Pockets, Not Pyramids

The Ministry of Health (MOH) recently started including little paper inserts with the boxes of 100 condoms that they distribute to hospitals, dispensaries and VCTs. The inserts contain instructions on how to use and dispose of condoms. If you cut out the shape printed on the inserts, fold along the dotted lines, and glue the sides together, you end up with a little envelope-like pocket that holds three condoms, with the instructions appearing on the outside.

Neetha and I first noticed these paper inserts a few months ago. One day, while trying to stay awake during a speech by some unidentified MOH officer, we tried to fold one into a condom pocket. It took about ten minutes to make one pocket (we didn’t have any scissors so we resorted to tearing carefully), and we decided that we frankly didn’t have the patience or manual dexterity to make another one.

It didn’t make any sense why the MOH thought anyone would take the time to make themselves a condom pocket. Wouldn’t a person who was taking condoms want to spend that time taking more condoms, instead of folding a flimsy piece of paper that could only hold three? Many branded condoms sold in Kenya come in similar pockets made of cardboard, so they’re sturdy. But these do-it-yourself pockets from the MOH were made of newsprint, and were too time-consuming to be practical. We wrote it off as a well-intentioned but pointless idea.

Side note: The thought occurred to me later that maybe the inserts weren’t the MOH’s idea, but the condom manufacturer’s idea. MOH condoms are manufactured by a company in China, which always makes me laugh since all my life my Taiwanese parents have insisted that nothing made in China should be trusted. Therefore, something that could mean the difference between a long, healthy life or genital ulcer disease should especially not be trusted. But I digress. The AIDS prevalence rate in Kenya has been cut in half in the last five years, so go Chinese condoms! Either way, there’s no explanation anywhere about exactly what these inserts are for or how to fold them into a condom pocket. Perhaps the assumption was that it would be obvious. After all, Neetha and I figured it out.

Today I was in the office with Godi, who was compiling month-end reports. He had a stack of these inserts on the table and was using the backs as scratch paper. It seemed a little inappropriate for a VCT counselor to be doing this, but since I’ve never seen a single person take an insert, I couldn’t fault him for recycling. As he told me about his day, I absent-mindedly started folding one of them into a condom pocket. Ten minutes later, when I finally finished, he looked confused.

“What have you made?” he asked.

“You can put three condoms inside and take them with you,” I explained, showing him how the instructions appeared on the outside of the pocket. “It takes forever, though. I don’t know who would actually spend time making them.”

He was impressed. “How did you know you can cut it and fold it like that? I thought it was just instructions for using condoms.”

“Oh, I don’t know,” I said. “There’s a shape that looked like it should be cut and folded into a pocket.”

“You know, people don’t like to take condoms,” he said. “They won’t go and take them from a big box like you have. They fear to be seen. So it is good that you have made this.”

He told me that the MOH is phasing out the current “Box-O-One-Hundred” packaging and coming out with smaller, more discreet condom pockets like the one I had just made, that holds three condoms. Except that fortunately, the new pockets will be made of cardboard, not newsprint.

“Do you think people prefer the smaller pocket?” I asked. “I thought people liked to take many condoms at a time.”

“Most people will only take condoms if they are given, for example during a VCT session,” Godi said. “But if they see these small pockets with three condoms inside, they might take them, because they don’t look like condoms.”

I didn’t really agree with the last statement, since the pockets have instructions on the outside with pictures of someone putting on a condom. But he had a point.

We keep hundreds of boxes of condoms (100 condoms per box) in the reception area for people to take as they please, but I’ve never seen anyone take one. It’s perhaps too intimidating to be seen taking condoms from a tall pyramid of Box-O’-One-Hundred-Condoms, despite the fact that people are here for an HIV test, which presumably means they’re having sex and could benefit from condoms. But as is often the case in Kenya, what is most obvious cannot be talked about or acknowledged publicly.

Two more counselors came into the office and saw me stuffing condoms into these little gossamer envelopes. They were amused, despite the fact that they talk about and handle condoms everyday. “Unafanya nini, Justina?” What are you doing?

I showed them how to cut and fold the insert into a condom pocket, and they got excited.

“I never knew what these papers were for,” one said as she started cutting and folding more pockets for me to stuff.

“It looks so smart,” the other said. “People will like these because they can hide condoms inside.”

“We’ll start putting condoms in these pockets and putting them out in the reception area for people to take.”

“And we can put together more in our free time, so people can be taking them.”

They started passing out Packet-O-Three-Condoms to other staff members. “We have a gift for you,” they said, reveling in the opportunity to make their colleagues uncomfortable.

“Oh, no, I don’t use these things,” my co-workers would protest in horror.

I was surprised that so many of my colleagues became awkward when they were offered condoms, and were quick to distance themselves from the notion. Despite years working for an organization that deals with HIV, STDs, and sex on a daily basis, they still had so much internalized stigma about condoms.

I felt a sense of accomplishment today, accidental though it was. The counselors are excited about this new way of packaging condoms that will make people less shy to take them, and learned that the MOH didn’t just provide a stack of free scratch paper with every box of condoms.

Uvula Update. Nicholas didn’t have his uvula cut off after all. The guy who was supposed to chop it off for him ended up using a syringe to shoot his uvula full of an herbal concoction that shrank it to a manageable size. His throat is feeling much better, and his uvula is, he claims, much smaller.

The Indian Staring Project. I heard on the BBC this morning about a woman in India who organized 35 women to sit together along a busy street, where men usually go to stare at women. These women spent the day staring at men as they walked by, to make a statement about the cultural practice of men in India staring and harassing women on the street. Men who were “caught” in the project were interviewed and said that being stared at by 35 women was upsetting and made them feel self-conscious. They agreed that it was an effective way to get them to understand how it makes women feel to be stared at like objects everywhere we go.

I wonder how well a Wazungu Staring Project would work. Somehow I imagine that 35 wazungu sitting at my market attempting to stare down locals would only draw more intense staring from everyone around. Hats off to the women in India, though. I admire their courage and creativity, and look forward to returning to the land where staring is so taboo that, when I was eight, my mom chewed me a new hole for staring at a woman sitting behind us at church whose singing was as amazing as the fat lady’s at the opera. I’ve never stared again. God bless America.