murals for all!

With a brand-new site mate there were four of us, enthusiastic and sweaty in our little radius of 15km of western Mali brusse. We decided to get together for a little more than our usual weekly naps listening to our ipods and did a little mural painting campaign. We started out in Eric's, painted about hand washing and bleach well treatment. His host family gave us fresh milk, creme brulee! we declared, and we wandered into the brush in a failed search for the strong stocky genies. The next day we biked through the pink tinted cotton fields to my village; greeted the chief and my homologue, and painted a mural of the food groups. As we napped and waited for the pasta to boil I went to the health center and grabbed Kristin to watch a birth. That night the milk tasted like goats. At Kristin's village the next day we painted a recipe for oral re hydration salts at the corner store as the villagers stared at our sweaty backs. Nighttime we built a fire, played exposing card games. Finally in Cary's village we painted a large handwashing mural on the mosque, felt guilty for defacing the religious building with our garish paints but the villagers loved it. That night they killed two chickens and started a dance party in the village square; we jumped around trying to imitate their swift legs, happily getting to bed at midnight. Early in the morning we jumped in his village bush taxi and made the long journey back to Kita, singing as we rattled off the strange insane wild life we've got here in the bush.

Call me Djeneba

On my market van, a wreck of tin I head to village. As the square homes round out and there goes the tin roofs only straw now and too goes my ‘Dina ness.’ I become the Djeneba of non-eloquence, long-skirted and dirty feet. In Bambara/Arabic Dina means religion, and Djeneba eludes to the djenes, the spirits that haunt our mountains. So there I am, elusive as religion, concrete as the spirits and as strange as the two. My bachelors of science is not impressive compared with the matchless skill the women demonstrate sifting corn; seamless twists of their wrists effortlessly shower pounded corn powder. I sit feeling outcast in my cross-legged position, like the men; respond by leaning forward, legs apart, skirt fastidiously tucked between my thighs like these women of grace do. Still they somehow find me worthy of attention, even seek me out during the awful heat of the day when I am tempted to lay on my huge glorious foam bed splurging on the ipod battery to listen to a podcast ‘cause I’m always just tired.

But the morning drained me weighing babies; this one in the honey colored arms of the Fulani women, her skin and huge eyes tell of her Northern anscestors, long buried stories of the lost Israelite tribes. Her baby is terribly malnourished, marasmus, skin hanging off his arms face looks like a mushroom beginning to shrivel. He’s lost weight since last time but that was months ago when I did the porridge demonstrations, where has he been? She won’t go to the hospital so I give her bags of the enriched porridge we have from UNICEF – expired but still good soy/corn blend but still I’d rather them learn that they can do it all on their own they don’t need our handouts, its just a dead end. Cook with peanut oil and come back next week your baby is sick goddamnit please come back with your husband so we can do something just a woman alone is nothing here.

And off again next week on the 6am bush taxi to Kita, a woman gets on in the still dark morning; her baby looks asleep wrapped in a colorful sheet his legs are so limp. He’s sick - going to the hospital - and next to my sitemate an hour later the woman starts to moan as she lifts the covering, softly shaking the baby. We stop at the next village and my site mate looks at me – did that actually happen? the baby died by my side – we get out and pace as one of the passengers writes a notice of death to air on the radio tonight. The woman is lead away shaking her head, her pink headwrap has unraveled. The rest of the ride my sitemate and I can’t stand the men next to us who are joking that we should cook them rice, be their good wives while they smoke their cigarettes next to the now empty spot. We are in no mood for chauvinism as innocent as they think it is; even though it’s not their fault the baby wasn’t theirs still we both are boiling with anger – at who? Then we are in town, how is the sun so strong at 8AM? These people seem like actors to me, their dresses too colorful their gestures too dramatic the backdrop too sandy and all burnt sienna. "Tubab muso ni" I am known as now, ‘little white woman,’ anonymous for the moment, the nameless white void.

Off we go to the capital, and there we meet other volunteers and drink too much and have excited conversations about digging wells. So here again I’m Dina and I can make sounds that impress and my jeans feel strange against my thighs. Then we drink more and make messes of our reputations, but what can we do? As a friend wrote, “We’re a messy bunch. This is Africa.” Yes, we’re all a bundle of want and need and passion and grasping for respect. There’s so much sand in our 20-something lungs and we’re alone but not lonely but surely sexually frustrated in our villages; so we try to relate to our American peers as we sit in the outside bar that plays Phil Collins and Tracy Chapman and damn do we try hard.

But the morning comes and I’ve submitted my proposals and I ache to be back in village even if no one knows my ideas on cognitive psychology or the brilliance of Brian Eno. ‘Cause there I feel more Dina as Djeneba and maybe there’s something to this nameless name, its not so arbitrary after all and I miss the mysterious little world waiting for me inside that hut.

BBC article: Thousands of Nigerian women 'found in Mali slave camps'

An article from BBC News Africa, about the girls I met in the gold mining town in western Mali.

September 29, 2010
http://www.bbc.co.uk/news/world-africa-11438341

Nigerian girls are being forced to work as prostitutes in Mali "slave camps", say officials in Nigeria.

The girls, many of them under age, have often been promised jobs in Europe but ended up in brothels, said the government's anti-trafficking agency.

The brothels are run by older Nigerian women who prevent them from leaving and take all their earnings.

The agency said it was working with Malian police to free the girls and help them return to Nigeria.

Continue reading the main story
Related stories

Nigerians lured to work in Italy
Nigeria's 'respectable' slave trade
Tales of woe from Nigeria's child 'slaves'
There has been no official comment from the Mali authorities.

Nigeria's National Agency for the Prohibition of Traffic in Persons (Naptip) said officials visited Mali this month to follow up "horrendous reports" from victims, aid workers and clergy in Mali.

They said there were hundreds of brothels, each housing up to 200 girls, run by Nigerian "madams" who force them to work against their will and take their earnings.

"We are talking of thousands and thousands of girls," Simon Egede, Executive Secretary of Naptip, told a news conference in Abuja.

"We are talking of certainly between 20,000 and about 40,000," he said, but did not give details of how the figure had been reached.

In a statement, Mr Egede said girls were "held in bondage for the purposes of forced sexual exploitation and servitude or slavery-like practices".

"The madams control their freedom of movement, where they work, when they work and what they receive," he said.

Abortion clinics
The trade is centred around the capital Bamako and large cities, but the most notorious brothels are in the mining towns of Kayes and Mopti, where the sex workers live in "near slavery condition", said Naptip.


Many of the brothels there also had abortion clinics where foetuses were removed by traditional healers for use in rituals, said Mr Egede.

Most of the girls were reported to have come from Delta and Edo States in Nigeria.

Many were lured with the promise of work in Europe, given fake travel documents and made to swear an oath that they would not tell anyone where they were going.

On arrival in Mali they were told they would have to work as prostitutes to pay off their debts. Prostitution is legal in Mali but not if it involves minors.

Naptip said it had also uncovered two major trafficking routes used to transport the women from Nigeria through Benin, Niger or Bukina Faso to Mali.

Mr Egede said Naptip was working with the police in Mali to return the girls to Nigeria safely, shut down the trade and prosecute the traffickers.

The BBC's Caroline Duffield in Lagos said the Edo State region of Nigeria in particular had become notorious for prostitution, with thousands of women and girls leaving every year to make money as sex workers.

But the suggestion that there was an organised ring of older women operating as traffickers - and that they were tricking younger women into leaving - was new, said our correspondent.

Hey, leave those clits alone!

Warning: This post is graphic. It describes female genital mutilation and other negative practices.

“It should look like a flower,” sighs the speaker Madame Traore, cueing visuals of pastel Georgia O’Keefes, potpourri, and oddly, Kathy Griffin. We are sitting in a classroom at a three-day workshop on excision, women’s reproductive health, and children’s rights. All the local big-wigs are here: mayors, school directors, imams (Muslim priests) and radio DJs; trained midwives and traditional medicine women; town criers and local NGO workers. While I am the only foreigner amidst over 60 Malians, I realize I am also one of the movers in my community, and I am heartened to see how many people are passionate about this issue. I see my friend, who, disturbingly, I found out performs excision on the village girls, sometimes 20 girls with one knife. At least she’s here. And today, together, we are talking about the “should.”

We begin by discussing traditional practices here in Mali that can be detrimental, specifically those common in three ethnicities present at the meeting: Dogon, Peul, and Malinke. In addition to female genital mutilation and male circumcision, many of those present talked about practices such as ear and nose piercing, tattoo of the lips and the gums, scarring (often done on the sides of the face, next to the eyes or down the middle of the forehead), teeth filing, blood-letting, and taboos against certain foods for pregnant women and children. They also cited more traumatic practices of tribal initiation for men, extreme diets or force feeding for to-be brides, levirat and sororat, the tradition of marrying the brother/sister of your deceased spouse, degrading customs for sterile women such as putting hot pepper into the vagina or burning pubic hair, forced early marriage of girls, and forced child labor.

The common and arguably the most damaging practice that affects girls in these cultures is excision. Excision, the softer term used here for various types of female genital mutilation/cutting (FGM/C) or female circumcision, is extremely prevalent in Mali, one of the highest occurrence rates in the world with estimates ranging from 90- 95%. In my region, Kayes, the rate is at a heartbreaking 98%. Mali does not have a law that prohibits excision, despite efforts by the former president Konare to pass a bill in 2002 to criminalize it. Historically, female circumcision has links to Egypt, and is practiced in parts of Africa, particularly in the western and eastern countries, as well as in the Middle East. While excision is not a practice mentioned in the Koran or the Bible and has been discouraged by Islamic religious authorities, many of the participants cited a biblical origin. In the story, Sarah forces Abraham to circumcise Hagar, the Egyptian slave who bore Ishmael. God then commands Abraham and Sarah to circumcise themselves in response to their actions. There is also tribal traditions that are used to explain excision. Stories from the Dogon tribe include the belief that babies are born of both sexes, and just as the “feminine” foreskin must be removed from the penis, the “masculine” clitoris must be removed from the vagina, which also ties into Egyptian origins.

While in the past excision had sometimes been a ritual of the wedding ceremony, it is now normally performed on girls between the ages of birth until five years, and sometimes until puberty. The extent of the mutilation ranges from just the partial or total removal of the clitoris, known as clitorodectomie, to excision, the most common form, which includes the ablation of the clitoris, the labia minora and/or parts of the labia majorta, which is most common form in Mali. Rarer types include infibultation, a narrowing of the vaginal orifice where the clitoris and both inner and outer labia are ablated and sewn to create a small opening. The last type includes a variation of mutilations, including pricking the clitoris with needles, introducing corrosive substances to the vagina, and introcision, where the vagina is expanding through stretching or tearing the perineum (the area between the vagina and rectum).

The possible consequences of FGC are manifold and can be debilitating. The most obvious result of excision is reduced sexual pleasure, but is by no means the only effect the practice can have on the women and their families. The procedure itself can cause hemorrhaging, which could also occur as the vagina ruptures during childbirth, leading to anemia and possibly death. In addition, the scarred tissue creates a narrower birth canal, where the infant’s head sometimes cannot pass through easily, and sometimes even not at all. Often during a women’s first childbirth, the head becomes misshapen as the still soft skull becomes indented trying to pass through the vagina, which can lead to head trauma and possibly long-term brain damage. Mme. Traore explains that often, these infants do not cry right after birth, as their reflex center is affected. This explains all the bewildering silent birth I’ve seen. There can be difficulty during sexual intercourse, which can result in forced penetration, vaginal tearing, and rupture of the perineum. Infibulation can cause an accumulation of menstrual blood and urine, which can lead to uterine infections and sterility. Uncontrollable urination can also occur as the urinal passage can become defective. The procedure is often performed by untrained women and with unsterlilzed tools. These unsanitary conditions increase their risk of infection, including tetanus, HIV, and hepatitis B. Finally, girls who have undergone excision, particularly at a later age, can experience psychological trauma from the ordeal, affecting their sexual and social relationships.

Then why is it done? Participants cite reasons including hygiene, preservation of virginity, fidelity, increased male sexual pleasure, esthetics, society initiation and cultural/tribal identity. They agree that lowered sexual sensitivity is a major underlying factor, which is intended to reduce the risk of wife infidelity. While women have told me they believe the clitoris is unclean, there is no evidence of any hygienic advantages to excision; on the contrary, the procedure, the healing process and the subsequent possibility of vaginal tearing during intercourse and childbirth increases their risks of contracting infections, including HIV and other STIs. It is also believed that it helps facilitate a healthy childbirth, which also has no medical support; excision can actually create serious difficulties for the mother and the child, sometimes resulting in the need for a Cesarian section or even the possibility of maternal and infant death. As detrimental as it can be, however, excision has a strong traditional foundation and is important to feminine identity and social acceptance. As surprising as it may seem, a great deal of the push for the continuation of excision comes from the mothers and the older generation of women, who, in addition to wanting their daughters to have a normal status in their society, believe that it is necessity for their hygeine, reproductive health, and spiritual well-being.

During our talks on female and male reproductive systems we argue about women’s rights, the appropriate age for first marriage, and even a very humorous, if not awkward, debate on penis size (yes, men are men everywhere). We look at children’s rights, and how excision and forced early marriage of girls– girls are typically married off around age 15 in my village, as early as 12 - violates their vulnerability and their rights to a healthy childhood. Finally, we end the last day planning an activity to fight-excision in our individual communitites. The school director of my village suggests a theater competition, where the girls and boys will put on plays about the dangers of excision and the importance of promoting children’s rights.
At the end of the third day, we all gather together for a picture, and make our way back to our villages. I see my friend, who tells me that she has learned a lot. The Mayor says he wants to work on campaigns with the doctor of my health center, and is excited to see the theater competition. As for me, I will work in the background to support anti-excision campaigns. Though I find myself passionately against excision, frustrated by its recklessness and disturbed by its consequences, I am the foreigner, and I know I can never truly understand its complex role in female identity here. This is not my culture, and I know in the end it is not my fight.

A book, a book...

In between and during my time spent at the health center, fumbling in my language with my villagers, or here working and playing in Kita, I spend a good chunk of my time reading. Luckily, volunteers before me have joined in this art of social withdrawl, leaving libraries of books that supplement the ones I brought. I am halfway through my service and halfway to my goal of 100 books. So here is the list of 50 books I’ve read this past year:

1. On the Road – Jack Kerouac
2. Night Trilogy – Eli Weisel
3. A Moveable Feast – Ernest Hemingway
4. Do Androids Dream of Electric Sheep – Philip K. Dicks
5. Beneath the Wheel – Hermann Hesse
6. Dead Souls – Nikolai Gogol
7. Still Life with Woodpecker – Tom Robbins
8. The Prophet – Khalil Gibran
9. Sailor Song – Ken Kessey
10. Brave New World – Aldous Huxley
11. Grendel – John Gardner
12. The Picture of Dorian Gray – Oscar Wilde
13. Tropic of Cancer – Henry Miller
14. Mountains Beyond Mountains – Tracy Kidder
15. Dubliners – James Joyce
16. Foucault’s Pendulum – Umberto Eco
17. Poisionwood Bible – Barbara Kingsolver
18. The Fall – Albert Camus
19. Slapstick – Kurt Vonnegut
20. The Hamlet – William Faulkner
21. Greatest Russian Short Stories - Various
22. Catch 22 - Joseph Heller
23. A Clockwork Orange- Anthony Burgess
24. The Death of Ivan Illych and Other Stories – Nikolai Tolstoy
25. Things Fall Apart – Chinua Achebe
26. The Enormous Room – ee Cummings
27. Desolation Angels – Jack Kerouac
28. Letters to a Young Poet – Ranier Maria Rilke
29. Air Guitar – David Hickey
30. Sanctuary – William Faulkner
31. The Martian Way – Issac Asimov
32. Blink – Malcom Gladwell
33. Half Asleep in Frog Pajamas – Tom Robbins
34. Sula – Toni Morrison
35. Zen and the Art of Motorcycle Maintenance – Robert Pirsig
36. Heart of the Darkness – Joseph Conrad
37. Peter Camenzind – Hermann Hesse
38. Tropic of Capricorn – Henry Miller
39. The Plague – Albert Camus
40. The Awakening and Other Stories – Kate Chopin
41. Mostly Harmless – Douglass Adams
42. The Air Conditioned Nightmare – Henry Miller
43. Portrait of the Artist as a Young Man – James Joyce
44. The Sirens of Titan – Kurt Vonnegut
45. Kafka on the Shore – Harukami
46. The Stranger – Albert Camus
47. Desert Solitaire – Edward Abbey
48. Pylon – William Faulkner
49. The Alchemist – Paul Coelho
50. Atlas Shrugged – Ayn Rand

Cervical Cancer Screening Campaign

Cervical Cancer Screening Campaign – Bougaribaya Commune
Dina Carlin, Peace Corps Mali Health Education Volunteer
August 23-28, 2010

Six days, six villages, and 299 women later, Founeba and I returned from our cervical cancer campaign. We were exhausted, run down, but proud. Using visual inspection with acetic acid (VIA) and Lugol’s iodine (VILI), we screened an average of almost 50 women in each village, and had found that 48 women had at least the first signs of infections that can lead to cervical cancer.

This campaign was designed as a follow up to a workshop in May, where doctors and matrones from each of the 35 health centers (CSCOMs) in the the Kita Cercle were trained in visual inspection, a preventative screening method for cervical cancer. VIA and VILI is carried out by applying an acetic acid solution (for VIA) or Lugol’s iodine (for VILI) directly to the cervix. Pre-cancerous cells, known as cervical intraepithelial neoplasia (CIN), are cervical cells that have been exposed to persistent infections from one or more high-risk strains of the Human Papilloma Virus (HPV), which often lead to high-grade lesions. In almost 50% of cases, these lesions develop into cervical cancer. In VIA, precancerous cells form white areas (acetowhite) while in VILI pre-cancerous cells turn yellow (iodine non-uptake) when exposed to the solution. These results occur within a minute, and are easily seen using a strong light source. Along with Dr. Oussman Sangare, Chef de Poste at the Bougaribaya CSCOM, Mme. Founeba Dansira, the CSCOM’s head matron, the health center’s governing board (Bougaribaya ASACO), and community health workers (Relais), and myself, the campaign focused on expanding the accessibility of VIA and VILI to communities without health centers, as well as promoting the importance of women’s reproductive health care and the CSCOM’s activities.

After informing all the villages of our campaign schedule the previous week, the doctor went to Kita to attain some final materials needed for the screenings. The morning of the campaign, the matrone and I found ourselves alone, as the doctor had had to stay in Kita indefinitely due to domestic difficulties. While this left only Founeba to perform the screenings, we decided to go ahead as the villages were awaiting our arrival. Armed with my backpack full of supplies – speculums, placental probes, cotton, gloves, acetic acid and Lugol’s iodine - we set off for Karo, our first village. We arrived late in the morning, and set up in the hut of the Relais. Founeba did the screening in the dark hut, using a flashlight as the women laid on a bamboo bench. I sat outside the door, taking down the information of the women who crowded around me. Founeba explained the procedure, and performed the screening. At the end of each screening, I would run in to confer with her results and record them. From time to time Founeba paused to breastfeed Omou, her 8 month old baby, while I tried my best to trudge through the questions, helping them gauge their age despite their lack of birthdates, and talking to them about family planning and STI prevention. When we finally finished after 5pm, we had seen 43 women, had found 9 of them were infected or had high-grade lesions, and had seen two cases of suspected cancer. With the women’s approval, we gave the list of the positive women to the Relais and spoke individually to her and her husband, if available, trying to convey the importance of a follow-up appointment at the health center. We urged the Relais to follow up on these women to ensure treatment was sought.

The second day we gathered the women at the school of the next village, Bagnakafata, where we designated one of the classrooms as the screening/consultation room. By midday the sky had darkened and the rainstorm raged as we performed the screening. Many of the determined women waited, soaking under the hangar as we called each name, while the rest of the women went home. We ended the day with headaches, colds and 10 new positive cases or infections. The next few screenings went much more smoothly as we became used to the system and had additional help. Some we did in classrooms, others in dimly lit huts. After the six days, we had seen 299 women, and found 48 of them had infections or pre-cancerous cells. We urged many of the positive screenings come into our health center, where the test would be repeated by Dr. Sangare. However, several screenings showed high grade lesions or invasive cancer, which we referred directly to the health center in Kita. The Relais were encouraged to talk to the women in their individual village about the importance of following up with their screenings, and to organize transportation and fundraising.

There are still missing links, however. It is difficult for rural women to find funds to travel to Kita, but, due to lack of equipment, the health center is unable to provide adequate treatment. In an ideal case, immediate treatment would be available, like cryotherapy and loop electrosurgical excision procedure (LEEP). Linking screening to treatment is critical in providing comprehensive prevention in rural areas, as the probability of follow-up treatment decreases with multiple visits. Both are simple and minimally invasive treatment options, but are currently unavailable at the village level. A follow up to this screening campaign would include investigation into the accessibility of such treatment methods at the village level. For now, however, there is infrastructure in place to support these women, at the cercle, regional and national levels. With the support of their communities and annual preventative screenings, and with further investigation on increasing the availability of appropriate treatment techonologies, we can start to makes moves towards reducing cervical cancer here in Kita, and in Mali at large.

This must be the place

Feet on the ground, head in the sky…

I came back to village after almost two months of America, the steel and bottled water still swimming in my stomach. My hut, of course, was a mess – bits of my new straw roof was strewn across my bed and floor; the termites had eaten out my bookshelf and some of the books with it. But how good it is to be home! I came back, not as a guest, a burden, a novelty, but as just another villager, missed but not paraded.

The first night I got back, I walked to see Soliba and caught her on the path. She said she was going to the health center, where her friend was giving birth. I joined, and as we came we found little Tene’ba, the tiny older midwife, happy to see me as she sat outside. Soliba went inside; Tene’ba told me about her friend’s baby, how it had died during the birth. The young mother lay curled under a piece of fabric; Soliba and her sisters sat quietly. I went in to see the baby, a plump thing, but gray and of course silent. Tene’ba spit on the baby and folded it into a clay pot. It fit so neatly into the little pot, all the sudden out of its tiny existence. We walked to the treed area next to the health center where they are buried. Two of the mother’s friends joined us with a daba, a type of shovel. Tene’ba broke the soil, as she did she let out a cry, intensely violent and controlled, a sad anger. I thought, at least someone is angry. After the pot was in the mound she spit on the ground, three times, the animist warning off of evil spirits. We walked back to the health center and washed the dirt off our feet.

A few days later my host mother Hagi invited me to join the women from the Women’s Association, who were farming at the peanut fields to raise money for our garden project. We went out early, the first ones there beside the little drummer man we met on the way, who told us he was drumming to call in the women to work. They came in with dabas and their littlest babies, maybe twenty in all. The man beat his drum the whole day, keeping a persistent beat that the women worked to. The Griot, a sort of town songstress, came and sang with the women in her faded yellow lace outfit, and the women would sing in response as they bent over their rows of peanuts. They worked in groups of 5 or 10, all of them in a line, progressing in time with the other women as they cleared the weeds from the new peanut plants. They insisted I sit in the shade and watch the babies, but every once in awhile I would come and relieve some of the women who looked tired. We would stop sometimes to dance; someone would throw a scarf to the next women, whose turn it was to dance to our claps and the drums. We worked until late afternoon, the women working bent throughout the day. Making food for their children, working together, what more could we have to celebrate? And I thought, this anger I've seen, this joy I feel is as human as technology is not. Without the computers, the gadgets and cell phones and nothing but our hands in the ground, we find that all we have is each other. I like that.

Africa is Sexy

Sitting in my hut, the new straw roof is even worse than the last one; it’s not sealed, and I feel each irate wind. And my kitchen is a mess and it won’t be dry enough to fix tomorrow morning. And here I sat rehearsing my anger speech to the village, how I would tell them I couldn’t live another day in a busted hut. But the music in my ear, Devendra Banhardt plucking along, is just too damn beautiful and sexy and bright and now I’m grinning and excited for my upcoming trips around this place, and to come back and chat with Soliba and see other volunteers and paint more health murals. So I just can’t stay mad or sad in this electric storm and I’ve never been able to, I just feel the energy glittering and I’m on the world’s greatest adventure, I am the fearless pioneer of treacherous truck rides and jumping to the drum beats and filling empty bellies and sucking enveloping sculpting all of this.

Yea, Africa is sexy me and Eric agreed the other day, sitting on the floor of the Chief’s lodge in the gold mining village. What is sexy about Africa? We pondered this and sweat dried foreheads, snacking on peanuts on the scratchy plastic mat. And the more we talked we felt how sweltering these hot days are, sultry and invading, as if the air is pressing its heavy body against you, with intoxicated passivity you ache under its weight. There is no promise of a release except for these electric rain storms, and when it rains it begins with the violent winds where the dust makes you squeeze your eyes shut tight; then the rain swells and unleashes its tiniest drops first and then bigger, faster, your pores cry for relief. Soon the rain is too strong, you can escape under the shelter of leaky straw but maybe you are better off getting wet, sopping, streaming, but finally cool.

So we sat smelling the roasted goat meat and we saw this taunting "modesty" of the African Muslim culture, the innocence easily seen through as the endless children parade by; let’s not pretend they all sprung from the drowsy gardens. Everyone is together, sweltering skins touch as we squeeze in Bush taxis or sit and talk on the one mat or bench around. And if you are not touching, right next to everyone, well then you are alone in the bush and you are really nothing if you don’t reverberate with everyone in the overflowing drum circles and call out to one another in song. Yes, Africa is sweltering and naked and orgiastic with human energy, so concretely human.

Help Raise Money to get solar electricity for my health center!!

This project is to install solar electricity capability for the community health center. This health center provides care to seven villages and their surrounding hamlets. The seven room health center is located in a rural village 60 kilometers from grid electricity, and includes a maternity ward, a pharmacy, as well as general medical consultations and a laboratory.

Currently, most of the health center’s activities are limited to daytime hours. Emergency nighttime care is facilitated through the use of a flashlight or oil lamp, which poses dangerous complications to the patient from the lack of visibility. Births and emergency medical needs are frequently carried out under these insufficient conditions. The electrification also includes the capability to power a refrigerator that stores the center’s vaccinations and injectable medications, a weekly vaccination campaigns being one of the critical functions of the health center. As the current gas-powered refrigerator is sometimes low functioning, vaccinations and medical injections are at risk of exposure to high temperatures which could severely damage their effectiveness, posing a serious health concern to the population.

Through a meeting with the community governing board of the health center, the lack of electricity was identified by the community as an immediate need. The community agreed to contribute 25% of the total cost of the project, in collaboration with the Mayor’s office, the governing health committee (ASACO), the health care center (CSCOM) and the community members from all seven villages.

To donate, please click on the link below:
https://www.peacecorps.gov/index.cfm?shell=resources.donors.contribute.projDetail&projdesc=688-332

the air conditioned (nightmare)

. We're
alive and shall be:cities may overflow(am
was)assassinating whole grassblades,five
ideas can swallow a man;three words im
-prison a woman for all her now:but we've
such freedom such intense digestion so
much greenness only dying makes us grow
(ee cummings)


Ok, so the Henry Miller title is a little extreme - lets call it a daymare - but seriously, summer in New York and I've never felt so goddamn cold. Here I am a month and a half later, the three week trip stretched (far too long) when I found out the searing pain in my jaw were my wisdom teeth crowding my too-tiny mouth. Though a year is not quite as extreme as Henry Miller's decade abroad, I can sympathize with his feeling of alienation in this country I grew up in, happy there as I can be at times.

The air inside is sharp with recycled cool, bossy, as if it's doing me a big favor sparing me from the wrathhful sun. Well thanks alot, but I think I prefer the wind outside, humid and hotdog scented as it may be. Everything is in neat little squares here: pockets of laundry or sewage smells, blocks of Russians in Brooklyn and Africans in Harlem, the old Jewish ladies in the Upper West Side, and square little dog parks for tidy little dogs. And ah, how smooth all the surfaces are - no rubble filled roads here, no hand-smoothed mud walls or stalls made out of old wicker mats. Yes, all the beds feel like clouds, and the grocery stores make my beloved Kita market look as lame as a lemonade stand. And then theres the pizza, bagels, sushi, tacos, cheese, cheese...

So sure, New York City can be wonderful in the summer. It puts on a beautiful face despite the humid days; free concerts in the park with wine hidden in paper cups, Michael Jackson tribute raves in the subway cars, galleries and museums, concerts on ferries. But then, without a warning, I soon found myself fluttering with stress. I trembled near the cell phones that refused to sit quiet, decisions of where to go and who to meet that filled me with guilt and that urgent feeling of short timelines. What I re-discovered, of course, was the familiar stress of frivolity, the privilege of picking which bar to spend our ready cash, what throw pillows will match the framed mirror. Don't get me wrong, it's not that I think we'd all be better off finding enough food to eat, but what I've really begun to see clearly is stress is everywhere, and always as real as you make it. But theres this new part of me that I felt clawing at my throat, the state of panic I felt at the huge department stores (I think the devil lives in the Palisades Mall), and try as I did to push away these hippie-fits, there they were. Sadness cried rhinestones, sat on thin toilet-seat protectors with the dark-skinned nannies as they pushed someone else's child. Oh, the tragedy of breast pumps.

I was able to get to DC for the Fourth to see my college friends. Of course it was oodles of fun, but as I looked around there it was again - though the families in practical fanny packs felt a little more comforting, I couldn't understand how these people could all be together waving the same $5 flags. Where is the passion, the need, the grasp? How can anyone hear their own thoughts in this sea of eyes on iPhones?

After, I took a trip up to the Catskills, and there I finally felt the paranoia subside. I forgot how green New York can be, how entertaining a watering hole. We sat by the creek with Kerouac asking ourselves how the Tao is unnameable if God is God, and it felt nice to be present in an outward sense, without vicarious internet or our outfit to notice. It stormed one night up there, the mountains silhouetted in purple as the bonfire raged on. I loved its defiance, so real as I held onto him, or Him, or the rain soaked air.

But back I go to Mali, and I'd be a liar if I didn't say how much I'll miss dear America, shopping and movies and cheese. It'll still be there, and maybe when I get back I can feel as alive under steel as I do under straw. Until then, goodbye air conditioning, you've tried your best!

stranger in a strange land

Here I am en route to America. Already in Charles de Gaule airport I feel a strange tingle of confusion at this intense commercial hub, combined with a bit of giddiness and nausea (but that’s probably from the parasite my body is busy making comfortable). As Soliba said, I left as the moon began to die, and I will be back when a second new moon begins again. To count days by the moon – there is something so existential about that, so much realer than looking at a calendar, staring at these symbols for something that is right in front of us anyway. I showed them a postcard I had of the stature of liberty, explaining that it is a symbol of my home. As I told them of the enormous figure of a person made of stone, they look frightened. “Does it kill people?” they asked me, and I realized they thought that LIberty was a “jeni,” the spirits that live in the rock cliffs near our village. I’ve heard stories of these jenis. They were the apparent cause of my 12 year old friend Gosu’s black eye, which he claimed was from by the rock hurled at him by a jeni he came too close to. My PC friend stationed in the village next to me told me of animist rituals for the jeni involving hanging monkey corpses at the mountains they live in. Him and our photojournalist friend went up to the hills, curious about this legend, and ended up running, frightened, after seeing a giant two-legged creature that was throwing rocks at them after they got too close.

Recalling the last talk I had with Soliba, we sat squeezed next to each other despite the long wood bench in her hut, her 2 year old son Amadou leaning his head on my lap and her daughter Domandou exploring my white fingers. This airport suddenly feels cold, disconnected. It is so large; vast and vacuous, there is no danger of being invaded by another traveller’s tired coffee breath, no chance of a shocking contact with anothers’ arm, the air conditioning thwarting any disastrous odors that dare to escape the human skin. We all sit in the terminal, equally separated by our chest level armrests and stare at our computers (I’m no exception). Along we float on aerodynamic soles, eyes averted, and I feel so tiny in this chrome fortress. Yes, we are as elusive as the jenis, frightened at proximity we throw rocks into any collective culture, not a body of people but scattered hermits in our hills. I hope Mali avoids the avalanche, the Nike-colored debris are just beginning to flake away. . .

Golddiggers

All that is gold does not glitter,
Not all those who wander are lost

On Friday I finished my cervical cancer formation in Kita. A photojournalist friend of mine, on assignment from the NYTimes was heading to a gold mining town on the Senegalese border. I decided to tag along with him and our other friend, feeling the need for some adventure, and probably feeling a bit bored with Africa. Well, I definitely got a wakeup call.

So off we went. First we jumped into a rickety old van (bush taxi), and flew as the rain licked our backs to a nearby village where we heard we could get transport the next morning. There we had a hilarious time trying to find out the schedule of the trucks going; each person we asked gave us a different answer with a satisfied grin of self assurance, until after the 30th person we were ready to smash our Nalgenes (damn these reinforced plastics). There was no other option except waiting by the side of the road, and we found a nice spot under the tree and hung out with little children crawling all over us, until we finally flagged down a pickup truck going at 5pm. In we squeezed ourselves into the truck bed, along with 10 other Malians searching for gold.

We rode, all wrapped around each other and literally hanging on for dear life, driving straight through a river and winding through paths in the forest through the dark. We finally reached it the next morning, covered in dust; we could barely distinguish between the Africans and us, all the same color for the moment. We rode down a roller coaster of valleys and streams and saw the buzzing mine below us, thousands of glittering bodies like black coal digging in the hand dug mining holes supported by logs; their headlamps flickered, glowing eyes looking out from the abyss. We drove up again into the hill of the village we were staying in, and here more young men stood in clouds of dust from crushed rocks, while others poured the rock dust through a little water conduit to try to wash out the gold. Finally the gold dust would appear, a few almost invisible shiny flecks in the water that they put in a tiny little metal dish to extract, evaporating all the excess water. If they were lucky enough to gather a gram of gold they sold it on the street corner, opening little paper packets of gold leaf and nuggets that they slid to each other like a drug - not that there is much of a difference, really.

Of course many of the men we talked to told us they had been here for months, a year, and found nothing. Mostly it was sad, a slew of young West Africans in this world of putrid toilet water, sink holes and Obama paraphernalia. Since they found gold five years ago, the tiny village of a few hundred people boomed to a few thousand, with most of the young men who migrated there living in makeshift shacks or thrown together crowded mud huts. You felt a sense they missed the mark – excited by the idea that they could find more than their quiet villages could offer, they ended up here, wasting the money they weren’t earning on street food and prostitutes, family-less but wearing cool American jeans. There was one pump for the thousands of men who lived there, and the streets were spotted with hand dug wells every few feet. The doctors we interviewed told us of the daily deaths due to water borne diseases, exacerbated by a measles outbreak, pandemic STIs and almost no medicine or equipment.

One night we went out for a drink with a Malian we had met while eating our macaroni and goat meat dinner. A tall gorgeous Nigerian woman, about 19, sat down next to us. “I remember you!” she said to me in perfect English, smacking her lined lips. “I saw your hair; I almost went crazy it was so long!” She said the Malian name she donned was Kati, but in the bar she was known as Goodness. She told us how she hated it here; she had been here for about a month, and missed her home in Nigeria. “Maybe I’ll be able to leave in a few months, I don’t know,” she said, disturbed. We asked her about what she was doing here. She told us that a large woman had come to her village, promising to take her to Spain to work in a restaurant. She had went, was put in the back of a truck, and ended up here – a remote mining town. There was no more big woman, only a “boss” that told her she needed to pay him a million CFA (about $2,000) if she wanted to go to Europe. There was only one way to pay that off here, of course. “It was something I had never wanted to do.” Forced into prostitution. Trafficked. I sat with the blood leaving my face, tears in my eyes, as she got up in the middle of a sentence and ran out. My friend went to talk to her, and she told him how she felt stranded. Trapped. No Bambara, no French, no money, no family who knew where she was, no way of leaving. Later, we found out that there were hundreds of them here, all with the same story; none of them have left. Hundreds had died since this ring was started a few years ago. I suddenly loathed every man I saw, the men that forced her here, the dirty men touching their mini skirts with guilty grins, even the one who had taken us here. Because they are all apart of this. And now so are we. This is something we all know about, it happens, it is terrible but it’s always someone else. But to look her in the face was another story.

The next day I went back to Kenieba, a town where a few volunteers lived. I got on the truck, away from the dust covered miners, and they are so lost, the women are so lost, and I needed to be somewhere I knew.

Cervical Cancer Screening Formation in Kita

Cervical Cancer Screening Formation
May 10-14, 2010; Kita CESREF, Mali

Cervical cancer continues to present itself as one of the most devastating diseases plaguing women in the developing world, and despite its worldwide drop in incidence rates due to technologies such as Papilioma smears and colposcopy, it has risen to the deadliest cancer among women in Mali due to lack of access to these tools. To initiate an attack against cervical cancer, a four-day formation was held from May 10-14 to train 35 doctors and 37 matrones from the rural health centers (CSCOMs) in the Cercle of Kita in a process known as visual inspection.

Visual inspection using acetic acid (VIA) or Lugol’s iodine (VILI) is an easy and accessible way to screen for precancerous cells, which when found can be treated to prevent the growth of invasive cervical cancer. Acetic acid or Lugol’s iodine is applied directly to the cervix, and any precancerous cells turn white (in the case of acetic acid) or yellow (with Lugol’s iodine) upon application. These positive results can be seen using a flashlight, and can be diagnosed by any healthcare worker with minimal training.

The first two days of the formation was held with the doctors from each of the 35 CSCOMs in the Kita Cercle, and the final two days was held with 37 matrones from the 35 CSCOMs. Sessions were facilitated by doctors and sage femmes (clinical midwives) from the local CSREF, who had recently received training from Dr. Tekete, a specialist at Gabriel Toure University Hosptial in Bamako. The first day of each training consisted of lectures on the epidemiology of cervical cancer, as well as its incidence occurrence and current available preventative treatment methods. Using visual aids, the participants were trained in the recognition of precancerous and cancerous lesions on the cervix, as well as positive screenings using VIA and VILI and general infections of the cervix. The participants practiced preparing the acetic acid solution, and went over forms used during and after the screening procedure.

The second day of the formation for both groups consisted of practical screenings using volunteers from the CSREF and two of the local Kita CSCOMs in Darsalam and Mardiakambougou. The participants took turns questioning the patients, preparing the solutions, applying the acetic acid and Lugol’s iodine, and assessing the result. Afterwards, they counseled the patient and completing necessary paperwork. The participants were instructed in steps to take during a positive screening, which in general included referring patients to the CSREF in Kita, where they perform a biopsy to be analyzed prior to treatment. Over both sessions 22 women were screened, with 5 positive cases where biopsies were taken to be analyzed.

Throughout the formation the importance of early, regular screening was stressed. Each of the 35 CSCOMs received a speculum, a placental probe, 50 ml of 100% acetic acid and 200 ml of Lugol’s iodine, provided for through Peace Corps and outside donations. All participants were urged to perform these newly acquired skills during their regular practice at their health centers, with an emphasis on screening during regular pre- and post-natal consultations. Finally, the healthcare workers were encouraged to set up regular village-wide screening campaigns, and to continue to ask for help if they are lacking supplies or adequate training. To conclude the training, a questions and answer session was held to ensure comprehension, and participants left with an encouraging assessment of the skills they had gained.






> 
 

A pain in the ass

Rising to its reputation, Africa comes along with a whole buffet of exotic medical issues to boast about. I've felt many a surprising spark of envy as my fellow Peace Corps Volunteers relay brave stories: worms crawling underneath their skin, removed with a Swiss army knife; bacterial dysentery announcing its immediate arrival at the beginning of a two day bus trip; your array of intestinal worms, amoebas and other parasitic invaders; and malaria leaving volunteers achy and hallucinating. Our bowel movements are a regular topic of conversation, and, as our saying goes, "you aren't a real volunteer until you've shit your pants." Sadly, I haven't earned that badge yet. Other than a three week long battle with Giardia (parasitic dysentery), I've avoided most of these encounters, ameobozoa and animalia alike. I know, I know, we can't have it all. But alas, I knew this love affair I've been having with mangoes would come back to bite me in the ass.

Yes, thats right. The Tumbo fly, aka the Mango fly, has struck in the most unforgiving of places. It all started when I came back to village, as I sat squirming in the hard wood chairs during my community meeting, a strange feeling of aching on my bottom invaded my already lacking attention. I assumed I had bruised myself in my local Bush Taxi as I tried to balance myself on the hard wood bench during the bumpy ride. On further inspection using a pocket mirror and an unspeakably awkward position, I saw a strange red bump right in the middle of my left cheek, with a black dot in the center. Perplexed, I looked in my healthcare manual, assuming a strange rash of some sort. And there it was. Apparently, the Mango fly is nicknamed for its favorite breeding grounds - damp and warm - which is also well provided by clothes hung out to dry near mango trees. So there in my sun-drying underwear it found a perfect place to lay its eggs. Those eggs were then transferred to my, um, behind, as I wore said underwear as it burrowed into my flesh. The eggs then hatched into larva, creating the unrelenting feeling I was having of tiny pins, exacerbated by the lack of comfortable, cushioned seats. The health manual advised immediate removal. Thanks. As per its instruction, I covered the area with Vaseline, which apparently suffocates the larva, bringing it to the surface. And then I squeezed - pop! - out squirted the larva, finally relinquishing my left cheek from its occupation. I was flooded with relief as I cleaned the empty wound and went back in my hut for a nap, Tumbo fly free, with my wounded part in the air.
And so, well, Africa I really do love you, but right now you are really a fucking pain in my ass.

freefalling

 
Here the old women are the best – toothless and with breasts like empty plastic bags almost touching their belly buttons; their breasts speak of endless babies fed and calmed, babies that crawled all over them as they sat and made soap and stirred iron pots of sauce, gossiping with their co-wives. The wander around quickly now, with careless energy – finally free agents, they seem younger than the women my age, who are slow and heavy with their husbands and children. They are the real liberated demographic here, the shackles thrown away.

I remember the funeral we went to last month – it was three days long, from morning to night. I went two of the nights. Under a hangnail of a moon we sat with the women, our backs pressed against each other in little groups around the wood benches, with the men across from us. The old women greet me with big eyes and hand me a coffee flavored candy, and joke about me carrying babies on my back. Earnestly they ask if I can take their son or daughter with me to America; I smile and say something funny and feel uncomfortable like I do every time. Its all a big joke, but I think sometimes they really do want to come, and it makes me sad. Then out of the darkness one woman begins to sing, a song for the old man who died. She sings a few lines of repeated phrases in a cracked piercing voice that seems to grab at the eardrums and throat, the beginning of a wail that just swells in song and subsides. The crowd of women respond in unison, again repeating a phrase or sound over and over again – la laa allah la – ending in echoes of the reverberating voices. After a moment of silence another woman is moved to sing, and she sounds even more broken, more beautiful.

And today, as I came to Founebas house for our evening talk, Assitan and Salifou, two of her children grabbed my hand and took me off to their grandmother, Magkara. As we sat down she ran in to get me some peanuts, and Fanta, who is about 80 comes bopping in with her one tooth, grabbing my hand earnestly – “Ca va?? Ca va?? Tres bien??” I don! (you dance!) she declares, and starts singing in the middle of a growing circle of children. The usual “lets all look at the Tubab” dance party ensued, while I tried to follow her moves. She looks like shes about to fall and catches herself, arms akimbo and then falls again, and I see she is strangely in control as she sings in this strange dance. I try and it feels great, but I am still awkward. We throw ourselves like ragdolls to the voices of the crowd. Then she does the shoulder dance, as if she’s moving through a crowd, all power and strength. We do the stool shuffle dance together, picking up our wood stools in rhythms. Its the silliest thing I've done in awhile. But I don’t feel like a silly Tubab anymore, with Fanta, and at 80 years old she might just be my favorite person here.

Murals promoting health

These are a few murals I've painted in my village; they are a good tool, no words needed!

Vaccinations

 

Good Nutrition

 

 

Handwashing Before Eating

 

A mango for your thoughts

On my hammock, listening to the goats baah fiercely - they've got a lot to say - news in French hums in the background on a crackling radio. It finally rained, after almost four months of parched mouths and dry wells. They call these the mango rains. O happy mango season! I've been eating so many mangoes my shit is bright orange, five, ten a day. Every house I go to they give me piles and piles; the other day a little girl came to me, grinning, and handed me one bigger than her head. Yummmmm.

Today was beautiful. Since the health center in my village services the seven surrounding ones, waiting for the patients to come to us is certain failure, especially when it comes to the devastating, all too frequent childhood diseases. With that in mind, frequent vaccinations to the surrounding towns is key, and my village did a 3-day Polio vaccine campaign with the Relais, or community healthcare workers. I rode to Karo with Nerega to give out Polio vaccines. Karo is about 7 kilometers from my village, across rock cliffs and now empty fields, some burnt down in anxious preparation for the rainy season in a few months, and palm trees. Nerega pointed out the palms that the Christian villagers use to make "banji," palm wine that smells like gasoline but is delicious when mixed with lots of sugar. The Christians invited me to a meeting of theirs, since "all Americans are Christian" and I can't come up with a coherent explanation of Judaism that they can grasp. Still it was interesting to talk to them, a vast minority here, they are struggling to try to create a community out of this strongly Muslim village.

Anyway, we made our way to the other side of the cliffs and there was Karo, a smaller quieter version of my village, with huts decorated with big blue flowers and stripes of red and black mud. We went from concession to concession, and gathered all the children under 5. Since they typically have no idea how old they are (birthdays are all but forgotten here), we checked to see if they were to old by having them reach over their heads to see if their arms were long enough to touch their ears. I dropped the oral vaccine into their mango sticky mouths as Nerega painted their little pinky fingers purple with a marker and drew white crosses on the doors in chalk. By the early afternoon we had vaccinated 167 children. We rested for lunch at the Chief's house and had chicken, macaroni and (of course!) mangoes. The Chief was impatient at my slow language, but then I realized that he couldn't see. I realized our language is so much more then sounds, and without the emotional cues that comes with vision I am sure I was completely incomprehensible to a blind old man. Its hard though to overcome that anger, and I become stopped up and insecure. The Chief told me how difficult it was for his people to get to the health center in my village, how women were stuck delivering on the rock cliffs on the way.

When I got back to village I hopped into a UNICEF Jeep with Oussman, the doctor and a Sage Femme, an nurse/obstetrician who was there to survey the health concerns here. We went to another village in the commune, Keniekenieko. There, I channeled Oussman's anger at the dismal healthcare there - all the sudden I saw only malnourished eyes staring quietly in their mother's bony arms, who responded with infuriating giggles at his pleading disapproval. But the worst is always the fathers, how can you not see! They look over at their children's gold tipped kwashiokor hair, acting surprised as they suck on a cigarette. Yuck. But at the end of the day, they don't know, they don't know. The protein is right in front of their faces - houses full of peanuts and fields ready to be sowed with beans, and they think that if the rice fills them up then they are doing their job.

Every Friday though I have been cooking fortified porridge with the mothers of the malnourished children, showing them how cheaply and easily they can improve nutrition with ground peanut and a little lemon or baobab juice, mashed mangoes. I go back and forth to the food groups mural I've painted, and I hope I see that light bulb go off. Some of the babies are already improving, and in general there are more and more women coming to get their babies weighed everyday.

living in heat

Back here in Bamako - the expensive taxis where only the metal frame of the door is left - pool parties in Military houses with ex-pats, NY Times photojournalists, Marines, architects, aid workers, all the Americans who are stranded together in this surreal world of pseudo western living in the poorest city in the world - I can't shake off the creepy feeling of this strange life here in the capital. I like the real Mali better. Well, sometimes.

I came here after a week long training session in Kita, where me and Foune'ba, the Matrone, developed plans for projects we want to work on in the next few months: getting electricity for the health center, cooking fortified porridge for the mothers of malnourished children, making mosquito repellent, etc. We met with several NGOs in the Kita Cercle, and had training sessions on how to deal with food security, an issue Peace Corps is stressing right now with the global food crisis.

Home has been the usual - great but a rough few weeks, I have barely been sleeping and my jaw hurts from grinding my teeth, I realized I really needed a break. In general I have been doing a lot of teaching at the health center and the school, talks on AIDS and pre-natal care, handwashing and birth spacing, etc. Kristin and I did some drawings with the crowded fourth grade Bambara class to send to the States for an art exchange program. All we had were my crayons and colored pencils and the flip-chart paper Peace Corps gave us, but the kids were thrilled and drew pictures labeled in Bambara of their huts (sobugu), drums (tam tams), millet pounding mortars (colon), donkeys (falli) and other things they see in their village. After they would finish a part of their drawing each one would come up I also helped out with a training session for community health workers (Relais) who are trained to go house to house to educate the villagers directly on general family practices such as malaria prevention, family planning and water sanitation.

I think the heat really is beginning to creep up on everyone - the feeling of suffocation clogs your mind and its hard to, well, just deal with anyone. Theres been alot of violence lately. Babies crying everywhere - my host father hits his son with a stick, goes back every time he whimpers, and sits there for the rest of the night slowly hitting it on the side of the house. Does it make you feel like a fucking man? I would love to ask, but I know I need to live with these people for two years, so I go home and draw furious charcoal sketches instead. His wife recently ran off with her 2 year old daughter to her boyfriend's, and he hasn't seen his baby since, I know he's sad. Sitting in my health center a huge commotion at my neighbors house. I watch as the 16 year old second wife runs out, I saw the birth of her baby a few months ago when she was still 15. The first wife and her husband run after her and grab her, each hitting her with a stick. She is screaming and I run halfway out but I know I can't help her. Someone stops them and she runs towards me, I lead her away and tell her to sit at the health center for a bit, just let her calm down for a minute, but no, my host father (who is the Vaccinator at the health center) yells at her to go back and draw water from the well. She stands at the well sobbing with the water pull in her hand, letting the rope down even though theres not even a bucket next to her. Her bright orange shirt reads: Rejoice With Me. I know, its not my place and not worth the risk to get involved. And they don't see any alternative. But hell, who's place is it then? For now, the disgust on my face tells them something, I hope.

So yes, I needed a break, and I am here in the air conditioned PC stage house with wireless internet and I want to go back already. But when I walk outside there is still the street food lady who sells rice and sauce under a shack covered with old rice sacks, and she'll make fun of me for being a Malinke and I'll joke with her about her ethic group. And I'm still in Mali after all.

Earth babies

My house is built from mud and wood -

I watched them make one just like it the other day, a crowd of shirtless men in dirty cotton pants weaved the soft new wood into a circle, glued with a slab on wet dirt; over it they spread more mud and made a cone shaped roof, added bundles of straw. Together they lifted the roof and it lay on the mud foundation, and that was that. No aluminum siding, or iron supports, no fiberglass insulation or plastic window frames. It is the earth and I am it –


The days here are now hot, it clings blanket like in the form of beads of moisture all over my body. It is exhausting and I nap for hours and wake up with raw heat rash on my neck and arms. Most days I sit under the mango tree outside my hut where the men spend those long daytime hours, under the little green mango bulbs that are threatening to unveil their seductive yellow-orange fruit and I can’t wait till they start to fall, they fall on our heads they say and we won’t be able to sit there anymore. And days like this I miss NY and the rage of art and music and people don’t stop, not even to drink tea but here it takes hours to brew and mix one small pot. Its dry here now and the vivid (slight hallucinations) I get from my malaria medication tips the straw roofs with an orange glow and the leaves of the trees are sometimes outlined in neon blue. I remember an early Francis Bacon painting I saw of an African boy squatting in a pale green yellow field, he’s alone and the field is immense and almost colorless but still bright against the dark boy, and I think damn did he get the simple fervor of this place. I feel sad knowing that these children will never be inside a gallery but there is art in the baby blankets they sew with big colored flowers and tie their babies to their backs. That’s as close as art can get, wrapping your little warm vulnerable family on your back.

And it is here the balance lies, the painful ignorance of love, the endless toil of Zen clad, monotonous labor. At times I feel such tragedy knowing that I have ever heard of a food processor, while women here gather around a big hollowed out wood mortar, three women in elegant fabric uniform from their head wraps to their skirts. They pound their grains together in the narrow bowl with heavy sticks bigger then they are, it’s a flawless rhythm – one, two, three – each brings the stick down from over her head, sometimes they clap as they throw the sticks in the air. Their daughters are next to them, sifting out the shaft from the pounded grain, it sounds like soft maracas. My own flabby arms feel songless after years of microwave buttons. But of course they toil and sweat under the grueling sun for hours, making meals for their families, they call this “husband work.” Of course they all want to go to America where its so much “easier.” Still I cringe at the thought of my dusty villagers in America – I can see them in sad crowded Harlem apartments and they don’t have their nieces to bring them gourds filled with peanuts but they can eat cheaply at McDonalds with a plastic fork, no Griot excited off Kola nuts will bless their sick babies and no one greets them and asks how the people in their home are, how they are feeling, how is the work in the fields – but their floors are made of dirt and their children are tiny from malnutrition and maybe this is all just romanticizing.

But I recall a scene from a month ago, the old traditional midwife (now phased out by western medicine) was attending a young woman’s birth as the usual Matron was having a baby of her own. Both were on a thin mat on the floor, the young woman in child’s pose grasping the midwife’s back while she squatted on a low wood stool, she was grasping the young woman as well. The woman’s head lay on her shoulder – and with each contraction they swelled and groaned together, as if the midwife as inseparable from the woman and taking her natural share of the pain (oh, Great Sisterhood!). They held each other, and the ground was there as well which rose up to meet them, the little arrows of gravitational force always pointing up, their support –
The most rational birth I’ve seen.

And so here I am in my house of mud and straw, it is friendly and cool in the heat of the day. After all, who needs iron when you are this close to the earth?

its nice to be nice

Back here in Bamako, to the familiar smell of burning trash and fried plantains, the endless traffic sellers pushing phone credit up to the window. I've just come back after two weeks of travelling through Senegal and The Gambia: 70 hours of bus rides, street sandwiches of Maggi roasted goat meat and hard boiled eggs, gorgeous beaches and softball games of volunteers running around with drinks in their hands. Me and about 90 PCVs from Mali boarded two buses destined for Dakar, the beautiful beachside city on the Sengal Atlantic Coast, where the annual West African Invitational Softball Tournament is held. After a sweaty 30 hour ride we piled out of the bus and into the Club Atlantique, a shimmering oasis of America in the depths of West Africa. We were all overwhelmed at the incredible infrastructure in Dakar - sidewalk lined streets, tunnels instead of the infuriating traffic circles of Bamako, restaurants offering sushi, indian, thai, tapas! Heavenly. We met up with hundreds of volunteers from Senegal, The Gambia, Ghana, as well as the "refugees" from all the recently evacuated countries of Madagascar, Mauritania and Guinea. It was rambunctious as we had tons of energy bottled up from weeks in the African bush to expend, and that we did. We met some sweet young Moroccan med students and me and my friend went with them to Goree Island, one of the old slave ports of the Atlantic Coast. We sat on the beach with the boys as they played Moroccan music and 90s rock songs on the guitar, jumped off the boardwalk into the freezing cold bay. The place was filled with artists selling bright cloth paintings and sculptures of old pieces of plastic and metal. In the middle of the really lovely city of sandstone and a huge "castle" on a hill (built by the rich slaveowners)was the small slave house - a few rooms dark and cramped, with a tiny door that opened onto the sea. You imagined the men and women and children pushed out of their crowded rooms to line up at the small door that looked out to the ocean, where the boats waited destined for New York. Above the door was inscribed:

"De cette porte pour un voyage sans retour ils allaient, les yeux fixes sur l'infini de la souffrance."
This is the door for their voyage without return, their eyes fixed on the infinity of suffering.

As the tournament ended we hooked up with a group of volunteers from The Gambia, a sliver of former English territory in the middle of Senegal. After hours of waiting for the ferry we heard news that was was leaving immediately, and we ran with our bags and arrived in Banjul, the island capital where all the signs were in english and there is a whole strip of restaurants and clubs. We stayed in their Peace Corps house and we went to the beach down the street each day, as the male prostitutes in rastifarian attire, known as "Bumpsters," tried to pick us up with lines like "its nice to be nice!" and "can I make you happy?" It sounds strange but its one of the key draws to The Gambia - all along the beach you could see middle aged women with their muscular Bumpsters, sipping mango juice. We rented body boards and picked up shells to give as gifts to the children in our village and envied their ocean in dusty landlocked Mali.

A few of the Mali volunteers were going to a smaller island, so I tagged along. We hopped on the ferry back to the mainland, and found a jeep to take us through the brush. We blazed through the seemingly hidden path and got to a little cove on a river, where a few Gambians took us across on their brightly painted boats of hollowed out trunks. We had the Island to ourselves, and hung out with the Gambian farmers some of whom spoke Bambara and played us their drums, and we played in the huge waves on the rockless soft beach. Finally it was time to go home, and we boarded the bus destined for Bamako still dizzy with the bright day on the beach.

is a woman, is not a woman?

Disclaimer - This one is pretty graphic. It includes descriptions of female genital mutilation (FGM), childbirth and abuse.

These past few weeks have been - rough? eye opening? One wednesday morning I walked into the CSCOM, where I wasn't planning on staying long. Soon I found out that a woman was about to give birth, and I figured I would stick around to help out the Matrones as I normally do. I found the woman alone on the dirty, dusty floor of the recovery room, wiggling on her side as she rode through her contractions, all by herself. She looked older, probably in her forties with buzzed graying hair that looked bare and vulgar without her headwrap. Her American third-hand shirt was the color of the sandy ground, and a torn grey skirt was covered in her embryonic fluids. Perplexed by this site, I walked into the birthing room as the Matrones brought in a timid looking 19 year old. She had just given birth the day before, and as she was unable to make the 12 mile trek to the CSCOM she gave birth at home. The Matrones were yelling at her for not coming into the CSCOM to give birth as the girl looked down in shame. They put her on the birthing table, legs apart with her feet on the stirrups. And there it was. The scars from her circumcision had torn during the birth, leaving a wad of torn flesh where her clitoris should be, her labia torn. Likely, she was recircumsized in preparation of her impending birth, a common practice here. Traditionally, it is thought that a child should pass through a "purified" canal to enter the world. As if the clitoris is a septic tank. I was not suprised; 95% of women here undergo some degree of FGM, which ranges from cutting the clitoris to complete mutilation of the vagina. This, however, was far more extensive than any other mutilation I have seen. The doctor came in and began sewing the torn area. Of course, there is no anesthetic available, and the girl began breathing deeply with shut eyes as one of the matrones held her hands forcefully behind her head, yelling at her to keep her legs open. As the surgery continued, she left to tend to the birth of the woman on the floor. The girl in front of me was now writhing in pain, her eyes popping as she grips her thigh. I felt faint. I've seen much gorier surgeries before, but this tiny girl was wide awake and helpless. She screams as the doctor sews stich after stich. I know hes only doing his job, but at the moment I hate him as if he embodies all the men who allow this to happen. There is nothing to do but hold her hand. I am meditating to take away this pain in an area that should glow with pleasure and new life and is now a dark sewed up hole, a crater of pain which she is ashamed to feel. The rough work of the doctor and the cast off complaints of the Matrones who continue to yell at her "negligence" seem callous as she strains to keep her legs open.

When the surgery is over, twenty minutes later, the Matrones tell her to get up and throw her clothes, dismissing her without a thought to her pain and exhaustion. She carefully stands with eyes rolled back with tears and walks out, back to a 12 mile walk home to a husband I pray will leave her alone until she can heal. In the meantime, in the so called recovery room, Founeba finally pulls out an ashen, tiny infant from the writhing woman who doesn't seem to have much awareness of where she is or why shes there. She is muttering that the woman did not have any pre-natal consultations. The baby is premature, tiny and grey and barely breathing. But its alive. I am often amazed here at the resilliance of the human body, especially the fragile infants that always seem to just make it. And truth is, too many of them don't (infant mortality rate here is 15%). But back to the woman who now lies on a dirt and blood covered mat on the floor. Founeba is yanking at the whitish grey umbilical cord as if its a pulley, but its still apart of this woman now and I can almost see her uterus jerking with each pull that I can measure by her breathy moans. The afterbith won't come out. I breathe in as I watch Founeba dig her hand all the way to her wrist, and she is twisting her hand trying to grasp the placenta while the womans moans are deeper now and pleading. After a minute she pulls the spongy mass out, and I think of movies where the medicine man pulls out a human heart through his mouth. It all seems ridiculous but also perfectly rational and completely real. And so its done. The woman is helped up and shown the bed where her baby lays, and she lies next to it like so many mothers here I've seen, looking absolved yet newly burdened, exhausted.

It is difficult to watch these scenes, obviously, and I am always toying with the question: what is a woman here? What makes them different then what I'm used to? As an individual they seem like a non-entitiy, medlded into 13 year old brides and 15 year old mothers. I think one of the most frightening things about the day was what I interpreted as the apathy of the matrones, at least in their exterior behavior. Yes, patient care here has never really been prioritized, albeit mentioned, in their health trainings. It often seems like their idea of "professionalism" goes hand in hand with a sense of superiority, which comes across as condescending, intimidating. But I think one of the survival tactics for al women is the all too familiar victim blame. Because if its the woman's fault for not going to her pre-natal consultations or trekking 12 miles to give birth, then this will never happen to them. Blaming their men for not paying for their wives' healthcare, or blaming tradition for continuing this damaging pracice of FGM - these are huge barries, and not in their immediate control. So instead of a sisterhood of understanding they villianize their neighbors or just look the other way.

A few days later I was telling my sitemate about what I saw. She told me about the day before, looking out at the road that connects to our villages and seeing a girl wedged between two men, who was sobbing as the men hit her. As the bus stopped for a minute, two of the men in her village jumped into the bus with sticks to help in her beating. My friend knew these two men well. She asked her host mother why they were beating her, what she had done. The girl was on her way to a village to marry a man, miles away from her family and her boyfriend, who she was forbidden to marry as she was promised to his other man. How dare she cry. We both sat with tears, because, goddamnit, this is not just a TV commericial, this is our home now and our neighbors and friends. And its hard to not feel helpless.

The reason for my visit to her village was a different wedding, that of her host brother. During the two day long celebration, the bride is concelead under a thick white sheet that covers her face, as she does her "bride duties" of washing dishes and cleaning. This tradition is to hide her face, as the young brides are normally sobbing through it all. Its not so different than our wedding veils, but until now I never imagined its role this way. Here though, it is perfectly logical. Its fine that they are leaving their families at 12 to marry strangers. The message is clear - just hide the tears and pretend its all ok, for traditions sake.

But most of the time I don't feel so helpless. A week later one man from my village's health committee came to me after attending a conference against FGM, and my doctor and matrones and I discussed how it is an important issue to breach here. We discussed beginning some campaigns in my village to raise awareness about its dangers. This week I also saw one of my host mothers pack her bag after I witnessed my host father try to attack her during some argument before dinner. Maybe she'll come back, maybe not. But I was proud that she stood up to him. And yesterday, I got a ride into Kita with the my doctor. He was on his way to the Gendarmerie to file a police report against a teacher who raped his wife's 13 year old sister. He was angry, and told me how this is a real issue here. And the more I talk with the younger women in my village, the more I see their desire for change. The girls in high school tell me they want to wait to get married, go to high school and maybe university. No more hiding, please.

so this is the new year

Tonight the glaring arbitrary nature of time seemed to unfold to me – the idea of “now” and “modern” and how much it contrasts between here and America. To me this really reveals the strange and, well, unrealistic way we think of time as if it doesn't need a context. We've entered 2010 now – a year that sounds incredibly futuristic, covered in chrome and white plastic and slow electronic music. And in America, 2010 means a certain type of modern: little hand-held computers like the Ipod touch and the global environmental crisis and stem cell technology and GM food, even the 3-D televisions I hear are about make its way onto the market. And its a necessity to have several cars per family and a laundry machine, or it has been for the past 50 years. But here, modern progress means schools that are based on a government regulated system (albeit loosely and haphazardly) and cell phones complete with the one square foot service spot in the middle of the cornfield, where I need to stand on a rock and wave my phone in the air. No matter that they missed an entire century of landlines. But reality here is that only the lucky few can even afford a phone, or have anyone they know outside of the village that they care to talk to. Hence, the only form of communication really accessible outside the village is the dusty RAC radio in the health center crowded with doctors and other staff from the region screaming about emergency calls from a city days away. And in the village we have the local Griot, a town crier who can yell the news to the only people they need to hear it from.And then there's the new car that the doctor just bought, easily the wealthiest person in the village, after maybe the Mayor. His 1991 Toyota with the scraped off paint and rusty stick shift is one of the shiniest things the village has seen. The donkey cart is the main mode of transportation. They thought I was crazy when I described a clothes washing machine; the one tap recently installed in our village seems like enough of a luxury when you can spend an extra minute drawing water from the well.
And hey, that's progress. That's now.

pocket full of peanuts

My pockets are full of peanuts - or rather, the little sack I bring around with me each evening as I make my neighborhood rounds - along with my soap for washing my hands, my sacred flashlight (the solar rechargeable batteries quickly fading), my notebook and a real ink pen which I splurged on at the Tubab store in Bamako. After my cold bucket bath beneath a fading orange sun - which blazed with fury 30 minutes ago - I lock my tin doors and walk down the short dirt path to Founeba's house, making sure to avoid the goat shit and broken Baobab fruit with its white chalky center scraped out by the grubby hands of some bare bellied toddler. I pass the piles of peanut shells, the last ground remains of the waning peanut harvest season, and stacks of irregular mud bricks freshly molded from the cool earth. Foune'ba is probably sitting on the low wood stool in front of a black iron pot licked by low flames, which is propped on a pile of dried mud, creating a stovetop of sorts. With a wood stick she is stirring the sauce bubbling in the pot - tiga dega na (peanut butter sauce) or saga saga na (a slimy leaf sauce) - which she'll taste and add more Maggi or peanut butter like precious bit of gold ore. I read to her as she tends to the sauce and her two month-old baby Omou who is swathed in bright patterned cloth with her brown little face quietly looking out. When the sauce is done she gives Omou her breast and I hand her the health manual from which I've been reading, and help her stumble through the Bambara translation which I can read fluently since I've grown up sounding out letters but she has only learned to read since her training to become a midwife. I envy her understanding even if she still confuses every n and m and I've learned that for both of us it will come, dooni dooni (small small). We read about AIDS in Mali as she gasps at the statistics, or about weaning children off breast milk without creating protein deficiencies, or the importance of vaccinations. And while yesterday she was angry at me for leaving to visit Kristen on the slow Saturday, and even more for my carelessness in leaving my chair and soap outside which to her feels like an ostentatious show of my money, we're over it. We both know were differed - I resent the mother like role she tries to take which is really just communal coexistence regardless of our professional relationship, and she doesn't always grasp my American independence. We're both learning.

After the darkness begins to filter in I say my night blessings and take off for my host families house as one of Founeba's daughters (or one of her husband's other daughters, she's wife number 4) follows with a bowl of sauce and rice sitting on her head without the slightest threat of its downfall. The women carry themselves with model like stability despite the threat of their dangling earrings. I eat dinner with my host father and his two younger sons; his older sons are off at the nearest high school, 2 hours away in Kita. I wash my hands with the soap which I have been offering them for months but they finally accept, which could have something to do with the big hand washing mural I've just finished on the wall of the health center. We all squat around the bowl on the floor as he grunts and holds the flashlight. Tonight Sani is making dublini, hibiscus tea. It is heavy and sweet with its fragrant magenta juice and equal parts sugar. A group of her classmates show up. Their presence is at a first glance imposing; their tall thin figures draped in bright panyes which don't match their skirts, which don't match their shirts or their headwraps anyway. Their swirling palate of color is lit by the bonfire which we sit around, and in fact all I can see are the distant family bonfires where the women squat on low stools around their endless children snacking on their after dinner roasted peanuts. The complete night scene is only broken by an occasional anonymous passerby with their flashlight whispering good evening with equally whispered responses from attentive ears. As the girls sit down the intimidation fades as I recognize each face - 13 and 14 year olds, strong and emboldened by their impending roles as wives and mothers only a year or two away. Even some classmates their age carry their notebooks atop their round stomachs.

As my host mother Hagie shells the peanuts in a weaved bowl the group alternates between pensive silence, complete and comfortable as they stare into the fire, and lively gossip about the village. I am slowly beginning to carve out the Malinke words and phrases from the dark cloud of sounds, which I can connect to the Bambara words I've learned and sew together with context, the quilt of Malian languages. Their chatter sounds like drum and base; their tongues heavy with h and j sounds, interrupted sporadically by the quick high pitched l's and k's.

After long stretches of silence I feel I've put in some decent "family time" and move on to the next concession over, Soliba's house. Here I sit down amidst a warm chorus of greetings and bubbling children who run up to me and smile. I sit down on the wood bench, relieved that they don't scurry to get me a better chair - the respectful motion always embarrasses me, and anyway I'd much rather sit next to my friends with their children at my knees. Some of the toddlers lay on my lap and try to play with my hair, which they still can't believe is connected to my head, and mutter questions that I have no chance of understanding with their lispy Malinke tongues. I am teaching Soliba English, and we've gotten a few phrases down that she's asked to learn. These are of the utmost importance here: "Come eat!" "Lets go to Behon," and "How is your family?" These frequent Malian phrases sound random and quite useless in the American English. But of course language is so much more than just a string of sounds; it is entwined with all the peculiar way each culture lives, what they value, what is respectful or even trivial in this little Malian culture that is, well, the whole world. At least to them, and for this moment me too.