My Stoop

Hello from Kiribati!

Yesterday I found a dead gecko in my dishwater.   I reached into the dishpan of gray, tepid water (with a subtle remnant of soapiness), and there it was in my hand: a dead gecko.

Let me say that this was a cataclysmic moment for my time here in Kiribati.  But perhaps that is getting ahead of myself, seeing as this is the first many of you have heard from me since I trotted off on this adventure.  Let me begin again…

Hello from Kiribati (say Kir-ee-bus)!  I know almost every one of you just said KIR-ee-BAT-ee.  What I get a kick of is that it was, in fact, an Englishman who created the written language of I-Kiribati.  It’s really too bad that “Hooked on Phonics” hadn’t existed back then… Anyhow…

This is week 3 of my time here in this tiny country in the central Pacific ocean.  Kiribati is a country made up of small coral atolls, twenty-eight of which are inhabited, spreading across over 3000 kilometers of ocean.  A coral atoll is a formation of dead coral built atop a dormant, deep ocean volcano.  There is only one true “island” in Kiribati has been long since strip-mined to bits for its phosphate reserves.  I am on the most densely populated atoll called Tarawa, which is overcrowded, ostensibly rural-feeling in spite of this, and the seat of national government for this small Pacific republic of 93,000 inhabitants.

As many of you know, I’m here doing an internship with the World Health Organization, linked obliquely to my medical studies at Dalhousie University. During this six week internship I was asked to provide technical assistance to the health-promoting schools program of WHO in Kiribati. Essentially this has meant meeting with government officials and organizing the logistics for the deployment of a health and hygiene education curriculum for primary schools, aimed at reducing the burden of worm infection (helminthiasis) among school children.

This project is quite complicated given the context and is fraught with obstacles.  Indeed, the project was initiated by WHO’s regional directorate in Manila as a tribute to the memory of one of the world’s leading parasitologists who died as a consequence of SARS, Dr. Carlos Urbani.  Kiribati was chosen as a country in which to pilot the project.  There was, however, only limited preliminary work done in partnership with the government here.  And that means I’m here, essentially, to catalyze local buy-in and commitment and get the ball rolling.  I won’t say much more about the work—it has been quite stimulating and I have loved working with WHO in both Manila and here in Kiribati.  There is a cadre of incredibly gifted professional staff in the region, and it has been a pleasure getting to know some of them.

Kiribati is a incredibly complex and challenging place.  It is a least developed country with all related economic consequences of this.   In spite of this, it has large resources for subsistence living.  Fish are plentiful. Anything grown is not, as the soil is not particularly arable for large-scale food crops.  The people are incredible.  The sequelae of poverty is apparent: infectious diseases like TB, diarrhea-related illness, micronutrient deficiencies (Vitamin A which causes night blindness, anemia from the lack of iron), worm infection, worsening chronic diseases like obesity, metabolic syndrome, and diabetes.   Social problems like rampant alcoholism, cava abuse, and domestic violence is woven into the fabric of society here.  The population pressures in southern Tarawa, where I am, are akin to Hong Kong.  Except here the water table is very shallow and there is limited sewage/septic systems.  90% of I-Kiribati (eee-Kir-ee-bus; the people) “beach toilet”, which means wading onto the sandbar or shallow water at low tide, and defecate on the beach.

There is a large lagoon, 10 kilometers or so in span, around which the islands of south and north Tarawa embrace.  While this lagoon is open to the ocean, causeways linking various islands and limited tidal exchange mean that the sea water is mostly stagnant.  And this is where beach toileting is practiced for the most part.  As a consequence, all of the reef fish are heavily contaminated.  The fish that people eat are mostly deep fish from the ocean proper.  Fish like yellow fin tuna (among the best I’ve ever eaten). Raw fish (sashimi) is a widely held taste and is indeed among the safest food because it has not been sitting around without refrigeration.  I’ll say more about food a little later.

There is electricity available only on south Tarawa, although a few of the “Outer Islands” have spot generators to run a refrigerator at a store.  There is extremely limited Internet access, almost entirely dial-up unless you have a satellite or live beside the telecom headquarters.  The only provider is this government-owned corporation that had a monopoly until last week.  There is essentially no television.  Radio is available a couple of times a day.

Transportation here is fascinating.  First off, the only international carrier offering flights to Kiribati is Air Nauru.  Now, before Christmas their plane was repossessed in Los Angeles for failure to pay bills.  There was a period of no flights before Air Nauru managed to charter flights from Air Pacific (a Qantas partner) and Air Alliance.  There are presently one to two flights to Kiribati per week:  One is direct from Fiji on Air Pacific and the other originates in Brisbane, Australia, and makes a milk-run to Honiara (Solomon Islands), Nauru, and then Tarawa, Kiribati.  It is extremely problematic because people get stranded in the country for weeks at a time.  Next week Air Nauru has opted to pull its flights which means all travelers will have to wait and see when the next will be available.  For the past two weeks, it has arbitrarily moved its flights from Thursday to Friday, meaning people with onward connections had to be reboot all flight segments.  It’s a bit humourous, actually.  There is a culture of patient understanding, it seems.

I have a crystal memory of arriving three weeks ago. As we broke through the clouds, a thin strip of land was revealed, hugged by crystal water which transmitted the deep azure of the coral beneath.  We landed at the international airport— quite literally a tarmac and a rough-looking “terminal” building (essentially open air). Apparently the tarmac is used for sleeping at night by locals and soccer games during the day by children.  They have to go over the runway before a flight lands to ensure there’s no one on it!

It was chaos in the “arrivals area”, with 200 eager passengers, mostly I-Kiribati with a handful of expat development consultants,  pushing their way to the immigration and health clearance counters.  I waited for nearly three quarters of an hour to get my bag (only 20 kg allowed).  I waited as they unloaded box-after-box of cigarettes.  That was certainly an indicator of what I would learn about health in the subsequent weeks.  (As an aside:  Recently a consultant for one of the UN agencies asked the government why alcohol and cigarettes were so cheap in Kiribati.  The answer: “So that people can afford them….” That illustrates it spot on.)

I was met by the WHO driver, in an ostentatious four-by-four Toyota SUV which has not practical value in a place like Kiribati.  We drove to my hotel, the Lagoon Breeze.  As we went along, I was intrigued by the fact that the land mass is so narrow that you can see the vastness of the Pacific through the trees on one side of the road, and the lagoon on the other.  Small thatched-roof homes on either side of the road, clustered around a “maneaba” – a community gathering spot akin to a community hall – but so much more.  And the people— the people were everywhere:  children wearing shorts, waving and yelling “I-matang” (people from the land of Matang – caucasians).  People in the water – swimming, playing, defecating.  And Pacific dance music blaring from anything that has the capacity to play music.

That is how my time in Kiribati began.  And I tell you, in spite of the challenges to the work, I’ve had a great experience.

I’m staying at the Lagoon Breeze.  It defines itself as a hotel (and is among the best in the country) but it is more like a rooming house.  The rooms are on the second floor and have refrigerators.  I’m in an air conditioned one (which is good because it’s 33C during the day).  It is clean, has hardwood floors (a rarity), a basic desk, a dresser, and a bathroom with a flush toilet.  There’s a common kitchen on the main level.  There’s sometimes gas for the stove and sometimes not.  The Lagoon Breeze is run by “Ronnice”.  His prices are akin to extortion in this country — $66 Australian per night.  I managed to negotiate him down to $40 per night which includes nothing.  I careless asked for laundry to be done last week and when it game back it had a bill for $67 (about the same Canadian).  I challenged him on this with no success but it teaches me a lesson!  I’ve been quite happy at the Lagoon Breeze. I had tried to find a flat-mate but there wasn’t any availability.  So in the end I just decided to eat the expense and stay there.

When I arrived in Kiribati, the WHO representative was out of country.  I was essentially on my own with the local staff at the WHO office.  I set to work on my health-promoting schools project but soon realized that meetings take time to set up.  I offered myself to UNICEF who were in the process of launching a nation-wide measles/rubella supplementary immunization program.  And I moved my project along day by day.

Being on your own also gives yourself incentive to get out and meet people.  As a result, I’ve met nearly every expat in the country.  Every gathering seems to bring in the entire “I-Matang” population:  Tonight there’s a big farewell party for a super Kiwi woman who’s leaving the country for good.  I’ve gone snorkeling with this cool chic Sarah (who’s been a super star in helping me to settle in).   Most people here are Australian or New Zealand volunteers and they seem to be filling senior ranks of government and the judiciary including the “people’s lawyer”, the chief prosecutor, and the solicitor general, the chief engineer, among others.  There are many expat teachers and volunteers with NGOs. There are several diplomatic missions in country, the Australian High Commission being the largest.  Greg, the senior AusAID (equivalent to CIDA for Australia) had a bunch of us back to his house for wine after the launch of the UNICEF campaign.  Last night we had a movie night which was well attended as well.  And dinners: I’ve been well cared for by my new friends.  I’ve tried to contribute to these feasts but, as yet, I’ve found it challenging to find much more than Weet-bix (the Aussie wheatabix) and UHT milk for food!

And that brings me back to my dishwashing (ahem, “washing up”) experience yesterday:  What does one do when one finds himself squeezing a dead gecko in a bowl of tepid water?  One screams profanities, lets go, and stomps back up to his room.  That has not been the only critter I’ve encountered.  There seems to be a rat—yes, a RAT, in the Lagoon Breeze. I woke up the other night to a crinkle-crinkle-crinkle sound of cheap plastic bags being moved about.  I grabbed my flashlight and directed it to that corner of the room.  And there he was: a rat about 9” long.  Having heard from my friends Jasmine and Damian that said rat had been spotted previously, I was prepared:  Ben, one of the other Australian volunteers, asked me to take his fishing spear home last week (he was heading in another direction).  Well, I propelled myself out of bed and chased the rat around and around until it exited my room through the panes of glass in my window.  And last night the rat chewed two holes in my curtains.

I hate rats.

The days in Kiribati were better when I hadn’t discovered dead geckos in the dishwater and rats in my bedroom.  Okay, perhaps cataclysmic was a bit of an exaggeration, but at least it kept you reading this far!

And the work is proceeding well. More on that and other details from this adventure sometime soon.

In the meantime, “tiabo” from the middle of the central Pacific.

Yours,
André