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KIRUMBA, DEMOCRATIC REPUBLIC OF CONGO – Widows are common here; water is scarce.
Every day, the trek is the same. Women fill their giant yellow jerry cans in the Cyahulwa River, the community’s only water source, and lug them home tied to their heads and backs. The walks can take hours. The full jugs are heavy. A family of four uses at least 5 gallons of water each day. And in a country with an average annual income of $410, the $2 jugs are prized commodities.
Kirumba is a rural town, 117 kilometers (73 miles) from Goma, the capital of DRC’s North Kivu province. The town sits in the forest of Virunga National Park, which abuts DRC’s borders with Uganda and Rwanda.
The near-constant conflict over tribal tensions and the bounty of minerals here has left as much as 40 percent of the population of eastern DRC widowed, according to Widows for Peace through Democracy, an advocacy group.
Salome Masika Karupia’s husband was killed in conflict two years ago.
According to Nande tribal custom, Karupia, now 36, should go to her husband’s brother upon her husband’s death. She says her family suggested she marry her husband’s younger brother.
Instead, she became what’s known locally as a chaudronnière, or boilermaker. But she doesn’t weld metal; she collects plastic scraps and “welds” them onto damaged water jugs. Repairing water jugs is a lifesaving profession here, residents say.
Karupia is the first woman in town to become a chaudronnière.
Everyone in Kirumba uses plastic containers to transport stream water for cooking, cleaning and drinking. The hand-me-down bottles sustain the wear and tear of the townspeople’s rugged daily journeys.
In fixing the bottles, Karupia salvaged her independence too, she says. Karupia can repair as many as 50 jugs a day. She charges 100 francs (11 cents) to patch each hole, 200 francs (22 cents) for a large one.
Although DRC holds more than half of Africa’s water reserves, 51 million residents – three-fourths of the population – lack access to safe drinking water, according to a 2011 U.N. Environment Program report. Most of those residents live in rural areas such as Kirumba. An estimated 36.5 million residents of rural DRC did not have access to safe drinking water in 2010, the report says. They risk contracting deadly diseases, such as cholera, by drinking untreated water from rivers, lakes and streams.
Every morning, Karupia combs the streets of Kirumba in search of plastic scraps.
Surrounded by piles of taxi-yellow jerry cans to be mended, Karupia lights a fire. With a knife, some firewood and a patchwork of plastic, she gets down to work doctoring the jugs. By the time she gets to the last jug in the pile, her hands are hot and covered in black soot and ash. She gets burned sometimes.
But it’s worth it. Karupia is earning a reputation as the best at her trade.
“People are surprised to see me do this job,” she says. “They are surprised because they believe that this business is for men.”
Karupia learned the craft at a workshop in Kikuvo, a village 8 kilometers (5 miles) away, where she used to live. She worked hard to perfect her craft, she says. Now she travels through the surrounding markets, fixing the coveted water jugs wherever she goes.
"I love my job," she says. "I approach it with the right frame of mind. It gives us food, clothing, medical care and even rent."
Since her husband's death, Karupia has cared for her four sons alone.
Other women often chastise her for doing this work, she says. But she disregards them, responding, “Haven’t you ever seen a military wife?”
Karupia sees no reason why she shouldn’t master her craft.
“In life, there is no formula,” she says. “I want to demonstrate that there is no such thing as a stupid job that earns you a living.”
Salima Kasereka, president of the local chaudronniers union, calls Karupia a master of the craft.
“She does it more carefully than we men,” he says. “Now she only needs more tools to better serve the population.”
Her customers agree.
"I appreciate the way Karupia repairs cans and bottles," says customer Mbweki Mwindiki. "I am trying to fight for her and even bring her other customers.
Muhindo Kabuyaya, a Kirumba resident, says it shouldn’t be surprising to see a female chaudronnière.
“If there were also women masons, why not this?” he says. “We do not own the trades.”
But some people believe women, especially widows, are not right for this trade.
“I have never gone to Karupia,” says Masika Mitaberi, a Kirumba resident. “It’s not for women to do. She must be too lazy to work in the field.”
Aise Kanendu, a local human-rights worker, says widows’ rights are not respected here.
“After a husband’s death, the whole community might not be concerned with the widow or the children,” she says.
But now that Karupia has proved to be good at her trade, the community is supportive of her career, Karupia says.
"I love my profession," she says.
Karupia is becoming a role model for women here, says Kalindera Katembo, a local businessman.
“If all women had the spirit of creativity like Karupia, our country would be developed,” he says.
Sylvestre Ndahayo, GPJ, translated this story from French. Merveille Kavira Luneghe, GPJ, translated interviews from Kiswahili to French.
WHAT: See cattle traders from Northwest Cameroon haggle over cattle and goods.
WHERE: Bamenda Cattle Market
WHY: Each Thursday, in the early morning, herders from throughout Cameroon’s Northwest region gather at the Bamenda Cattle Market to sell the cattle that provide their livelihoods. Some traders trek for up to eight days to get to the Bamenda highlands area, where the city can be seen from above. Buyers come from many of Cameroon’s major urban areas to buy livestock.
The cattle market is the largest of its kind in English-speaking regions of Cameroon, says Taiwe Alban, a veterinarian from the Regional Delegation of Livestock, Fisheries and Animal Husbandry, which oversees the cattle market. Up to 1,500 head of cattle are there each Thursday, he says.
The cattle herders are from various tribal groups, but Alban says the 100-year-old market is dominated by the Fulani, whose traditional occupation is cattle rearing. So many Fulani gather at the market each week that a mosque was constructed a few meters away, guaranteeing that the Fulani, who are primarily Muslims, have a place to pray.
For some herders, the market day is lucrative. Some say they bring in as much as 5,000,000 francs ($8,670) on market day, Alban says. An estimated 300,000,000 francs ($520,000) changes hands each Thursday, he says.
Visitors can watch a lively regional tradition as buyers and sellers view the cattle, and they can also find souvenirs and taste local food. Herbs, dresses and household goods are for sale near the cattle market. Roasted or barbecued beef, which some say is the best in the region, is available, as are many types of beer and soft drinks.
DETAILS: The cattle market is open Thursdays beginning at 6 a.m. It is in the Bamendankwe, Bamenda I Council Area, Mezam Division. Taxis can take visitors to the cattle market.
WHAT: Go thrill-seeking on the Tana River
WHERE: Near Sagana, Kenya, a town about 100 kilometers (62 miles) from Nairobi
WHY: The sound of howling water greets visitors as they arrive at Rapids Camp Sagana, at the end of a bumpy, roughly 10-kilometer (6.2-mile) ride from Sagana town.
The camp is a leafy oasis in the middle of a vast rocky plateau that otherwise has little vegetation. Visitors might be tempted to walk to the edge of the Tana River, the longest river in Kenya, to swim or behold its beauty and take pictures as soon as they arrive, but it’s a dangerous spot – the rocks along the riverbed are slick from years of polishing by rushing water. One visitor drowned in July when he dived in without a life jacket, trying to rescue companions who had slid into the water, says William Kinuthia, the camp’s proprietor. The companions were rescued. In another incident, a military officer drowned when he tried to take a swim.
Kinuthia discovered this place when he was 14, as he and his mother were visiting a relative in the area. The beauty of the river stayed with him for decades, he says, and he returned in 2006 to develop and open the camp.
Now, the spot is renowned for its water sports. The camp is set to host 2016 Olympic qualifying events canoeing and kayaking in November.
Amateur thrill-seekers must register with the camp and wear safety gear – life jackets and helmets – before they go into the river. In one spot, people lie on their backs as the water carries them into a deep whirlpool, then tosses them up to the surface. The whirlpool is called the Devil’s Toilet Bowl or the Angel’s Bowl, depending on what the visitor feels once he or she has been thrown into the whirlpool, says Peter Mbuthia, a guide at the resort.
Another option is, with life jacket securely in place, to jump into the water and be carried about 50 meters downriver. Or try jumping from the top of a 40-foot waterfall, or go whitewater rafting along a 12-kilometer (7.5-mile) stretch of the river known for canyons, water cataracts and rapids ranging from grades one to five.
Other activities include river boarding and rock climbing.
Rapids Camp isn’t only for thrill-seekers. The camp hosts corporate events and family picnics, and it’s possible to camp overnight.
DETAILS: Visitors can use public transportation to get to Sagana town, then take a cab to Rapids Camp. There are no public transportation vehicles plying the dirt road between Sagana town and Rapids Camp. Special events and activities have different rates.
- Plunging down the waterfall (two jumps): 1,600 shillings ($15.45)
- Water gliding: 500 shillings ($4.82)
- Whitewater rafting: 7,200 shillings ($69.45)
- River boarding: 850 shillings ($8.20)
- Kayaking (full day): 4,000 shillings ($38.60)
- Rock climbing: 400 shillings ($3.85)
- Camping (tent and bedding provided): 1,600 shillings ($15.45) per adult
For more information, go to www.raftinginkenya.com, or call 254-732-308-026.
WHAT: See the spot once considered the source of the Nile River.
WHERE: Near the town of Jinja, on the shores of Lake Victoria in Uganda’s Eastern District.
WHY: The Nile River is often associated with Egypt, but the spot where the river pours out of Lake Victoria’s northern edge in Uganda has long been considered its source.
Recent explorations have determined that the White Nile’s waters might begin as far south as Rwanda or Burundi, but Jinja, a town in eastern Uganda, still celebrates the lake as the source of the river. The Blue Nile runs through Ethiopia and Sudan before joining the White Nile on its way to the Mediterranean Sea.
To see the spot long celebrated as the White Nile’s source in Uganda, branch to the right just before you reach the town of Jinja, traveling from Kampala. Move through a thick canopy of trees on the river’s western edge, and about 300 meters from the park entrance, you’ll find steps that descend toward the water. On the riverbank, there are stalls where vendors sell souvenirs, crafts and locally made clothes. A group of traditional dancers often performs nearby on the weekends, and visitors can participate, says dancer Ismah Misango.
A small reptile park features crocodiles, snakes and tortoises.
Boat rides are available for those who want to see the exact spot where the Nile flows out of Lake Victoria. There, the water is shallow and visitors can step out of the boat and onto the rocky riverbed. From this point, the river begins its journey of over 4,000 miles to the Mediterranean Sea. On its way, the water flows through Uganda, South Sudan, Sudan and Egypt.
British Indian Army officer John Hanning Speke in the early 1860s identified Lake Victoria as the source of the Nile, says Abdul Muwema, a local tour guide. The explorer is said to have seen the lake flow into the river while standing on a hill above the waters, Muwema says.
A monument to Speke rests on the western side of the river.
DETAILS: Admission to the park, known as Old Boma, costs about 10,000 shillings ($2.75) for foreign nationals and about 2,000 shillings (55 cents) for Ugandans. A shared boat ride is about 10,000 shillings ($2.75), and a private boat ride is about 40,000 shillings ($11).
For more information, call 256 793 845255 or 256 771 817959.
BUENOS AIRES, ARGENTINA – María Isabel Valenzuela Rivas, 62, knew she was overweight, and she wanted to do something about it. She considered weight-loss programs near her home in Chile, but the only places that offered such programs were too expensive for her and didn’t include the medical treatments that she wanted.
Valenzuela Rivas broadened her search to neighboring Argentina, where she found what she was looking for: a center offering specialized treatment under the care of a doctor, psychologist, physical therapist and nutritionist. Even including airfare and accommodations, Valenzuela Rivas says, the center in Argentina was much more affordable than anything she could find in Chile.
“Regrettably in my country, health is completely commercialized,” Valenzuela Rivas says in a Skype video call. “There is a public system that is dreadful, in which a person can be waiting two years for a spinal operation. And if they leave the public system, the cost is so high that it’s almost unpayable.”
More than 14,000 foreigners spent an estimated $182 million on medical tourism in Argentina in 2014, according to data from the National Institute of Tourism Promotion, and the Argentine government hopes to attract many more people.
Last week, the Argentine Congress of International Medical Tourism – the first of its kind - met in Buenos Aires, and the government announced a five-year plan to increase medical tourism revenue to $500 million annually and become the premier medical tourism destination in Latin America.
Experts on the industry say the escalation of medical tourism could negatively affect the medical needs of Argentines. Government officials say citizens won’t suffer and that the country needs to expand the field.
Tourism represents 7 percent of Argentina’s annual GDP, says Miguel Cané, president of the Argentine Chamber of Medical Tourism.
The majority of the country’s medical tourists come from other Latin American countries, according to the National Institute of Tourism Promotion. Forty-one percent of patients come from Chile, 29 percent from Uruguay, and 30 percent is divided among people from the rest of the world, primarily Ecuador, Bolivia, Peru, Colombia and some Central American countries.
The majority of them – 67 percent – visit Argentina in search of curative medicine procedures and treatments, according to the institute. The remaining 33 percent come for cosmetic treatments, including cosmetic surgeries, liposuction, weight-loss programs and cosmetic dentistry, among others.
Though reports vary, the global, medical tourism industry is valued at $38.5 billion to $55 billion, according to Patients Beyond Borders, an international medical and health travel publication. This is based on about 11 million cross-border patients worldwide who spend, on average, $3,500 to $5,000 per visit.
In the Western Hemisphere, Costa Rica, Mexico and the United States are the top destinations, according to the publication. Potential cost savings on medical procedures is a main incentive for travelers, who in nations other than Argentina primarily travel for cosmetic surgeries, such as dentistry and weight loss, among others.
Alejandro Muñiz, vice president of the chamber, says one of Argentina’s advantages is that its medical system is affordable and highly developed. This is attractive for foreigners who don’t have health insurance, he says. [[embed_image_1]]
Muñiz says a coronary bypass surgery in an Argentine clinic costs an average of $26,000.
According to research published this year by the American Heart Association, the cost of that procedure for an uninsured patient in a U.S. hospital would be between about $45,000 and about $450,000 – as much as 17 times higher than the average cost in Argentina.
Miguel Cané, son of the chamber president, and the general manager of La Posada del Qenti, a medical spa and resort in the Córdoba province in central Argentina, says one of every 15 guests at the inn is a medical tourist. Valenzuela Rivas was one of those tourists. The inn offers plans to lose weight, stop smoking or control diabetes or stress, he says.
Foreign patients choose Argentina because treatments and procedures are inexpensive, but also because the country has prestige, says Dr. Jorge Lantos, medical director at the Sanatorio de los Arcos hospital in Buenos Aires, Argentina’s capital. The training of doctors in Argentina is renowned worldwide, he says.
Patients also enjoy shorter waiting periods than they might in other countries, Lantos says. In Argentina, he says, waiting lists for medical procedures are usually around 10 days.
But some experts are concerned that more medical tourists in Argentina will mean poor care for Argentines. Eugenio Yunis, a member of the ethics committee at the United Nations’ World Tourism Organization, says medical tourism could negatively affect the poorest sectors of the country receiving the tourists. Medical tourism can generate more economic returns, such as occupancy in hotels and restaurants, he says. But that form of tourism tends to divert the attention of medical professionals to foreign patients.
“For it to be sustainable and generate long-term, equitably distributed benefits, it should be developed with very high ethical standards, given that it presents higher vulnerabilities than other segments of tourism,” he says.
Cané, the chamber president, says that with the existing medical infrastructure, the country can attend to foreign patients without compromising its citizens. Cané is also the founder of La Posada del Qenti, where his son is general manager.
“That is the limit,” he says. “In no way will attention to international patients be privileged over the need the country has.”
Cané, who considers Canada and the U.S. to be major competitors, says a significant challenge will be to divert tourists as far south as Argentina.
Muñiz says clinics and other facilities catering to medical tourists don’t expect to see an influx of foreigners this year but that he expects growth to be a big focus in the coming year.
“The expectation is that we continue growing and we achieve in positioning ourselves as a leading country in the region in the field of medical tourism, which in some way we are already getting,” he says.
Rishi Khalsa, GPJ, translated this article from Spanish.
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