8/7/09

So I’ve been here for exactly a month now, and I am constantly amazed at how one can adapt to a new home. As my internal body temperature has become adjusted to the constant heat, so has my temperance adjusted to the slower pace of Africa, and the subsistent lifestyle that values each loaf of bread as a part of their delicate, if fleeting, communal economy. I love my three times a day bucket baths, my saving grace after hours in the 110 degree heat, my nighttime flashlight lit conversations with my host family (which still consists of many blank stares and awkward language misunderstandings), and cold sodas from the boutigi. We finally received our mountain bikes last week, and a bunch of us took a ride down to the Niger River and the adjacent canals, where we sat and watched the men pull sand and the occasional fish from the river. It is always refreshing to get out of our village, which seems to grow in children, goats and trash piles each day, and visit the neighboring areas which are all much calmer, to say the least. We have gone to the neighboring village with Peace Corps volunteers several times, where there is great rock climbing with beautiful views of the surrounding villages. Sometimes it is really frustrating to see the practices of some of the villagers, and as a trainee and not yet a full PC volunteer, it is difficult to assess my place to institue the changes I hope to work on soon. No, don't let your children run barefoot through urine-filled soak pits, festering with nitrogen-fed algae and shistosomaisis! Do not feed your infants tea and coffee instead of breastmilk! And no matter what I've told my host family, they still believe that ground millet three times a day will somehow make their children strong; instead, you see their children protein deprived with the telltale pot-bellies. We spoke with UNICEF the other day about possible regional collaboration to improve latrine use and water sanitation, which could be an interesting initiative. I am hoping to speak with them in a few months for a possible regional initiative for diagnosing and treating cervical cancer. One thing I am realizing though is that I really need to work closely with my community before engaging in these loftier goals.

Gender and development is another area that I am really looking into at the moment, which would really tie into my work at the Community Healthcare Center, since my Malian co-worker is a Matrone (much like a midwife/nurse). There are some staggering statistics concerning women: for example, the average Malian women has 7.2 children (compared to the American 2.3 children per woman!). As polygamy is common here (my host father has two wives), you can imagine what kind of pressure exists both physically and financially on Malian families. Education on birth spacing and family planning is a major component of easing these stresses. Another sobering statistic is the widespread acceptance of female genital mutilation (or excision) - 95% of adult Malian women have undergone some form. Apart from all the other aspects of the affects of FGM on women, from a health standpoint this practice is extremely dangerous. While paying close attention to cultural sensitivity, I am hoping that, with time, I can work towards educating my villagers on these issues.

Last week the health volunteers visited Fana, a nearby city, where we were given a tour of the radio station, radio broadcasts being a useful vehicle to educate a large population on healthcare issues. After that, we went to the HIV/AIDS (or VIH/SIDA) clinic. We could not help noticing the discouraged affect of the doctor, as he told us of the overwhelming stigma that AIDS has in Mali, and the minimal national governmental support for the disease. The frequency of AIDS in Mali is actually one of the lowest in Africa, affecting 1.6% of the population (even lower than in the US, 1.7%), but these numbers are misleading as HIV testing is extremely uncommon. While international aid has been invaluable in providing free HIV/AIDS treatment and support to those affected, the majority of the population is still largely ignorant and/or skeptical of the disease. Many Malians simply do not believe the disease exists at all, that it is just a manifestation of the international aid organizations to make money, or have other ideas about its origins (contracting HIV through condom use, for example). After visiting the clinic, one of only 8 currently operating in the county (although 11 more are opening around the country in the near future), we visited a community of HIV positive individuals. After shaking their hands and joking with them, they told us of how their home communities had demonized them, forcing them to fight their illness without their families. Before we left, they thanked us several times for our courage – the courage to shake their hands and look past their disease, and treat them as people worth fighting for. After visiting Fana, I was speaking to my 25 year old host brother about his understanding of AIDS, and he told me of the widespread denial of the disease. It really does bring the relative access of information and sympathetic healthcare we have in the States into perspective.

This week at the training center has been a blur of classes on agricuture, water sanitation, safety, cultural training, etc., and tomorrow we are going to a nearby village to work on community assessment with a women's association. On Sunday I am visiting my permanent village for a week, followed by two more weeks at my homestay before I complete my training. I will be in a small-ish village of 7,000, about two hours from Kita, a pretty central city in the Kayes region (Mali's Western region). It is definitely "en brusse" (aka quite rural), but there is another volunteer about 5k from me, and another is 8k. I am really looking forward to beginning my real work here.