The following are some things that have surprised me during our time in Cavango, a rural area in Angola:
A percentage of children are expected to die. When taking a history on a patient with children, we find that virtually all women have lost children. When asked how many they have, a common answer is, “I had 7, and 5 are living”, or even, “I had 10 and lost 4”. What a tragedy it is to loose a child. Here, families actually expect to lose them, whether to illness, to difficulties during labor, or to miscarriage.
Lack of control. The people are used to the thought process: whatever happens, happens. I was shocked at a reaction a patient had when we told her that we found a colon tumor on ultrasound, and that she only has a year to live. She reacted by saying, ok, with no change in facial expression. It truly seemed to not phase her. She sat for a prayer, and then she walked out just as she walked in, no questions asked. Death is an anticipated part of the culture; they do not try to stave it off like we do in the US. There really is no means to do so.
No designated facility to go number #1 and #2. The people relieve themselves anywhere outside. They strongly reject the idea of having a place to defecate where others already have gone. They believe that if they defecate on top of someone else’s droppings, the evil spirit that left that person could enter into them. It also just does not make sense to them why anyone would go in the same spot as someone else. Why would anybody want to go into a stinky, dirty place when they could go outside in the breezy, open air?
Women do a lot of heavy lifting. They have a large amount of daily work responsibilities, such as gathering wood for fire, fetching water, gathering corn and mushrooms (the only foods I’ve seen them eat), and cooking. They carry everything on top of their head, often in very large baskets or plastic tubs, over far distances. I have yet to figure out how they are able to get that huge load up there! We have quite a few women who come into the clinic complaining of back pain, understandably!
I am constantly wowed by the people here. There will be more culturally shockful posts to come.