Peace Corps Potlatch

As I rode the furgon to and from Tirana this week, it seemed that about half the streets in Albania are torn up and being repaired. The new pocket park in the empty lot between apartment buildings near my home was recently finished. Water and electricity service are noticeably more reliable. It is no coincidence. Local elections are scheduled of the first week of May. I asked a friend if he thought it would be good if they could have elections year round. He said they had to pay for all of this after the elections and that the increased spending also meant increased payoffs through the various levels of corruption. He didn’t think it was so great.

I had to go to Tirana to have my eye seen by a doctor. I had tripped on the stairs at the nursing school where I teach a class. I did a face plant at the bottom. There was a fair amount of blood and lots of bruises on my face, chest, left arm and right leg. They crowded around, but I was able to get away from the surge of helpful students. I limped home and stopped the bleeding with a butterfly bandage and some pressure. I sat for awhile with ice over my eye. Ibuprofen was pretty effective. Nothing was broken and my vision seemed ok, so I got on with my work. I took it easy for a couple of days, but then the eye began to show signs of infection.

Pilots tend to be pretty cavalier about their health, but anything that might potentially ground them sends them running to the nearest clinic, preferably one that does not keep good records. Luckily, I don’t have to worry about the FAA on this one, as there was no abrasion of the cornea and the infection seems to be clearing with the prescribed antibiotic drops from the Peace Corps medical officer. Maybe I just did this in sympathy with Catherine.

I asked the country director if he thought the older volunteers were more fragile or more accident prone. He said no and that he had just had to send one of the young new volunteers home from pre-service training with a broken leg. All of the volunteers in my service group who are over the age of 50 have had health issues or injuries. Half have been medically separated from the Peace Corps.

I think the problem is that as we age we get used to our routines and supportive environment in our home community. Youngsters are not so enmeshed. Also, the Peace Corps medical services are very centralized in the country of service and the world, so any need for care pulls the volunteer out of the community and sometimes out the Peace Corps. In that, the treatment philosophy is like the military which relies of quick medical evacuation of wounded troops for comprehensive care. Unfortunately it is also the most psychologically stressful. Proximity of treatment and the maintenance of routines are techniques which the military has evolved to try to avoid secondary problems from “battle fatigue”. The Peace Corps does not seem to understand this and some of the problems I have heard of in the treatment of volunteers who have been medically separated and seen with Catherine’s care and other volunteers from my group may be a result of this. In her case, the disruption of waking up in London and then being plunked down in Tucson with an uncertain status and without a structured plan of treatment has been almost as stressful for her as recovering from the injury itself.

For me, my neighbors and Albanian friends called frequently and came by to visit. They brought gifts of food and probably would have brought raki, as well, if I drank alcohol. Actions of that sort seem to be reflexive among Albanians. Of course, I had to serve coffee and cookies to my visitors. Luckily, I have a pretty good stock in my pantry and my wonderful drip coffee maker allowed me to make coffee despite my physical impairments. I had to retell the story of my injury many times as my listeners intoned, “Bo, bo, bo, bo”, which is the shqip expression of sympathy. We would shake hands, hug with air kisses to both cheeks, and they would wish me “te shkuara” as they left. I would head back to my sofa and ice pack for a few minutes before the next group arrived at the door. I was also offered all manner of folk remedies, but I think I will limit the treatment of my eye to the prescribed eye drops, thank you.

Both before and after my misadventure, I have had visits from other Peace Corps volunteers to put dibs on my stuff. It is embarrassing how much I have accumulated in just two years, but a PC tradition is to pass it on to those remaining in the country. I wanted to give the volunteers in Korca first pick. One, from a previous group, who has returned to live in Korca because of an Albanian boyfriend, even recognized some of her stuff among my belongings, although she admitted a few items had been passed to her from her predecessors. The coffee maker will go to a volunteer who frequently has multiple houseguests passing through Korca. The matching dishes (service for 6) will go to another volunteer who likes to cook and entertain. Markers and crayons, and, especially, 3 by 5 cards are valued for teaching project. Good books are always passed around. I have some board games; Monopoly, Risk, Scrabble, and Twister. No one was particularly interested in Furgon Driver. There is not much novelty in something you live with every day. My oven thermometer, sewing kit, iron on patches for jeans, feather duster, and my large roll of duct tape elicited anticipatory cries.

My worn clothes will be given to the Catholic sisters for distribution in their work with the Roma community, although my coat, gloves and ski hat will go to Isufi and Macha for use at Bigell. My computer and associated paraphernalia are going to the older boy from Thane where I lived during PST (sadly, the boys never did get to Korca for a visit). I plan to travel pretty light on my way home and I hope not to have to ship anything.

The swelling on my face seemed to subside pretty quickly and the bruises almost look like a port-wine birthmark. People in Albania are very tolerant of abnormalities of appearance. They rarely seem to have benign growths removed from their face or neck. Large goiters are common. Noticeable limb abnormalities never seem to evoke a second look. I have been told it is part of the culture to accept “God’s will”, but maybe it is also because many are relatives or from large enough families that any disrespect would be avenged. I continued with my usual activities and even used my injury as a visual aid for a first aid lesson in my high school life skills class.

On Friday evening there was a string quartet recital at the Kultural Palace. They were from Tirana and played works by Mozart and Debussy. It was quite good and I noticed two things that were new to my experience in Albania. First, no cell phones went off during the entire performance. There were still noisy interruptions, however, as young people in cars, with political party flags flying, raced up and down the city streets, honking horns in support of their candidates. Second, after prolonged applause from the audience, the group played an encore.

Potential

Just a couple of weeks into their pre-service training, the new group of volunteers that arrived in Albania in mid-March were sent to visit current volunteers throughout the country. Three came to Korca. They all will work in community development, so they were placed with the two volunteers in the city who work in that area. I joined them for dinner one night.

They are all young, eager and well educated; typical Peace Corps volunteers. I think there are only two over age 50 among the new arrivals. They all had the usual reasons for volunteering. They all seemed happy with their host families around Elbasan. They all seemed a bit frustrated and confused with the language and culture. After dinner they went to a new recreation center for young people. It was recently opened by the city government in the upstairs of a restored 19th century building. I checked it out, and they had done a nice job fixing the space, but it was loud and crowded. I left before my ears were too painful.

I offered to show them the trail to the top of the mountain, but they thought my usual 7:30 am start time on weekends was a bit too early, so I headed up the road to the cross by myself. There were lots of people out since it was a fine spring morning. I saw many of the regulars and we exchanged greetings.

It has warmed up considerably recently. We have had sunshine a few days in a row and temperatures have climbed into the upper 50’s. Daffodils and dandelions are blooming and fruit trees are in blossom; seems like it happened overnight. My neighbors across the alley from my kitchen window have spread out a large collection of shoes and sneakers which they are offering for sale (one seldom sees used household items or furniture, but used clothing is for sale everywhere in Albania). Several families came by to try on a pair or two and I could overhear lively discussions as to price and desirability. I don’t know how long this improvised shoe store will continue. The little general store which my other neighbors ran in their modified garage for years, recently closed when the government mandated that all such stores had to have electronic cash registers that could automatically calculate sales tax (20%). Most of shops like this only make a few dollars a day, and can’t justify the expenditure of a few hundred dollars for the required machine, so there has been a spate of closures around town. I have heard that in other cities, where the enforcement has been lax or the officials more readily paid off, this has not yet occurred.

My Peace Corps experience is limited to Albania, but I have worked in missionary projects in Vietnam and Mexico and have seen the same thing. When a market opens up, entrepreneurial people will jump at the chance to participate. It is only when it is closed by corruption or safety concerns or limited by transportation or other infrastructural needs that it fails to flourish, and even then, there is usually some attempt at commerce.

It seems to me that the best thing we can do for a developing country is to provide market opportunities. Isn’t that really what has helped China develop? Much of the West has provided markets for goods produced by inexpensive Chinese labor and the US Navy provides security for ocean transport. I sometimes think that providing money to a corrupt administration just incentivizes that element of society that finds it easier to steal than to create. That money can come from foreign aid, or from exploitation of natural resources, or from trafficking in drugs, women or children.

The Peace Corps, of course, gives young, eager, well intentioned and, mostly, inexperienced volunteers to do…what? It seems we hang out among “the people” for a couple of years and teach English or health topics or write grants (at least that is the menu in Albania); nothing there to motivate the kleptocracy that rules much of the developing world. I am not sure exactly how it fits into any model of foreign aid. Some projects I have seen do seem to have potential, like the cross border project between Macedonia and Albania to stimulate a garment production industry. The community development volunteer in Korca has been busy with that and seems to be accomplishing something.

The effects of my projects seem more nebulous. Dr. Isufi is making great progress in his training. He is a quick study and eagerly reads through any material I provide. Our course is frequently interrupted by people just barging into the clinic room where we work. One day it kind of got to me, but Isuf just shrugged his shoulders and said, “It is Albania”.

Work with the environmental test equipment at the public health department has been slower. One day we spent an hour learning to turn the apparatus on and off. There is a button on the gadget that is pretty clearly marked as a power switch, but I had difficulty getting that concept across. After we finally achieved consistent performance, we all went out for coffee to celebrate. Later this week we will tackle storing data and downloading it to a computer for analysis. I am working hard to figure out how to present this. Given the problems we have had, I am not optimistic we will accomplish much except consuming prodigious amounts of caffeine.

My life skills class at high school is going ok. My co-teacher is away in the US, having a baby there to procure the child an American passport. I am not confident she will return. There may be another teacher to take the class when I leave, but it will likely revert to the passive pedagogical practice that characterizes the system here. I doubt that the more active curriculum I developed last year will persist in any form, so this time I am doing lesson plans that conform more closely to the textbook. I am also being stricter with the kids if they are disruptive. Isufi has told me repeatedly that when I go home I will be part Albanian. Perhaps he is right.

Catherine continues to spin her wheels in Arizona. Really, except for her evaluations she probably could have done her rehab here in Albania and received a more active program. Fortunately, her clever nephew had the idea to look up computer programs used by the VA for returning Iraqi and Afghan war vets with brain injury. The two of them went down to the local computer store and purchased a couple for Catherine to work on. He works at a Walgreens, and I know Americans often go to the drug store to inquire after over the counter remedies. Catherine is also going to a local gym to participate in an exercise class. Maybe “do-it-yourself” rehab is what the PC had in mind all along. At least there will be no impediment to her continuing this when she heads back home to rural Oklahoma.

In spite of this, I still think she has the potential for a pretty good, if not complete recovery. Unfortunately, it will not be in time for her to return to Europe for our post PC travel plans. Right now I am not confident she will be able even to do the US part of our plans, so I have checked into changing our tickets to shorten my travel time alone and get myself home to Idaho. It is amazing how little credit the airlines give you when you have to change your travel plans. The US portion of our tickets actually cost almost twice as much to change as to buy entirely new tickets with another airline. Europe is more regulated, so I don’t think it will be too bad if I use the value of Catherine’s ticket to come back home a bit earlier, although I have offered it for free to any of the other volunteers in my group who is willing to pay the transfer fee.

This is not the finale I had envisioned for my two years of service, but, I suppose it will have to do. I have been working on my “Final Site Evaluation” document, one of many that is required at end of service (I have learned of this piecemeal, since I missed the classes on this held at the Close of Service conference when I was in London). There are four categories for projects: finished, unfinished, abandoned, and just an idea (never started, but has potential). I have had my share of all of these, and for a lot more in life than just the Peace Corps.

Old Woman Days

I remember hiking in the mountains a while ago with another volunteer, who remarked how dry the winter had been. I reminded him that a few months prior most of the country had been flooded to the extent that several of the volunteers had to be evacuated from coastal cities. He replied that yes, but since then it had been very dry. It was a day that was sunny, but cold. The snow underfoot had a dry, crunchy feel. He often comes out with proclamations of this sort and I know from experience there is no point getting into a discussion on the topic.

Anyway, I have thought about that more than a few times the past couple of weeks. It has been consistently cold and rainy. Each morning when I look up at the mountains to the east with the thought of a walk towards the cross, I am put off by the fog, clouds and virga swirling along the route to the top. I crawl back into my down sleeping bag for a few minutes extra sleep before I force myself to get up and do my exercise routine. I carry my umbrella as I walk around the city and may actually get to use it if the wind isn’t blowing too hard. Otherwise I pull the hood up on my Gortex shell over my Polartec jacket. Since the inside of an Albanian building may not be any warmer than outside, I am grateful for modern textiles.

I mentioned that the weather was not very spring-like and Isufi explained that these cold, wet days were called “dita e plaka” (old woman days) that come at the vernal equinox as a harbinger of the good weather to follow. He suggested drinking raki as an antidote to the cold. This was not a big surprise since raki is widely prescribed by Albanians as a panacea for all things internal and external. Since I don’t drink, I guess I’ll just have to rely on layered clothing.

Catherine, in Tucson, has complained about the heat and aridity. I try to be sympathetic, but I’d bet it sounds feigned. She is finally undergoing evaluation at Barrows. She sat around without much direction for almost a month and it is progressing so slowly that even if everything comes out perfect she is unlikely to be able to complete it before I finish in Albania. I have delayed my planned close of service date by about a week and I will have to figure out what I will do with the plane tickets that I already purchased. I have some friends from the high school where I teach who are planning a trip to Montenegro and Croatia and I will likely go with them, continuing on by myself to Slovenia, Hungary, Austria and Germany. The flight from Berlin to New York leaves mid June.

There are several things that need to be done before I leave Albania. All volunteers have to write a Description of Service report. The hardest thing for me in writing this will be selecting among all the various activities I have engaged with in Korca. This is supposed to be an important document for returned Peace Corps volunteers to be used for future employment or grad school. I am not looking to go back to grad school yet again (I have had plenty, thank you) and I doubt that my Peace Corps service will be much of a factor in my prospects for future employment. I am thinking of going back to at least part time work, since I think I would be bored just sitting around and there are some things I talked about with some folks when I was home visiting that sounded interesting. I also know there are plenty of volunteer service needs back home in Idaho.

I am fortunate in that. Some of the young volunteers are pretty scared about the job market back home. Friends of mine, who left Albania early because she needed “emergency” knee surgery, have been in limbo, still waiting after months for authorization for the surgery and not able to leave their family to widen the employment options for him and she can’t start a new job and then be out for extended physical therapy. It seems like sending people home after illness or injury without any direction or support is a Peace Corps pattern. That was one of the complaints voiced by the former volunteers in the television piece about dangers of Peace Corps service, and another volunteer I know, who went home after emergency abdominal surgery in Albania, also has complaints about the medical follow up provided for her. I don’t understand what the Peace Corps’ problem is with this. It really isn’t that hard to do a good job and it saves money in the long run, not to mention avoids embarrassing publicity. Maybe it is just another sign of inherent bureaucratic incompetence.

As is apparently a typical experience for volunteers, some of my counterparts have reacted to the sudden realization that I am leaving soon by thinking up lots of new projects they would like to do before I leave. I have politely declined most of the suggestions and have made clear for those that I have accepted that I am leaving in less than two months, no matter where we might be in these activities. I also have things I will need to do in preparation for leaving, and those will get priority. I would bet that they will have to be reminded of this when I pack up and pull out. They have already asked me who is coming to replace me. I don’t know. That is, as we say, above my pay grade. I am just a volunteer after all.

That is not to say that I will not miss my many Albanian friends. Every day a dozen or so walk up to me and ask about Catherine and ask me to give her their good wishes. The other volunteers in Permet have told me that they cannot walk down the street without being stopped repeatedly for the same reason. The documents from the close of service conference talk about readjustment problems for return Peace Corps volunteers. One that I read mentions volunteers feeling special and loved by a service community and that young volunteers miss that feeling when they return home. However run down or trashy your neighborhood might be, it is home with a daily routine that one has grown accustomed to. At this point, it is no longer stressful and it is the prospect of the high speed, high stress pace of American life that is daunting. It will probably be easier for an oldster like me who does not face prospects of a difficult economy or grad school that the youngsters do.

Also, among the conference documents is also a close of service check list. It is pretty long and I need to get started if I am to get through it in the seven weeks I have left. That seems like hardly any time at all. First though, I am looking forward to the promised good weather to resume my daily morning walks up the mountain. It really helps me keep things in perspective and focus on the tasks at hand.

Fshati

It seems that most of my friends in Korca have some attachment to a village (fshat) somewhere in the region. They may still have relatives living there or even own an old house and a garden. They prize the apples or figs from their trees and opine that the wine or raki, made from their grapes or berries, is the best in the country. The air and water are better there. Palo and Moza, my landlords, go to Dardhe. Fehmi has a place in Kapshtica, outside of the small city of Bilisht. Isufi has Bigell. I go to see my host family in Thane.

I had promised Catherine’s host family and my family that I would visit as soon as I could after I got back from London. It was the only way to stop them from phoning constantly. Last weekend there was snow and ice on the road over the Qafe e Thane, the pass over the mountain between Lake Ohrid and the Skumbin River that flows from huge springs under the Qafe e Thane through the center of the country, including Elbasan. This weekend warmed up a bit and the road was dry. I took the bus on Saturday morning.

Monday was also the Muslim Dita e Veres, summers day and a national holiday. Elbasan is predominantly Muslim and has a festival that draws a crowd from all over the country. There was a stage set up on the boulevard in front of the castle in central Elbasan. Music- traditional Albanian, rock, rap, Brazilian and more blared over the loud speakers. There were so many people pushing and shoving in the throng that surged around the stage that it felt like what passes for a line at the post office. Ballakume, the traditional cookie for Dita e Veres, were on sale everywhere. Over the weekend the price dropped from 110 lek to 80 lek.

On Saturday night, a large group of volunteers, mostly from Group 13, but a couple from my group 12, met at an Elbasan volunteer’s home for green curry rice and vegetables. Albanian food is wholesome and fresh but tends to be pretty bland. One of the volunteers had received the curry spice in a care package from home. It was a welcome change.

Sunday morning I took the old Udhetari (travelers) bus that I rode so often during PST out to Thane. My host mother was working in the carrot patch in her garden as I walked up to the house. Her older son was sleeping up stairs, the younger son was playing with friends, her husband was working in Greece and her mother-in-law was visiting her son who works in Italy and lives there with his family (the recent easing of the visa requirements for Albanians to visit eurozone countries has let her go there twice since November).

She called her older boy down. He has been studying English at the Turkish college he attends in Cerrik, a small city just beyond Thane. He is actually getting pretty good. The younger boy has filled out a lot and is still very athletic. He had been playing soccer with his buddies and had been called home to see me. She served coffee and fruit and then went to work making homemade ballakume with fresh eggs from her hens, hand churned butter from cream she milked from her cows that morning, and corn meal from her harvest last summer. The sugar was from beets grown elsewhere in Albania, although I suppose she could have used honey from her hives as a sweetener instead. In less than 20 minutes they were served hot from the oven and were much better than any I have eaten previously.

Her sister and her two young daughters came over from next door. Jesika, who is now 9, was the one with whom I played “Tjeter” (other) to find words for various categories of nouns when I was first learning Albanian. Her younger sister, Vanesa, has also grown a lot. I was pleased that she remembered me, although I had been told that she frequently asked where I was when I left for Korca after PST. We all chatted easily (my Albanian is not as good as some of the younger volunteers who by now speak fluently and are hard to distinguish from native speakers, but I can carry on a conversation). They asked about Catherine, of course, and talked about the volunteers they had from group 13 and the new ones they expect next weekend as Group 14 is due to arrive to begin Pre-service Training on Wednesday.

Liri, Catherine’s host mother stopped in as she had heard that I was in the village. I assured her I was coming there next. My host mother insisted that this would be after dreken (lunch). She served meat and vegetable soup, salad, yoghurt and homemade bread to us all. A short time afterwards I headed a few blocks away to visit Comeri and Liri and their family.

Of course, coffee and homemade ballakume were served. I had to argue forcefully that no, I did not want to eat lunch again, and was having a hard time getting down yet another ballakume, no matter how good they were. That seemed to satisfy Liri, although she did give me a few to take with me. I apologized to Comeri that he had not been shown the respect he deserved when he had come to the hospital in Tirana to see Catherine. He seemed to accept that and appreciate the apology, which, in itself, was a sign of respect. This family was not having another volunteer stay with them, although this was attributed to an upcoming wedding for the next daughter who had recently been engaged and not to any hard feelings towards the Peace Corps.

We talked a lot about Catherine as they are very close to her. Aldi, the older of my host family’s boys, offered to help them Skype with Catherine from a village lokal that has internet. I thought the coffee shop in Thane had really progressed when they stopped butchering cows in the middle of the room while you were drinking your coffee, but now they have a computer with a web cam. Things are changing quickly in Albania, even in Thane.

I walked back over to my host family’s house. Several people from the village came outside to say hello, including Beni, my host family’s nephew who looks like the Fonz. I enjoyed talking with him, although he is not working and spends his days hanging out at the lokal. I think my family is not happy with him. He tried to sneak into Greece to get work, but was caught and sent back. Apparently, he has not done much since.

I did extract a promise from my host mother that she would send the two boys to Korca for a couple of days next week. There is a school holiday for Sultan Nevruz. I have off from Preka as well and would love to show them Korca. They have never visited there before, even though it is less than 100 miles from Elbasan. I had given them money for the furgon ride before and next week would be a great opportunity as there is also not a lot of farm work right now. They were excited at the prospect, although their mother complained that she would be lonely without them. One of their neighbors is a furgon driver between Elbasan and Korca and she plans to send them with him. I think they may actually come.

Besides Dita e Veres, Monday was my two year anniversary in the Peace Corps. Although the term of service is technically 27 months and my official close of service date is May 27th, volunteers in my group can leave early with the permission of the country director. This is usually related to school or job opportunities. Some in my group are starting graduate programs. A few are going to teaching or training programs in Europe or Asia. Sometimes health issues are involved. One couple is leaving for graduate school and she is pregnant. Even if she has a speedy and full recovery, as we continue to hope, Catherine would not likely be allowed to return to Albania as a volunteer. What is not clear at this point is whether she will have a medical discharge or just close her service in the US. She is scheduled for an evaluation at a well respected treatment program in Phoenix and we are hoping, at least, for answers to our many questions regarding recommended therapy and prognosis.

I have not yet set a close of service date. I have enough unused leave that I can close anytime in May, or even a bit before if I want, but I am committed to working with Isufi and Jani and teaching my Life Skills class while the main teacher is off on maternity leave. I will probably shorten my travel through Europe to just a few cities I would like to see before I head home. I already have our tickets from Berlin in mid-June and I am not sure how easy they are to change. I was supposed to set a date at the Close of Service conference that I missed while I was in London. The staff has been very understanding and has not pressed me for a decision as we all anxiously wait for information from Arizona.

Back in Korca

Thursday morning I watched Catherine and her sister get into a London cab and drive off to Heathrow. The Peace Corps was flying them first class to Dallas, with a connection to Tucson. She has done remarkably well and the rate of early recovery is the best prognostic sign for brain injury. We have good reason to be hopeful. The latest plan was for her to see a doctor in Tucson early the following week and then request a referral to Barrow Neurological Institute in Phoenix for a comprehensive assessment.

I walked around Kensington Park for the rest of the day and then took the Underground to Heathrow for my flight. I had scheduled to fly through Rome and then on to Tirana. Flights in that direction had some problems, perhaps related to the evacuations from Libya. I had to rearrange my flights but, after spending the night on a bench in Terminal 4, was able to leave early the next morning on a flight to Rome with a close connecting flight. The flight was slightly delayed and then parked on the ramp, so we had to be bused to the terminal. I raced through security and then to the departure gate where we boarded another bus. We were taken to a plane almost next to the one on which I had arrived. I had hoped my inbound flight would park near my connecting flight. I have to be more specific on what I wish for.

I caught the bus from Mother Teresa International to the city center and then walked to the Peace Corps office. I walked past the dentist’s office and tried to figure out where Catherine had been hit. There were so many potential places. As one rides on buses or furgons through Albania one see many marble shrines to mark places where people have been killed in accidents. They usually have a name, dates, a photograph and some artificial flowers. One can see similar, but makeshift, markers along roads in Idaho.

I spoke with the country director and other staff that had been so helpful following Catherine’s accident. I thanked them for their support and understanding. It almost made up for the bad experience I had with the nurse that came out to London from the Peace Corps office in DC. I tried to take care of some of the administrative items from the Close of Service conference that had been held in Korca while I was away. Maybe it was jet lag, but when I tried to open the files I downloaded at the office in Tirana, my computer wouldn’t cooperate. Maybe I’ll figure it out when I catch up on my sleep.

I had phone calls and texts from friends, both volunteer and Albanian. Now that I was back in Albania and knew they wouldn’t be exorbitantly charged, I took the calls and thanked them for their concern. I promised to visit Catherine’s host family as soon as I could. When I walked into my apartment, I found a banner above the kitchen door from all the volunteers who were at Close of Service conference. It was covered with notes welcoming me home and wishing Catherine a quick recovery. There was even a cut out of a jet. How appropriate.

Saturday morning, I sorted through the large bag that the Peace Corps staff had left in my apartment with all the pieces of the medical machine I had brought back for Dr. Isufi. He arranged for his son to drive to my apartment and bring it to his office. In the afternoon, after assembling the pieces with glue and tape, we plugged it in. Much to my amazement it worked and successfully went through the set up test program. The French baggage handlers that had dropped kicked the box marked “fragile” across the tarmac in Paris had been thwarted by tough, US made construction. We went out for coffee to celebrate, but I begged off a celebratory dinner. I needed sleep more than food. Also, we still have to make sure it functions correctly, so a celebration is a bit premature.

On Sunday morning, I met the volunteer from Bilisht who is leaving early. She has been a good friend of Catherine and me, and it was sad to see her off on the furgon to Tirane. After that, I walked to the church where I met my friends from Preka School and the group of nuns who have also been such good friends. I thanked them for all their support and prayers. We have a lot to be thankful for.

The afternoon was sunny and bright and not too cold. Another volunteer from Korca and I hiked up the road to Mborja, a village east of Korca, and along a gravel road by a creek in a canyon leading into the mountains. We doubled back along a side canyon, through a shallow covering of snow under a grove of pine trees, and clambered up to the ridge where the cross overlooks Korca. We walked back along the paved road in the late afternoon. Benny, the caretaker at St. Theodor’s, a small orthodox church I frequently visit on my morning walks up the mountain, was working on the grounds. When he saw me he ran out to the road to enthusiastically welcome me back. I showed the interior to the other volunteer. It has some of my favorite icons in Albania and, thanks to Benny, it is well maintained.

Later in the evening, I met my friend Lawrence for coffee. Even though he is from Malta, he appears to have picked up some Albanian customs from his long tenure in Korca, so, of course, it involved a meal as well. I may be wrong. Malta is part of the Levant and may have its own, similar, tradition of hospitality. They are certainly taking in thousands of refugees from Libya, including hundreds of Americans that were recently brought there by ferry from Tripoli.

Monday, I went to the health education office at the Directorate of Public Health. The nurses and lab technicians I work with all asked about Catherine and wished her the traditional wish for a speedy recovery, which, in Albanian is “te shkuare”, that is, “to be as you were in the past”. That seems both an apt and difficult wish.

I also learned that my nurse counterpart was enthusiastic about going to a meeting in Tirana on Tuesday at the Ministry of Health. This was planned to honor the work of Peace Corps health education volunteers throughout Albania and to commemorate the 50th anniversary of the Peace Corps. All the volunteers, staff and principal counterparts had been invited. I was hoping she would beg off because she has so much work to do in her home, taking care of her young son, her husband and his parents, as is the responsibility of young Albanian wives. She felt this meeting was a special one, and worth the trip. Although I would rather remain in Korca and work on my projects with Dr. Isufi, Dr. Jani and at the Preka School, it would be awkward for her to be without “her volunteer”. I don’t look forward to another nine hours in furgons to and from Tirana and, yet another night at Fredi’s. Maybe I can also stand in for Catherine with her counterpart nurse from Permet. I know that would please Catherine.

This is London

With a few minor delays we all finally arrived in London. Catherine came by air ambulance, her sister and older daughter by American Airlines from Dallas and me and the younger daughter by British Air from Tirana. Transport from the Gatwick to Kensington was made more interesting by a Monty Pythonesque experience of each information desk person giving conflicting instructions. For example, we were sent back and forth twice between tracks going in opposite directions at Victoria Station and then the tube station where we were told to get off turned out to be wrong. We finally got in a cab and were safely delivered to the hotel the Peace Corps had reserved. The cab driver questioned me if I meant to give him so large a tip. I assured him I did. Since the PC is supposed to be an austere organization and relies so heavily on the internet for communication, it would have been considerate had they booked a hotel that was no quite so expensive or had internet service for less than $15 an hour extra, but at least it was walking distance from the hospital. We all settled into our rooms and then headed over to the ICU at Cromwell Hospital.

England is much more liberal than Albania for visiting hours and they were also much more aggressive in getting Catherine awake and off the ventilator. They changed her to short acting medications and, after repeating the CT Scan the next morning, began to taper sedation. Catherine showed some worrisome signs of increased tone and posturing which I later found out were likely due to the medications, but then opened her eyes and began breathing. Soon the endotracheal tube was removed and she was talking. Much to my relief, she remembered who I was. By afternoon she was taking a few bites of food and sips of coffee and sitting up briefly in a bedside chair.

On Saturday morning the rest of her tubes were removed and she was transferred out of the ICU to a private room on a locked ward. She was mostly talking appropriately, but a bit confused, confabulating and impulsive. Still, her underlying charming self was evident, as she was smiling, joking and enthusiastic. She had some mild difficulties with balance and coordination. Physical and respiratory therapies were continuing, but occupational and speech therapy did not work weekends at this hospital and she would not be seen for evaluation until Monday. This is where going to a hospital more specialized in brain injury would have been beneficial, but at this point, it is not causing any significant problem. I would like her to get a thorough evaluation rather than gloss over any deficits, since these are better attended to early on rather than trying to be remediated after they create untoward complications. The nurse from the PC office in DC does not seem to agree with that, but I don’t think it is an unreasonable request. She has made it clear that because I am not family, I really don’t have any say in the matter. Maybe it is too much to ask that since I am also a Peace Corps volunteer who has been affected by this accident, she might have some duty to be a bit more considerate of my feelings, but I can’t fault her for being focused on Catherine. We all should be. Whatever, we’ll see what Catherine’s attending neurosurgeon thinks, although I haven’t seen him around since yesterday morning. I think he has been busy with surgery at another hospital.

Catherine was pretty upset at waking up outside of Albania, but seems to be accepting the fact that her Peace Corps service is completed. I expect that when she is well enough to travel on commercial airlines, with her daughter and sister as escort, she will be transported stateside for whatever rehabilitative care she requires. If I am able to weigh in on the decision, it will be in a program of the highest competence and reputation. When that is accomplished, I plan to head back to Korca to finish up my projects. If Catherine does well enough, maybe she can fly back to Albania to say a proper “mirupafshim” to her many Albanian friends and her fellow volunteers and PC Albania staff. Maybe that is a lot to hope for, but the fact that I can consider it at all seems nothing short of a miracle.

Reanimacioni

I had planned to write this next post about the Close of Service conference which is scheduled in Korca next week. As I said before, plans change. “Reanimacioni” is the Albanian word for Intensive Care. I saw that word for the first time by the elevator in Spitali Hygeia in Tirana on Tuesday evening.

A few minutes after I walked into my apartment in Korca for the first time in more than two weeks, my cell phone rang. It was Fredi, who rents inexpensive rooms to Peace Corps volunteers who stay in Tirana and provides all manner of helpful services for volunteers as they learn to navigate the busy capital city. He told me he had just learned that Catherine had been taken to Military Hospital. This is the hospital that all ambulances take patients to in Tirana. I immediately called the Peace Corps medical officer and was told that she and the country director were on the way to the hospital. I tried to call Catherine. A short while later, the medical officer phoned to say that Catherine had been hit by a car and they were having her transferred to one of the new and well staffed private hospitals in Tirana, Spitali Hygeia. I had noticed the large, modern building when we rode the bus into town on Friday. I think I pointed it out to Catherine. The country director got on the phone and authorized me to leave my site and come to Tirana. That was nice of him, but I was on my way, whatever. I walked past the city center to the furgon stop and caught a ride with the same driver who had driven me from Tirana in the morning.

Several calls on the long ride back told me that Catherine had been hit by a car when crossing a busy street while walking back to Fredi’s from her close of service dentist appointment. The older lady who had hit her had actually stopped to help. This is unusual in Albania where any accident will result in protracted hassles from the police. She had contacted Fredi by calling the last number dialed on the cell phone. Fredi called the Peace Corps office and then called me. At first, she did not seem severely injured, but was confused and combative and then lapsed into coma. Rather than have me take a bus or a cab across Tirana to the hospital, the country director arranged to have a Peace Corps car meet me outside the US Embassy which is on the furgon route into Tirana. This was both worrisome and appreciated.

The Peace Corps programming and training officer was in the car. As we drove to Spitali Hygeia, he told me the Peace Corps office in Washington, DC, was contacting Catherine’s family and would make decisions about medical evacuation, if necessary. He offered to let me stay at his apartment, if I wanted. We met the medical officer and her Albanian assistant at the hospital reception area and took the elevator upstairs. The neurosurgeon spoke with me, and, after gowning and washing our hands with disinfectant, led us in to see Catherine.

It was a scene I have seen many times before, but never from the perspective of a loved one. She was unresponsive with tubes in her nose and mouth. I held her hand and stood there as long as they let me. After half an hour, increasing levels in the chain of command of the ICU nurses asked me to leave. I resisted until the ICU medical director explained that they wanted to limit stimulation and would I please leave now. This seemed a bit strange since stimulation is a main treatment of arousal problems, such as coma. Otherwise the medical care seemed fine. I tried hard not to be confrontational. This is a bit of a stretch for me. Perhaps I have learned something in the Peace Corps. Maybe it is just old age.

The next day, Catherine’s daughter arrived from Germany where she works at a hotel in the Alps. I had only met her once before when she visited Albania before starting her new job. Several of our good friends from our group came to Tirana to offer help and moral support. Many others emailed and texted kind words and a willingness to help in any way needed. Thank you very much, it meant a lot.
Many Albanian friends from Korca , Permet, Thane and Tirana called and some came to the hospital, although few were allowed in to see her. All were shocked and concerned. We have two groups of nuns in Korce and Bolivia, the Precca Society, Greek Orthodox, Muslim and Jewish friends busy praying. We have remarkable coverage. Inshalla, Catherine will have a rapid recovery and be incredibly angry that she was taken out of Albania before she could finish her service. She had planned to travel to Leskovik on Friday to do her breast cancer presentation for a group of women at the medical clinic and then travel on to Korca for the conference.

The Peace Corps office in Washington decided to transfer Catherine to a hospital in London. I don’t know much about this institution, but I have asked knowledgeable friends back home for their opinion. Meanwhile, Catherine moved and responded a bit when they allowed the level of sedation to decrease slightly. Other family members are meeting us in London tomorrow afternoon. We’ll see how things go. I am hopeful, but realistic and considering rehabilitation possibilities in the US. We will have to consider PC preferences, and I have to respect that I am not family and really have no say in the matter.

The day of her transfer, the country director drove us to the hospital for a last visit on the way to the airport. Her site mates from Permet came with us to see us off. Catherine’s host family from Thane was at the hospital, the father, two daughters and a son-in-law. They wanted to see Catherine, even though I had told them repeatedly when I phoned the night before that they would not likely be allowed to see her. I don’t think the authorities realized how close Catherine is with this family or maybe they judged them by their worn clothes, not realizing that they had worn the best clothing they owned. They were obviously hurt and felt a lack of respect that is probably the most significant offense in Albanian culture. This was assuaged by taking the whole group to coffee in the hospital café. There were many toasts to Catherine’s speedy recovery. I promised them we will return to visit them in Thane and made their youngest daughter promise to work hard in school, as Catherine would want. We parted at the hospital entrance and headed off to Mother Teresa International.

The country director was kind enough to grant me administrative leave to follow Catherine through her initial treatment. This is extremely considerate, since, again, I am not family. I have up to 45 days, which saves me from the prospect of early termination. I appreciate that. I have projects that I wanted to complete before leaving Albania, but there are other priorities for now.