Travelling for WHO – first to Botswana in Africa

Excerpted from Memories that linger”: My journey in the world of Disability
by Padmani Mendis

First Impressions and First Memories

But where are the trees? This was my first thought as the eight-seater circled the small airport at Gaborone, preparing to descend. Trees, green and water was what I was used to seeing in Asia and Europe. When I was preparing for my visit to Botswana, I had read that the Kalahari Desert was savanna on which grew grasses and small trees. Here I saw also that the ground was dry, yellow, sandy.
The airplane was small because the Gaborone airport at that time could not accommodate aircrafts that were any larger and certainly not jet aircraft. The route from Colombo required for me a transfer at Johannesburg to this eight-seater. During my first year of travel to Botswana I was fortunate that BOAC (later BA) – had a flight route that connected Hong Kong-Colombo-Johannesburg. This direct route was unprofitable and on my next visit I had to transit at either Bombay or Nairobi to get to Jo’burg. Five years later, Botswana had its own airport which they named the Sir Seretse Khama International Airport. I have not used this airport.

Sir Seretse Khama

The word Seretse Khama holds memories for me dating back to my youth. While at school and yet quite young, I saw in our morning newspaper, the “Ceylon Daily News,” what seemed to me to be an unusual photograph. It showed a couple standing arm-in-arm. The man was tall and dark with black frizzy hair. The woman was smaller with a light skin. I still see that photograph in my mind’s eye. The caption said that Seretse and Ruth Khama, formerly Ruth Williams, had married in London. The couple will be returning to Bechuanaland, a British Protectorate. Seretse Khama was the son of the former chief of Bechuanaland and was returning to be the chief himself.

This fascinated me, I know not why. I had to ask a cousin where Bechuanaland was, and she did not know either. Together we looked up the atlas I used at school to find out. Thereafter, I followed with interest what happened in that faraway country. I knew of the problems that were created by the British when Seretse returned to his country; and of the attempt by the British to have him and his English wife banished; how his people wanted him back and welcomed his wife with open arms; when it became the independent country Botswana and he became its prime minister; that the country was rich in diamonds, but was still desperately poor. Its diamonds were being mined by their neighbour, reaping the benefits of the growing diamond trade together with the benefits of apartheid for its white and wealthy minority, South Africa.

When Einar suggested that I start the CBR field trial in Botswana, I was just amazed. My reaction called for me to give an explanation to him and Gunnel. And here I was. Botswana was now a Republic and Sir Seretse Khama, GCB, KBE was its first elected President.When I related my story to Adelaide Kgosidinsti, my counterpart, she took me to visit Lady Ruth Khama. Sir Seretse’s health was failing rapidly. Ruth Khama lived in a villa-type residence, not large in appearance, with quite a few plants in the garden. I told her my story. She invited me to have tea with her.

Sir Desmond Tutu

Upon arrival in Gaborone I was met by someone from WHO and taken to check-in at the Holiday Inn Hotel. This was the only international hotel in town. There was another large hotel close to the station where most local people stayed. I too stayed there later on when Gunnel came to Botswana.While I was on the eight-seater from Jo’burg, I noticed a passenger walking down the aisle, greeting his fellow passengers. Going down to breakfast the next morning was difficult. I was alone – had never stayed in a posh hotel like this before. I was bashful and shy and probably showed it too. I sat down gingerly and ordered breakfast. Not much later came the sound of a booming voice.

Familiar from yesterday, on the plane. With a resounding “good morning” and a nod to each table, he sat down with a group.
After a while, seeing me, a lone strange woman in a saree, he came over to sit with me. He was wearing the collar indicative of his calling. Said his name was Desmond Tutu and asked if he could join me for breakfast. He talked with me at length. An exceptionally strong personality just oozed through his manner, his voice and his speech. There was no doubt that I was required to respond. Wanted to know where I was from, what my country was like, what I was doing, why I was in Gaborone, my plans and so on. He was gone the next day. The hotel people told me he had come to Jo’burg for the day to participate in a meeting. They thought he had gone on to Cape Town.

Very many years later Nalin and I went for a week’s holiday in Cape Town. On my birthday which fell on a Sunday we went to St. George’s Cathedral. Sir Desmond was Archbishop in Cape Town and St. George’s was his parish. He was preaching elsewhere that Sunday. So I did not meet Sir Desmond Tutu again. An anti-apartheid and human rights activist, he was the first black Archbishop of Cape Town, winner of the Nobel Peace Prize, the Albert Schweitzer Prize for Humanitarianism and the Gandhi Peace Prize. I had him in my memories and he enriched them.

Introduction to Botswana

The next morning I was sitting at the desk of the Chief Medical Officer of the Ministry of Health or MOH. He was a Norwegian and it was he who ran the health service in Botswana from the Ministry in Gaborone. There were very few Motswana – as the people of Botswana were called – medical doctors and these few had all studied abroad. Norwegians ran the entire health service. Seeds had been sown for a countrywide Primary Health Care Programme through the Regional Medical Officers of Health. This was said to be developing well and covering large parts of the country.
When he learned who I was and what my mission was, he sent for Adelaide Darling Kgosidinsti. While we waited until she arrived he attended to the collection of files on his table. He was obviously a very busy man and did not talk much.

Adelaide arrived. A lady with a large frame and distinctly commanding presence. She looked quite beautiful with her hair made neatly into a plait and folded round her head. Her skin, as was that of the people of her country, a distinctly lighter shade than those from the countries nearer the tropics like Kenya. Even Nigeria. Adelaide was introduced to me as the Commissioner of the Special Services Unit for the Handicapped. She was in charge of all disability prevention and rehabilitation services in the country. She was my National Counterpart.
The Chief Medical Officer and Adelaide had both met Einar. Einar had been to Botswana three years before me to plan for the setting up of CBR. The Chief Medical Officer instructed Adelaide to take me to Serowe and have me start on the task I had come to do for WHO. He did not show much interest in it. As I said earlier, he was obviously a very busy man. When Adelaide asked him how we should travel, he replied, “Take her on the train.”

Adelaide, I later came to know wanted to take me by road, which is how UN consultants are usually taken. But for me it was overnight on the train. I know not why. Adelaide slept most of the way. I had learned that she was not one given to chatting anyway. I was too excited to sleep. I enjoyed that train ride and repeated it many times, up and down to Serowe, a distance of about 300 kilometres.
However, there was but one experience that I did not look forward to on that train journey each way. I was required to change trains at Palapye, an important junction. This was around two in the morning and I had to wait near enough to an hour. At these times there was no one else around except for a few drunks weaving themselves around the platform. I was safe as long as I could stay away from their line of vision. There were occasions when I could not. Then it was always a game of hide and seek.

On our arrival early morning in Serowe a vehicle from the Regional Health Office met us. Our first visit had to be the Kgotla, the Office of the Chief to obtain his approval for my visit to his village and for my work here. The chief was in his colourful formal attire knowing that a foreigner was expected. Adelaide made sure that I followed all the proper protocols required by way of seating, greeting and conversing.
The Chief was most interested in how I was going to help the people of Serowe. He told me how families cared for their disabled members and explained a few traditional beliefs. He also told me that this was the largest village in Africa, with a population of 30,000 people. It was the home of the Bamangwato tribe and home to the Khama family. He was very proud of this, and naturally so.
Then the surprise – he said that he had someone from Sri Lanka working in his office.

He said I should meet him and had him sent for. In walked Mr. Swaminathan. He was the accountant in this small Tribal Office. That evening Mr. Swaminathan brought his wife together with his young daughter and son to visit me. We became friends. His children loved to visit me and play in my room. They were fascinated by my bedside clock and radio, obviously not having seen things used in the way I did. Here in a village on my first visit to Africa I meet a Sri Lankan. Mr. Swaminathan told me there was one more in Francistown, a large town in the north and another 30 or more in Gaborone. I met some of them on subsequent visits to Gaborone.

Some years later when I went to The Gambia, a small landlocked country in West Africa, I met around 30 Sri Lankans there too. In both places many were teachers, while others were accountants and engineers. More Sri Lankans were met when I went to the Bahamas on the other side of the world. We Sri Lankans had certainly spread ourselves around the globe.

Courtesy calls and finding a place to stay

After the Kgotla Adelaide took me to the social services office – it was a small one – to introduce me to Ethel Matiza, Social Service Officer or SSO for Serowe. Adelaide said she would be my counterpart in Serowe. We packed Ethel also into the pickup truck and went on to make a courtesy call to the Regional Medical Officer. He was from Hong Kong. When he heard that I planned to be in Serowe for three months, he invited me to stay with his wife and himself. They had a large house and plenty of space for a guest.

But Adelaide was quick to say thank you on my behalf. Because, she said, that she arranged with the director at the hospital to have me accommodated there. Which was just as well, because later I had a very small difference of opinion with the RMO. Being his guest would not have been of help in that. I learned a lesson here from Adelaide.
The director was waiting for us at the hospital. He showed me the room he had for me. The room had a bed and a dressing table. The mattress on the bed was bare with signs of long use. The windows had no curtains. I walked down a lengthy corridor to see the toilet and bathroom I would share. The bathroom had a bucket storing a little water. He then took me to the hospital kitchen and said I could prepare my meals here. I thanked him and asked if I could come back later?

Back in the vehicle, Adelaide said before I did that this was not suitable for me for a stay of three months. Ethel reminded Adelaide that there was just one option left – the Serowe Hotel. I said I did not need to see it, because that is where I would stay. Adelaide did not object too vociferously. I checked in at the Serowe Hotel and was allowed to choose my room – one of the only two that the hotel had. I chose the one with a window. Adelaide had never been here before.

Starting the field trial

We now planned with Ethel how we were to start the WHO field trial. The Regional Medical Officer had made it clear that we could have 15 Family Welfare Educators or FWEs – that is what the Primary Health Care workers were called – to participate in the trial. We could have these 15 for a maximum of three days, not more. Their routine work could not be interrupted. As soon as Ethel heard this from the RMO she sent off a message on the human telegraph line that the selected 15 should be at the community hall by 9 a.m. the next day. And they all were.
In the community hall the next morning Adelaide welcomed them, explaining to them that they had been asked to come to learn how to carry out this important task for the World Health Organisation in Geneva. And then she left for Gaborone to get back to her other duties. She came back to Serowe a couple of times to see how I was getting on. She went with us to the field to learn about CBR (Community Based Rehabilitation) in Botswana.

Ethel and I worked with the FWEs to prepare them for the work they were to undertake. We had enough Manuals to give one to each of them. We introduced them to all the components of the Manuals, discussing how each could be used; we had them describe and discuss the different disabled people – children and adults – they had met in their villages, the problems they had, and look for relevant parts of the Manual which they could use to give them advice on what they may do.

We set them problems to solve, case studies to discuss, turning the Manual this way and that, inside and out. Our aim, given these three short days, was to make them as familiar as possible with the actual physical handling of the Manual while learning it. At the same time as she was teaching with me, Ethel was also learning about the Manual. It was she who supervised the use of it after I was gone.
All in all, the entire workshop was essentially participatory and action-oriented. There was no other way. Serowe in Botswana was just one example of rural health and development and prioritising delivery needs. This was the reality in most developing countries.

This was the reality which CBR will have to use as an entry point. An essential first experience.Before the three days came to an end we made a programme with the FWEs. Ethel and I would visit them in their own areas of work. We asked them to get together in groups of three for this purpose. We would visit each group once a week. Before our visit, they would select disabled people in their areas who we would visit together. We would go to the homes of these people together, to continue their learning and ours in the use of the Manual.

And this field teaching and learning is what we did for the next 11 weeks in Botswana. It was at this time that the words of the Chinese Philosopher Lao Tzu came home to me with conviction:
“Go to the people. Live with them. Learn from them. Love them. Start with what they know. Build with what they have. But with the best leaders (teachers), when the work is done, the task accomplished, the people will say ‘We have done this ourselves’ “.

This has been the philosophy underlying my own CBR teaching from those first days in Botswana to this day.