games and cooking Mongolian food, but we’ve also got a few along the lines of herding sheep, observing an animal being slaughtered and learning the Mongolian waltz, which are going to be interesting to say the least (especially for those of you who know how well I can dance).
We’ve also started getting a few good stories under our belts from the last couple weekends. The first was the 13 mile hike that a group of did last week. It started with a hike to the nearby ruins and temples tucked into the hills, and ended with a trail-less ascent of the highest peak we could see from our town. Aside from the fantastic view from the top, my favorite highlight was the boulder fields we crossed that were littered with spiders the size of a silver dollar that would spin webs over every other crevasse.
A couple days ago we also had our first Mongolian karaoke session at the same place I went for my host sister’s 21st birthday—which, it turns out, is because it’s more or less the only night club in town. The main area is also exclusively decorated in red and green, including the lasers, which more or less makes it feel like a perennial disco Christmas party, though aside from that it’s actually surprisingly nice, all things considered. A group of the volunteers here in town all got together with our Mongolian teacher, Oogii, “Aw-gi”, (who I’ve actually gotten to know quite well since she is also a close friend of my host family), and a few of our host family siblings and parents, who we got to tag along for some dancing before moving upstairs to our own karaoke room. Unfortunately only a few songs in the power for the whole town went out, but we still had a great time hanging out by candle light waiting for the power to go back on before the police finally came and told us we should probably go. Undeterred however, we managed to pull some strings and have one of the volunteer’s host mothers open up her ДЭЛГYYP (“delguur”)—i.e. convenience store—for some snacks and drinks before migrating to one of the volunteer’s gers for the remainder of the evening.
We also got some mozzarella brought in from UB (Ulaanbaatar) the other day, so a bunch of the volunteers got together to make some pizza. We only got a couple slices each, but thanks to a good friend of mine who provided me with some last minute Italian seasoning and garlic powder they were still absolutely delicious.
Of course it hasn’t all been smooth sailing, however. On Saturday we played a few games of basketball against the business volunteers in almost 100° F heat, which left me with a skinned elbow, a bloody nose and a good case of dehydration despite drinking almost 3 liters of water while we were out there. More so than anything else though, it left me in desperate need of a shower—a real shower (i.e. the kind that doesn’t come from my lime green, plastic tumpen). However, I still had yet to activate my ATM card so that meant a trip to the bank in my sweaty athletic gear, towel in hand, to withdraw the fee I needed for the local bathhouse. Two banks, three attendants and 45 minutes later, I’m walking home in the midday heat, dirty as ever, because “activate an ATM card” never came up in any of the games of charades I’ve ever played.
There were also a few aesthetic details about Mongolia that I’ve realized I failed to mention in my last post. The first comes from the fact that until only a handful of decades ago, Mongolians never used to have anything that wouldn’t get eaten or biodegrade if they just threw it on the ground. This in turn has meant that it’s about as easy to find a public trashcan here as it is to find a blonde Mongolian. Consequently, my first morning here, I awoke from jetlag at about 4:00 am and decided to watch the sunrise. And as I looked across the field outside our dormitory, I noticed the ground was literally sparkling, giving this already picturesque scene a truly fantastic quality. That was of course until I realized they were the shards of countless broken vodka bottles… However, you would be surprised how quickly you get used to the broken glass. What takes a little longer is acclimating to the partially decayed quadruped jawbones and vertebrae speckled amongst the rest of the litter. And what almost certainly takes the longest of all is getting used to the post-slaughter piles of evacuated sheep-bowel contents that occasionally get wrung out along the side of the road. My apologies if you were planning on eating any time soon.
Rumor has it we’ve also had the first member of our M-21 group early terminate (ET). Most of us only knew him for a few days, but he was a cool guy, and hardly one that we would have expected to leave so early. Apparently though he was quite unhappy with the level of English he would be teaching and decided to leave before he got too far into things. I guess you just never know.
The weather has also gotten impressively volatile as of late as well. Contrasted with the early morning frost we had when I wrote my last post, we’ve recently been going through a bone-dry heat wave that regularly gets up to nearly 100° F as I mentioned before. It also comes with pretty spectacular, tree-bending wind, which I’ve heard is usually more characteristic of the spring here. Especially in the afternoons, you can sometimes watch small sandstorms blow in across the town stirring up a sandy haze and generating little dust devils on the corners of buildings. However today the wind finally blew in another cold front, and with it a mild thunderstorm that left us less than dry even after only the few minute walk back from playing frisbee in the park.
Overall though I’d say everyone’s been having a really enjoyable time, and we’ve got a few things coming up to look forward too. We’re about to have our summer holiday for Nadaam, the festival of the three manly sports, and the other volunteers are all coming back to our site for a view days so we can all spend some time together. I have no doubt it will provide some more stories worth sharing.
Monday, June 14, 2010
First Week In
Writing this now it’s very hard to believe I’ve only been here for a week. Probably because in that short period of time I’ve already met—and said good bye to most of—about 90 people, gone through a few dozen hours of language, culture and technical training, learned a new alphabet, and begun living with my host family here.
Pre-service training (PST) began with 5 days of the 75 of us living together in a dorm near the high school where we started our training. As you might expect, training initially consisted of learning the basic cultural norms and pleasantries, how to try to prevent, and inevitably deal with, our gastrointestinal maladies, what number to dial for a med-evac, and a general request that we employ our common sense whenever possible. However, we did also learn a few gems like how wrestling foreigners is something of a past time for certain ethanol-philic host country nationals (HCNs); how sometimes throwing rocks at a dog is the only way to keep it from biting you (hence why we’re all getting the rabies series—which I’m pretty sure now means I have virtually every vaccine I can possibly get); and how occasionally you have to take a hammer to the frozen stalagmite that’s been growing all winter in your outhouse.
However, if those represent the more trying aspects of service here, then the flipside has to be the people we’re working with. I can easily say I’ve liked every PCV, staff member, and HCN I’ve spent time with here so far, and that goes double for the six other male health Peace Corps Volunteers (PCVs) I roomed with for the first five days—one of whom for which this is quite impressively his first time outside the US. Currently the seven of us and the two female “healthies” are stationed with host families in apartments, houses and gers throughout the same city we did our initial five days in, alongside the half a dozen or so Community Economic Development volunteers (CEDs) with whom we’ll have cross-cultural training a couple times per week.
Unfortunately with the Peace Corps’ security policy, we’re not allowed to post the specific locations of PCVs, including ourselves, but I can say that we’re stationed south of Ulaanbataar (UB), and that the other Teaching English as a Foreign Language (TEFL) volunteers and Community Youth Development (CYD) volunteers are also stationed to the south and east of UB. When I arrived I was surprised to find out that about 60% of the M-21s (i.e. the 21st group to go to Mongolia) were here as TEFLs, and that only a handful of us are focused on health, CYD and CED. (Though I should note that almost everyone winds up working on something outside their specialty on the side.) Also I’ve found out that due to the “clustering” system they have here, it’s likely that I’ll be stationed in a larger city, likely an aimag (i.e. provincial) center, along with a volunteer from each of the other specialties. The idea is that grouped together we can help each other get access to more resources outside our specialty and more easily create inter-specialty projects. The company from my fellow PCVs will also undoubtedly be a plus, but being in a big city also means I’ll likely be living in an apartment and not in a ger, which I have mixed feelings about since I was looking forward to that experience. Of course an apartment—though not without its own hardships (such as not being able to control the temperature in the winter)—may likely be less laborious since I’ll be spared having to haul water and coal/wood/dung, and having to use an outhouse, so I guess I’ll just have to see how I feel about it once I get there.
Currently for these three months of PST, I have my own room in my host family’s apartment, which is surprisingly nice, and being on the fourth floor, has a magnificent view of the surrounding area. It’s close to the town center and the primary school (where we’re quite appropriately currently learning out “A, Б, Вs”), and despite the “soul-crushing” soviet architecture as one fellow PCV so aptly put it, the recently remodeled interior could be right out of the US—well, aside from the sparkly, periwinkle, floral relief wallpaper in my room. That might be a little hard to come by at home. But in terms of day to day living, the only real differences are the slightly limited cooking methods in the kitchen (just a hot plate for steaming and frying), the need to heat water in an electric kettle, and bathing in a large plastic basin called a tumpen.
Living with me are my retired host mother, 53, who used to be an accountant, and my host brother, 22, and sister, 20, both of whom are students. However, the other older brother, 28, who serves as a police officer, often visits with his wife and newborn, and the other sister, 30, who is studying in Singapore, will also be visiting for a few weeks this summer. Everyone has been very nice and accommodating, and my younger sister speaks enough English to communicate the basics, but without speaking well enough to rob me of my motivation to learn Mongolian. So far our activities have consisted largely of laughing at my attempts to speak Mongolian, laughing at my attempts to make Бyy3 (“boatz”, a type of steamed dumpling) and other Mongolian food, throwing around my frisbee and watching the world cup. Pretty par for the course from what I’ve heard.
And while the architecture may be less than inspired, the natural scenery here is absolutely gorgeous. Most days have been crisp and sunny, often with scattered clouds and the “big sky” effect of places with similar latitudes in the US like Montana and Idaho. Though the few days of rain we have had has made the smooth hills near our town a verdant green that gracefully rolls into the more distant, forested mountains. The high altitude, low humidity and northerly winds also give everything a crisp, fresh feeling, and while it has gotten cold enough to frost a few of these nights, I’ve felt well prepared for the cold and have actually been rather enjoying it (once the daily high is -5 F I may be singing a different tune though).
The food here has also been better than expected. Many of the larger towns, including where I am now, have decent access to fruits and vegetables, especially apples, oranges, carrots, cucumbers, potatoes, tomatoes and cabbage. However, they do seem to traditionally be used rather sparingly. Most meals consist chiefly of rice or a white flour noodle/dough base, some form of beef or mutton, and a rather mild seasoning. A bowl of candy, pieces of fried dough and slightly sweet biscuits are seem to be a staple in every kitchen. Basically it’s like a young, picky eater’s dream come true. The only thing of questionable palatability for me so far has been the “tu tset te”, or milk tea as it’s called in English. It’s basically just watered down, hot, salty milk that may or may not have had a tea bag dipped in it briefly. It was ok as a broth for a soup I had, but it’s kind of tough to drink straight up, especially once it gets into the tepid to cold range. The current PCVs say it’s an acquired taste. For now I’m playing the lactose intolerant card.
Anyway, I already have a few people I know want my address here, but for anyone else who wants it, or just wants to know what city I’m in, just email me at ned.lederer@gmail.com and I’ll be happy to let you know when I can. Questions and comments are also more than welcome. Hope everything is well for all of you back in The States, and I’m looking forward to sharing my next adventures with you sometime soon.
Thursday, June 3, 2010
Off Again
Let me start by apologizing for taking such a long hiatus with my updates. I have yet to close out my time in Vietnam with a final update as planned, though I'll mention that the highlights included leading a very creative sexual education tour, tying off my first sutures, and having BJ Novak (writer and actor on The Office) buy me breakfast in a Cambodian airport. For those of you interested, you can also view my photo album from the trip here: picasaweb.google.com/ned.lederer/Vietnam#
Now I'm off again for my 27 month assignment in Mongolia, beginning with three months of language, culture and community health training in the capital city of Ulaanbaatar. I'll be working as a Health Specialist Volunteer, likely teaching sex education, nutrition and education to prevent sex trafficking, though I won't know where specifically I'm assigned until the end of the summer. While in training my address will be:
And I will post my long term location as soon as I can. I'll keep posting updates here and start a new online photo album as internet access permits.
If you have suggestions, questions or specific topics you would like me to cover while I'm in Mongolia, please feel free to email me at ned.lederer@gmail.com.
Now I'm off again for my 27 month assignment in Mongolia, beginning with three months of language, culture and community health training in the capital city of Ulaanbaatar. I'll be working as a Health Specialist Volunteer, likely teaching sex education, nutrition and education to prevent sex trafficking, though I won't know where specifically I'm assigned until the end of the summer. While in training my address will be:
Jordan Ned Fosse Lederer, PCT
Post Office Box 1036
Central Post Office
Ulaanbaatar 15160
Mongolia (via China)
And I will post my long term location as soon as I can. I'll keep posting updates here and start a new online photo album as internet access permits.
If you have suggestions, questions or specific topics you would like me to cover while I'm in Mongolia, please feel free to email me at ned.lederer@gmail.com.
Friday, January 8, 2010
New Perspectives
After what was becoming a somewhat lonely couple weeks living solo in the guestrooms, I was pleasantly surprised when three new volunteers arrived at hospital. In true Vietnamese impromptu fashion, I had no idea they were coming until I ran into them in the hall, and while I was at first reluctant to have to split the internet connection four ways, the four of us quickly hit it off. One of the volunteers, Sara, is a Swiss physical therapist (PT) who just got her degree, and who is staying through the end of January. The other two are a Vietnamese-American couple from San Jose who stayed for about three weeks. The woman, Mai Huong, is a PT whose family left Vietnam when she was a young girl, and the husband, Minh, left Vietnam when he was about 18 and, as he would say, is still learning English in the US as an adult. He’s also an IT specialist, so he set up a wireless router for the guestrooms, solving that problem.
Since both Mai Huong and Minh are fluent in Vietnamese it has been really enlightening to get to learn so many things from them that I would be unlikely discover on my own. For instance they introduced me to a new dessert shop in town that sells a delicious concoction of all kinds of different flavored, sweet beans mixed with ice, coconut milk and a sweet paste. They also informed me of the Vietnamese custom of never praising the appearance of a child because the spirits may overhear you and decide to steal the child. Instead the proper etiquette is to compliment a child as being well behaved, to which the parent will then agree or disagree before lamenting how unfortunate it is that their child is so skinny and ugly. Additionally in Vietnamese culture, almost everyone gets a sort of official nick-name that is used informally as we would a person’s first name. And again to deter evil spirits, in some rural areas parents even go so far as to give their children nick-names like dirt, urine or feces in attempts to disguise them as something extremely unappealing to the spirits. Minh had a friend whose mother called him Fart until he was 18 years old.
I also learned that many of the hospital staff were members of the North Vietnamese army during the Vietnamese-American War. One of them even told Minh that they were about a month away from surrendering due to a lack of supplies and the incessant bombing when the war ended. I’ve also just recently seen the tragic and moving War Remnants Museum in Ho Chi Minh City, as well as the ingenious and impressive underground tunnel complexes about 70 km outside the city. Both are certainly worth seeing for their perspectives on the conflict. However, I must admit as a whole I haven’t been particularly impressed with HCMC. Someone mentioned it’s largely considered more of a business oriented city, rather than much of a destination, and I’d have to agree.
Much more interesting were the outings the four of us volunteers took to My Son and Hoi An, two world heritage sites near Da Nang. My Son is a secluded grouping of ancient Hindu ruins, impressively built without any form of mortar by the Champa dynasties between 300 and 1300 AD. Hoi An, in contrast, is best described as what you get when you give the invisible hand of economics a giant sewing machine and put it to work in a quaint, historic, Vietnamese coastal town. There is little doubt in my mind that it would win hands down in a worldwide tailors-per-square-kilometer contest. I would conservatively estimate 50-70 in the small area if you also include custom shoe shops. The custom clothing and other handcrafted items market makes Hoi An a huge destination for tourists. You can get a tailored suit for as little as $40, a very high quality suit for $150, and tailored silk dresses for as little as $15. It’s pretty much Adam Smith’s personal utopia set in French colonial Indochina.
I’ve also learned a lot from Minh and Mai Huong about the mindset of the people towards the government and vice versa. From their description, most people in Vietnam, especially within the younger generation, view participation within the communist political party simply as something you do to get a good job, rather than as a reflection of their personal ideological beliefs. More interestingly though is the government’s view of the people. The Vietnamese government is often criticized for the limitations it sets on citizen’s freedom of speech, for instance prosecuting those who publically denounce the government, and blocking access to networking websites like facebook (so don’t expect me to respond to my wall posts anytime soon). However, from what was described to me, the government itself even sees this as a less than ideal situation. Rather they view the restrictions as a stopgap measure to maintain what they currently see as the country’s top priority: peace.
With the recent suffering of such a terrible war still fresh in the minds of the government and the people, both groups see peace as the primary concern facing the country. Despite this, however, the government still perceives a threat from the country’s uneducated masses. It isn’t that they are a threat in and of themselves, but rather that they are a large group that could be easily taken advantage of by someone wishing to reignite a conflict. I hardly pretend to understand the situation well enough to have a well supported opinion on the matter one way or the other, but it definitely made me think when I first heard this rationale, and I would say it certainly seems a defensible position.
The most interesting insights though have been what I’ve learned through Minh and Mai Huong about the inner workings of the hospital. Before I understood in a general way that the communist government had a hand in the hospital’s affairs (they funded the new building for instance), but I didn’t know what all that exactly entailed. From Minh and Mai Huong, I learned that the most significant way the communist system affects the hospital is by creating an incentives system very different from our own in the US. Now before I go on, let me just preface this by saying that I don’t mean this at all to be a criticism of the hospital staff, or for this to detract from the great work that they are doing. As others have noted, Vietnam, as we know it today, is a country only about 40 years old and has been a world leader in its pace of development. As with all countries though, and especially the young, there are many ways to improve upon the current systems, and I think the current hospital system is one of those areas.
That said, the communist structure to the hospital seems to have created an internal operational system that doesn’t reward people for improvement. Promotions, for instance, seem to be based almost exclusively on political status within the communist party, rather than being based on professional merit. Due to the communist mindset of strict equity, there are also no financial incentives for the hospital staff to see more patients or improve their quality of care. The result is that the staff will get the same recognition from the hospital, and will receive the same compensation, regardless of their personal performance.
There is also a virtually complete absence of external pressures to improve the hospital’s performance. The Da Nang Orthopedics and Rehabilitation Hospital is the only public orthopedic center in the country, so there will always be a demand for their services, and there is currently no competition from other facilities to drive performance. Also due to the cultural mindset, and due to the lack of alternatives, patients are always completely trusting and deferential towards their physicians. The result is largely a lack of accountability to the patients beyond the doctor’s personal sense of obligation, which can be dangerous. Minh and Mai Huong related that in extreme cases they have heard of at other hospitals, parents have been known to even allow physicians to hit their children if the child is misbehaving. This is of course the result of far more factors than simply the Vietnamese hospital structure, but I do feel like it does help to illustrate the huge imbalance of power within the system that reduces accountability.
The manifestation of this lack of driving incentives and accountability was most evident in the conversation the four of us volunteers had with a few Swiss surgeons who came to the hospital as part of an ongoing program to teach arthroscopic surgery (http://en.wikipedia.org/wiki/Arthroscopy). They had come to the hospital several months prior to teach the surgeons here the basics of arthroscopy with the stated expectations that they would practice, and hopefully master the basic techniques, by the time the Swiss surgeons returned. Instead virtually no progress had been made at the hospital since their departure, and the surgeons never got a very clear answer on why this had happened. The rumors included a lack of confidence to continue without supervision, a lack of motivation to practice, and a rumor about it being some sort of administrative decision. Whatever the case though, it was clear the system had failed to meet the goals set out by the program, even when the program was explicitly for the benefit of the hospital.
The Swiss surgeons also had other complaints about the hospital’s operational structure, which can also be in part linked to its lack of accountability and incentives within the system. For instance after using a tourniquet in the operating room for two days, the Swiss surgeons found it missing on the third day. The explanation was that it had been borrowed from the general hospital next door, and they had not thought they would need it that day, despite the fact that they were performing the same types of surgeries. It is also not uncommon for patients’ family members to have go to the market to buy gauze, sutures and other supplies for them mid-surgery if the hospital runs out. If the hospital had a system concerned more about performance, these obstacles would likely be ironed out.
The nature of these problems of course goes beyond just the organization of the hospital. In general, Vietnamese culture is one that is very much focused on the present. Obstacles are confronted as they come, and people take life at a slow enough pace that you can usually count on someone being free next door when you need to borrow a tourniquet. The traffic system is largely the same way: people get by just fine with a fairly chaotic system as long as things are taken at a slow enough pace. In fact, when the traffic is light, these relatively unstructured systems even seem to run smoother than the more structured kinds. (No getting stuck alone at a red light.) However, the problem with both the traffic and the hospital arises when you start dealing with a high volume flowing through the system. The current hospital system with its semi-chaotic structure simply has too much inefficiency to see the number of patients a similar hospital could elsewhere.
And the administrator of the hospital, Mr. Cuc, is aware of this. Having just returned from a trip to Seattle to study US hospital administration, he wants to see dramatic improvements in efficiency in the hospital. However, the impression Minh and Mai Huong got from the staff was that he was largely out of touch with lower levels of operation within the hospital. He is after all an engineer by education, not a doctor, who was appointed largely through his status within the party. I am not trying to imply that he is incompetent. He is an intelligent man who works earnestly to improve his hospital. However, it is clear that his placement was chosen for reasons beyond solely the performance of the hospital. And, in a nut shell, that is essentially the greater problem: the system doesn’t have performance improvement built in as a goal.
Minh and Mai Huong’s also noted that another serious impediment to the hospital’s improvement is the fact that the staff has largely developed the mentality that someone is always going to come help them. This is something that I have also noted myself to a certain extent. When volunteers come to give lectures or teach new techniques, instead of being seen by the staff as a great opportunity to learn, it has gotten to the point where they clearly see it as routine. Even the Swiss surgeons who came at great expense to teach a highly desired new surgical method were met with a high level of absenteeism from the surgeons, and to some extent a dismissive attitude from the administration. The Swiss surgeons also noted that when something would break, no one seemed to think it was their responsibility to fix or replace the piece of equipment. The prevailing attitude seemed to be that someone else will replace it, which of course has cast no small amount of doubt on how much my efforts are really helping in the long term.
And while this mentality is unfortunate, I think the staff can hardly be blamed for it. I would estimate they see over a couple dozen volunteers a year, and when it is so hard for much of what the volunteers teach to actually stick due to the lack of resources, coordination and follow up, it is easy to see how for the staff attending the lectures could become as much a polite gesture as a genuine opportunity to improve their skills.
As for my own project, four months has gone from being a significant chunk of time to the blink of an eye. I’m halfway done, and yet in many ways I feel like I’m just getting started. So far it looks like things are on track for the hospital’s equipment, though the going is slow with all the government bureaucracy. What I fear may be a missed opportunity though is the chance to help get resources to the other charities I’ve gotten in contact with. In true spontaneous Vietnamese fashion, one morning over coffee with our local shipping agent, he decided to invite a friend of his over who works with the Da Nang Charity Association. That afternoon I’m meeting with their executive director who gives me a run down on the whole organization, and we discuss one of their program branches’ need for ultrasounds and other medical equipment.
The same shipping agent even went so far as to set up a meeting for me with the program director of Giving it Back to Kids, another local NGO, to learn how to set up a Vietnamese regional NGO office, all because she was a friend of his who was single, and he thought we might hit it off. It turned out to be a great meeting, however, where I gained new contacts and potential resources. And of course I now know how to set up a Vietnamese regional non-profit office, which, for most, is probably the world’s most obscure and mundane piece of trivia.
I’ve also enjoyed a few more of the developing world’s bountiful surprises. A couple weeks ago I noticed that a few of the flecks of dirt on the floor of my bathroom were moving, which upon closer inspection turned out to be tiny worms a couple millimeters in length. Having just taken a class entitled “Parasites and Pestilence” last winter quarter, I eagerly collected a few samples in the lid of a peanut can and rushed to the CDC website to find out what kind of nematode was now likely trekking its way through my interstitial fluid. You can of course imagine my disappointment when they turned out to be too large to be any of the parasitic candidates. After Giardia in Peru this summer, I was really looking for the next notch in my belt.
The new volunteers have also had their first run-ins with the guestrooms’ deteriorating plumbing. I was annoyed at the time when I found the laundry machine full, but it turned out my neighbors had actually taken a bullet for me after we discovered their clothes had all been stained yellow by the rust in the water. I think it’s pretty safe to say the building will not be missed when it gets torn down—which the hospital administration assured me before I left for the holidays, will almost certainly not happen before I get back. I guess I’ll find out shortly.
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