What They Taught Me

What the eye sees, the heart never forgets.

— Malawian proverb

 

After three months of Peace Corps training, I am sent to live and work in Mchoka, a village in Malawi, Africa, where I will serve as an AIDS extension worker. When I first arrive, I wander around the parched, red-dirt landscape, searching for people who might listen to the AIDS speech I’ve been taught to deliver.

In front of the village chief’s mud hut sit a circle of women rubbing dried corn cobs together, the speckled kernels falling into open baskets: tap, tap, tap. When they see me, they start to laugh and talk in quiet voices.

“Oh, onani apo, azungu nenepa kwambiri.” Oh, look at that very fat white woman.

At five-foot-eight and 140 pounds, I am not a small woman, but no one has ever called me “very fat.”

In our training they told us, “Your task is to forge connections and alliances with the villagers.” Without these connections, I can do nothing. So I walk to the edge of the circle and say, in Chichewa, “Moni nonse, ine ndi Ami.” Hello, everyone. My name is Amy.

More polite laughter.

“I want to chat with you about AIDS.”

The laughter stops. Heads look down. Hands become busy.

“Would you like to chat?”

One woman directs her gaze to the right of my head: in this small East African country, it is impolite to look someone straight in the eye. The woman sitting next to her jabs her in the side. She puts her head down and does not raise it again.

Since I don’t know what else to do, I launch into my prepared monologue. With each phrase I recite, I feel more uncomfortable. The women listen obediently, adults transformed into children. We are not connecting.

I later learn that most of the villagers already know what white people have to say about AIDS. Although they listen respectfully, in practice they disregard it. It is estimated that up to 15 percent of the villagers carry the HIV virus.

I spend many nights alone at my house, a cement box with a corrugated tin roof. I think a lot about sex. Why? Because I am here to teach the villagers about a disease that is spread through intercourse. Because I live alone in an isolated village. Because I am twenty-three years old.

 

Peeling blue and white paint marks the Mchoka Health Center. From nine to five every day, Nurse Saidi sits in a rolling chair with a broken wheel and attends to her patients. In the labor-and-delivery room, the same steel buckets that catch the white embryonic fluid and blood of childbirth are also used to mop the floors. The medical-supply room contains only aspirin and a dusty box of expired condoms. There is no bathroom, no electricity, no running water.

I have followed Abambo Banda, the man who sells bananas at the Tuesday market, to the health center. He carries his grown daughter on his back. She is so thin that her thighs are like sticks. People sit, stand, and sprawl all over the gray hallways and floors. Many display the characteristic signs of AIDS: cataracts in the eyes and ulcerated skin. A man with cholera lies in a puddle of clear, rice-water diarrhea. I watch the liquid pour out of the top and bottom of his pants. It smells sour, like vinegar.

A woman lying on the floor grabs my leg. Her cloudy, unfocused eyes are a symptom of malaria. “Give me . . . Give me,” she says, squeezing my leg with her hot hand. I reach down to remove it.

Abambo Banda circumvents the line and tries to walk straight into Nurse Saidi’s office. The waiting patients protest, and Nurse Saidi steps out to investigate the noise, her mouth tight, as if she’s just bitten into a lemon.

Nurse Saidi is the only practitioner for sixteen thousand villagers. She arrived at Mchoka Health Center a few weeks ago. Before then, the center was closed, because there was no one to staff it. Nurse Saidi has fled her abusive husband and left behind five young children: in Malawi, under all circumstances, the children belong to the father.

I asked her once if she misses her children. “Of course,” she told me. “But I’d rather they live without me than watch me get beaten.”

Now she yells, “Stop it, everyone! Stop it! I do not like all of this noise.”

Abambo Banda approaches her with his daughter, who looks as if she has fallen asleep or passed out. Her eyes are closed, and a stream of pasty white saliva rolls down her chin. Nurse Saidi looks at the girl, feels for the pulse on her neck, and announces, “She’s dead.”

Abambo Banda begins to wail: a deep, throaty howl that makes me think of curdled milk.

Nurse Saidi tells him to go outside. Then she attends to the next person in line.

 

I stand facing a queue of Malawian women with babies strapped to their sides and backs. Behind me are white plastic bags — labeled World Food Bank in blue — full of soy-corn flour. Together with two Malawian healthcare workers, Mercy Kuzimva and Mrs. Kazembe, I am distributing the flour to the mothers. Mrs. Kazembe, who is older than Mercy and I, gives the orders. The three of us are wearing brightly colored sarongs to cover our knees. (In Malawi, knees are sexually suggestive; breasts are not.) Many of the women are shirtless and shoeless. Their bare breasts hang like pancakes, and the exposed heels of their feet are cracked and crusty, like stale brown bread. The parched earth beneath us cannot produce enough food to feed everyone who lives on it. The sparse vegetation — hollow baobab trees, arthritic bushes, too-thin stalks of new corn — sticks out of the ground with exhausted persistence.

The midday sun burns the sweat off the women’s bodies; salty white trails line their faces and necks. I know many of them by name. In the mornings and evenings, I fetch water from the well where they congregate to scrub their pots and bowls with their bare hands. I buy goods from them at the Tuesday market — matchbooks and bars of hot pink glycerin soap.

To more efficiently give away the food, Mercy, Mrs. Kazembe, and I split up the tasks: Mercy determines which babies are malnourished enough to qualify for food aid. After each mother unwraps her child, Mercy lifts the infant’s arm, leg, or eyelid to search for signs of malnourishment. If a baby qualifies, the mother is sent over to Mrs. Kazembe, a sinewy woman with a square patch of greasy hair that glints in the sun like damp steel wool. Mrs. Kazembe shovels two scoops of flour — roughly the amount in a box of cereal — into the mother’s open bag. I prepare the big bags of soy-corn flour: dragging each one from the storage shed, shaking down the contents, and opening it by pulling the string along the top. I’ve just finished opening the last six bags. The line of waiting mothers stretches away from us for almost a quarter mile.

The mother at the head of the line, an obese woman named Amayi Banda, steps forward and shows Mercy her child. Amayi Banda sells fried potatoes, called “chippies,” at the Tuesday market; her own frequent consumption of chippies has given her an unusually large girth. Mercy searches her baby boy for signs of malnourishment: Is he suffering from a deficiency of protein in his diet? Is he starving?

Mercy holds up one of his fat, dimpled arms and announces, in Chichewa: “This baby looks fine. You don’t need food.”

Amayi Banda shakes her empty bag and demands, “Ndipatseni. Ndipatseni.” Give it to me. Give it to me.

“No,” Mercy says.

The waiting women start to cluck their tongues in disapproval. I can’t tell whom they’re unhappy with: Mercy for refusing to provide food, or Amayi Banda for demanding it. The two women stare at each other for a moment, and then Amayi Banda yanks her empty bag to her belly, pulls her baby boy to her bosom, and walks away with steps so heavy they raise clouds of red dust around her feet.

While Mercy waits for the next mother to step forward, she pulls on her long, braided hair and picks at the chipped red polish on her fingernails. I wonder if Mercy is intentionally flaunting her good fortune — a diet nutritious enough to produce shoulder-length hair and long fingernails. Most of the women in line have short, brittle hair and paper-thin nails.

The next mother unties the cloth holding her baby to her back and presents him to Mercy. The baby’s body is distended, and his enormous head — two or three times the normal size for a child his age — floats, as if filled with helium, at the top of his neck. His tiny features are almost lost in the middle of his puffy face: a nose, a mouth, two eyes sealed shut by yellowish pus. This child has kwashiorkor: his internal organs are swollen, and his body is full of toxic fluid. I reach a hand out toward him. The skin on his swollen arm crumbles beneath my touch. When I pull my hand away, his skin sticks to my fingers and falls to the ground in dry flakes. Mercy indicates to the mother that she will receive food.

As Mrs. Kazembe scoops the flour into the mother’s green-and-orange cloth sack, she yells at the mother in Chichewa: “He’s going to die! You have not fed your child. I will give you this food, but you probably won’t even give it to your child. You’ll feed your husband, yourself, and your older children. Won’t you? Won’t you?”

The mother simply keeps her head bowed low and repeats, over and over, “Zikomo, zikomo.” Thank you, thank you.

Mrs. Kazembe is right. If the child is near death from malnutrition, then the rest of the family must also be hungry. According to Malawian custom, the husband eats first, then the wife, and then the children, in order of age. Often no food is left for the youngest.

Mrs. Kazembe finishes pouring the second scoop of flour, and the mother, still hunched over, walks away.

Earlier in the day, I asked Mrs. Kazembe why she shouted at the women.

“It’s my job as a health worker to educate them,” she told me.

I also asked Mercy why so many children starved in Malawi.

Mercy said, “God misses them so much that he wants them back.”

Now Mrs. Kazembe turns to me and says, “Amy, come here.”

She motions for Mercy to back away, and I find myself facing the next mother. The determined lines of Mrs. Kazembe’s lips and brow inform me that it is my turn to decide which babies are most in need of food.

The next mother, a slight woman named Amayi Sokho, shows me her sleeping child. The baby looks like a bird, her tiny body all bones. She starts to fidget and rolls her head back and from side to side. Her lids flutter up, and her blind eyes wander around in their sockets.

They don’t name the newborns here for several weeks or months. Those who die are buried in unmarked graves. The mothers aren’t supposed to mourn their unnamed children.

I take a long, deep breath and nod to the mother: Yes, your child needs food. With the plastic shovel I heave two large scoops, more than the other women received, into her bag. I do not look at the mother. I do not look at the child. When I am finished and the mother has sealed her bag and left, I turn and walk away. Mercy and Mrs. Kazembe shout to me, asking where I’m going, telling me to come back. I do not answer.

I walk directly to my house. Once inside, I use duct tape to hang two skirts over my windows, securing all the edges so that no one can see in. Then I dig into my duffel bag and take out the cardboard box my grandmother has sent me. In the box are ten packages of Reese’s peanut-butter cups, a bag of Hershey’s Miniatures chocolates, four bags of Pepperidge Farm Goldfish crackers, and a bag of Fritos.

In breathless bites, I eat it all.