Mali Bohème

Only skin

2011-06-14T16:19:00.000-07:00

We are restless things

A ride with mountains humming in my ears, and I gain that needed reaffirmation of that out of reach feeling here, of brights too bright and darks too dark. The dirt road is bright orange despite itself. It’s smelled of rotten mangos since I got back, the end of the hot season’s tired offering. The scattered trash somehow sparkles today, and all the peoples movements are deep and heavy, struggles complete and through the skin. We pass a stalled car pushed by five teenagers, a kid wheel-barrowing sand, dusty donkeys. The burning trash offers a mystical grey smoke which gives the sky a sort of ethereal look, a hazy backdrop behind these ever-moving people, slow and meandering. Their energy is hot, melting, crystals dripping off dark skin.

So here we’ve stopped at the truck stop and someone thrusts a cup of tea at the driver. The ladies in mismatched fabrics with the plates on their head shout out their goods, boiled potatoes or eggs or luxurious apples, and men hold up boxes of generic cookies with uncomfortable names; cream bite, cream4fun, full cream.

Back at village, at Soliba’s house, we sit around in the usual circle. The men are deep in argument, snapping their fingers and giving hearty mhmmms. Soliba lays her 8-month old daughter Boubagari on her lap, massaging her back as she cries. She’s had diarrhea, but is on the upside. She has been making the oral rehydration salts, “healthwater,” that I taught her to make a few months ago. A half-tea glass of sugar, two pinches of salt, mix with boiled water. Soliba wears the earrings I gave her last year when I came back from America. She said she was wearing them while I was gone last month. I’ve been talking in her ear she says, reminding her that I’m coming back. She asks about the doctors that were here today; doctorwomen, I tell her, three and a driver who came to give our village women free birth-control.

Earlier in the day I sat there, watching them implant contraceptives into the women’s arms, and I was proud of the familiar faces that lit up when we told them they can prevent having children for five years. Many are scared though: at the sight of the blade, at the thought of their husbands. One walked out as we told her she wouldn’t be able to pound millet for two days, as the heavy work would hurt her sore arm. “Just say you are sick” we suggest; finally the doctor convinces her. She lays down suspiciously but walks out grinning, now after six kids she can “rest.” I tell Soliba about the five-year contraceptive, and promise that I’ll let her know when they all come again next month. She’s excited. They want this, they just need a little push.

And so I’m back to my hut now with its fiercely mustard mosquito net, and I realize it’s been two years under there, sweating with Mefloquin night terrors and squeezed with napping sitemates and crushed with gin-fueled sex when our skin was just too close and vibrating. The mud walls are full of termite mounds like swollen veins. They collide into conduits and diverge and eat my wood picture frames and their dirt falls all over my floor. I’ve never quite gotten the hang of keeping a mud hut clean.

And I am thinking back to last month when I said bye to a friend, my face as always in his chest and all tears – if only for your skin I think – because then we felt so far removed from this brightness, things are important and changing. But today Soliba with her big walk walked me home and we shook with her big dark hands and mine small and white and we were right there. The music is playing with its xylophone-like clangs and shrill voice of a Jeliwoman. I wonder when It will stop – faga – the verb also means to kill, but I am starting to feel the creeping pre-nostalgia and I know I don’t hate it so much. I’m just tired and my skin is prickly inside here. But hey, it’s only skin.

The Beige

2011-03-30T17:55:00.000-07:00

Everything is organic, a shade of taupe – mud and bamboo and straw and wood, except for the occasional tin roof or a blue plastic bag half hidden in a pile of discarded peanut shells. Even the leaves of the mango trees are pale and powdered with sand-dust. But everything else – the chickens, the old broken buckets, the chairs and gourd bowls, the goats and piles of hay and the weaved baskets and even our skin – are all a continuum of white and brown, so quiet you feel subdued by their modesty, but nonetheless unjudged. Perhaps out of fear of being lost in the Great Beige they wrap themse3lves in rebellious fabrics. The royal blues and seafoam greens and magentas and lemon yellows lay on their body loosely, like an extravagant afterthought, in concentric circles, repetitive patterns of abstract stars, flowers, strange items like pinapples, purses and ladders. The women fill the paleness with these colors, sitting forwards and backwards on the wooden benches, all of the younger women with a baby strapped to their backs with a mismatched sheet.

We drove here from our “big village,” the doctor, midwife and I, to talk about women’s health issues – pre-natal care, giving birth, family planning – and how they can improve all these issues by coming to the health center. The fifty or so women in the last few villages seemed mixed. I asked if they could think of any benefit to birth control the outspoken old woman screamed “none;” the younger ones, though, seemed focused on my explanation of contraception, or how to count your ovulation days. Today, as the doctor mentions birth spacing, a fight breaks out between him and the old men listening, citing Allah and words too quick for me to grasp, clear though through their dramatic body language. When we talk about going to pre-natal conversations or giving brith in the health center, the men groan about the $2 fee. I do the math with them, and we realize that they only need to drink tea twice a day instead of three times, for only a week, and the money’s there. They gasp, laugh. But will they give up their precious tea? This is nothing new; even in America people with buy flat screen TVs and not health insurance. I get it.

After our little talk we get ready for tomorrow – another village, a few more women. Maybe we are just rubbing the sand in our throats but it’s something to talk about. If fabrics can’t combat the meek, subdued Great Beige, well maybe sex is a start.

If I forget thee, Jerusalem

2011-03-30T17:46:00.000-07:00

In the almost finished fenced garden the women’s association we celebrated our success, the women thanking me over and over for completing the project as we danced to the djembe; my cheeks sore with grins. Wonderful. Incredibly awkward. I did dance bit and was surprised with how naturally I fall into their dance style now; my body leans and my feet swish and I move easily, not like the awkward days in the beginning, and I get laughs and ahs as much as the next muso. We did lots of dance-walking in the circle where the women grabbed my arm up high in recognition, “shooow!” We stopped when the hot sun was high for dinner and baths, later reconvened after in the town center. This time it was dark, and the drums seemed to beat more passionately as the younger girls danced and kicked up dust, backlit by streams of flashlights and hazy, like some dark sultry jazz dance – easier to dramatize the animalistic fervor in the dark. The fires of hay were sometimes lit to soften the animal hide drum tops, it smelled of cold and moist and sweet smoke. Finally after a few hours we marched together to greet the village chief and danced and sang in his concession. His old bent wife came out in her wizened excitement and sang “Dugutigi ma bo – mga a b’I fo!” The chief won’t come out, but he greets!

I step outside later to pee – the dust swirled in front of my headlamp, and I smelled the dust-desert, acrid and deep, it seems dark and dry in my nose and I remembered sleeping in a Bedouin tent in Israel and always at night the sand still holds the heat scent of the desert despite the night breeze. Love studying here, yes, even MCAT prep is okay; even the ugly orgo, the awkward carbon chains seem friendlier, more digestible than before, and I remembered first learning this under the fluorescent lights with the projection so far ahead, so inhuman and antiseptic and now there is always a child with his head resting on my lap or jumping over my shoulder as I try to explain what this is and here this is a brain – the head owner – and they grasp and laugh so that I can’t help loving these heavy MCAT books even though I’m scared shitless of my future I’ve got these bright white teeth giggles glowing in the bonfire to remember.

Light Chasers (or, Everything is Illuminated...sorta)

2011-03-30T17:31:00.000-07:00

Oh, my stifled bleeding heart! What a tourniquet development can be.

Passing half-built suburbs; skeletons of mud bricks, it’s hard to tell whether they are being built up or are falling down – the progress of ruin I guess. Reminds me of the crumbled Roman ruins, beautiful but far. Such hollowness there, like humans were never quite involved in it’s building at all, just a cheesy reproduction of Pompeii or Casarea – but no, it’s the slow sad beginning, only the thwarted start of the great crawl towards development.

Came back in January with bounding satisfaction. The solar electricity I had fundraised for had been installed, and I hopped on my transport with anticipation. With grumbling resolve it had been installed without me; I had waited a week for the electrician and the doctors to show up I finally had to leave for my conference in Senegal. The next day my villagers informed me they showed up, and I was happy to give up some control. Because this is, after all, their health center, their village. As a driver of ‘sustainable development’ part of my job is to empower them to do things on their own.

I got off the van and walked in the (intensly orange unforgiving) late afternoon light. There sat the doctor and some of the other members of the health board, those I worked with to raise their 25% of the cost. They jumped up and praised me for the work we did to finance the solar panels, and my ego rose and fell in cruel repetitions as my graze locked in on the wire snaking sickeningly from one of the six panels atop the health center into the doctor’s house. But he already has a solar panel my mind argued, and I smiled as they told me how well the lights all work – ah yes how wonderful! They can work now at night, the midwives can give birth with real light! - but oh man why the hell is it in his house. They took me on a tour and it is really incredible, a light outside when people run here for emergencies and one in each room, the vaccination room, consultation, pharmacy, maternity, the long recovery room…but then the vaccination fridge, one of the main reasons for installing the solar electricity, wasn’t working.

“Why did you take a wire?” I asked the doctor and off spurned a long soliloquy about how it’s helping the community by way of improving his personal space. “Well I would have put it in your house but it was too far.” Totally missed the point. I tried to explain to him that we cannot fund anything that benefits the individual. After meeting with the electrician I finally got the picture of what happened. It seems the electrician had not checked on the power of the fridge, which blew the system the first day it was hooked up to the solar panels. An expert does not necessarily mean expert knowledge. So instead, we still have a fridge which we pour thousands of francs of gas into, and extra electricity to give over to the doctor. We are working with the electrician now to siphon off the energy, so that the lights and the vaccination fridge will work. Maybe it will, or maybe this will just be another development project that only got so far.

The next week I began building the women’s community garden. The women had scraped together the incredible sum of over $200, from women who have to beg their husbands for a few dollars to give birth at the health center. I raised the remaining $2,000, and together we built the 8,000 square meter garden. Success, yes, we’ve built a fence. Now what. We need a well, we need the land cleared, and most of all we need to have faith that we, the village women, will get the use out of the garden that we hope. Will it save the village? No. But it’s a step, right?

So of course these projects are important. Not only for the shallow ego, or the tangible results of an actual structure (I built this, goddamnit), but as a means to help them, well, help themselves. The garden will allow the women to grow their own vegetables to feed their vitamin-deprived children, or even an opportunity for them to sell the vegetables and make extra cash to save for their children’s clothes, school supplies, pre-natal consultations. The electricity will increase the availability of healthcare during the frantic hours of the night, and to provide better quality care in the dark. But in the end, I have mer faith in the sustainability of the impossibly slow process of teaching, sensitization, and promoting behavior change. I can paint the3 whole town full of murals, all yellow and blue and bright, or give sweet talks on hand washing with soap, rubbing hot pepper or honey to drive my point; but it will take generations until these practices are actually done on any measurable scale, a significant sigma statistic somehow erupting out of these impossible constraints. Any my trainings to screen for cervical cancer will always be limited as long as the Malian government doesn’t think it’s a priority. . The more the word gets out, the more healthcare workers are capable and empowered to screen for it, maybe there will be less cases of invasive cancer, a death or two thwarted. Dooni dooni. Small small.

So here’s my grand inconclusion: aid is as devastating if given purely monetarily and even more so if given without a great follow-up system (sorry, because they ‘deserve it’ is not always enough), and as empowering if given from the painfully slow route of teaching and sustainable ‘leg ups.’ But these lines are more then blurry. So just like most volunteers I know, I can channel the frustrations of Ayn Rand as easily as I do the endless humanism of Mother Theresa. So, will Mali, Africa, the developing world ever get there?
Man, I don’t even know where there is.

Journey to the end of the night

2011-01-17T03:40:00.001-08:00

Travel is useful, it exercises the imagination. All the rest is disappointment and fatigue. Our journey is entirely imaginary. That is its strength.
It goes from life to death. People, animals, cities, things, all are imagined. It’s a novel, just a fictitious narrative.
And besides, in the first place, anyone can do as much. You just have to close your eyes.
It’s on the other side of life.
- Louise- Fedinand Celine, Journey to the End of the Night

Journey to Sikasso
So off I went. Thanksgiving was around the corner, so I guiltily told my village I’d be gone for a few weeks and headed to Kita, in time to take the night bus to Bamako. Our excitement at the empty bus waned to terror as - who knew we’d freeze to death in Africa? - the bus whipped on without windows through the cold night at 80mph; the four of us huddled in our flimsy clothes during the torturous scathing wind of the 4 hour trip. Finally the wind stopped, and we cautiously lifted our heads from inside our shirts to find ourselves in the cold brightly lit bus station, smelled like nighttime latrines. From there we were hustled to a busted bus company to Sikasso, spiked our Gatorade, and stumbled out of the steaming bus in the raw afternoon light 8 hours later ready for a nap.
The party was huge as peace corps usually goes, kids throwing off their Tabaski fete best, guys leaving behind the long dress-outfit called bubus, ladies their heavy head wraps , all to assemble for American style confusion, turkey tubs of squished potatoes Malian beer. We’re quite a site, walking through the markets, girls in pants and Northface backpacks past rice sacks of dried caterpillars and raw amber-like gum. Sikasso is on the Burkina Faso/Cote d’Ivoire border, and you can feel the intensity of mixed nations; young people scouring their borders wondering if there’s something different over there. Scary night at a club, as I as leaving a man with overwhelming testosterone insecure misplaced anger grabbed me to dance, wouldn’t let go, he slapped me after I fought him how dare a woman humiliate a man the other volunteers and I yelled while the Malian prostitutes laughed and the Malian men put their fingers to their lips and told me to shut up. You don’t understand, we shouted, we get to choose. He followed us back, freaked us out in the deep night to yell “I sorry!”, told us he was just embarrassed and lost his cool but I couldn’t even look at him; in fact every Malian man filled me with animal rage. A lesson learned, of course I am never alone and it could have been worse but even so, as comfortable as I feel here it is still a man-fueled place and a woman who doesn’t know her place learns. A sad comfort at being an alien here, the not-a-Malian-woman, and I know my defenses go into overdrive but I don’t know where to place American feminism into cultural integration.
Rest of the trip though calmed down and we piled into a station wagon to camp out by the waterfall. Too tight a squeeze so after we passed the gendarmes I sat on top, the great immense windy bush in front of me, speckled with mud straw houses. Sat under then cascade with Kristin and a box of Don Simone, ran unclothed at night in the freezing water and danced around the campfire, warm at night with three of us in the little tent. Good people.

Journey to Senegal
Left for Bamako and the next day Senegal for their All-Volunteer Conference, where three of us were invited as guest-speakers. I gave a power point on cervical cancer training and screening, got a terrific response, heard about some interesting projects – visual aid ideas, ameliorated porridge, rural libraries, community lead total sanitation techniques, simple cheap technologies like garden pumps and peanut grinders. The Senegal volunteers of course welcomed us into their world as the incredible community-love of volunteers goes.
And after, lovely, lovely ocean! The three of us found a car to take us to a beach town on the Atlantic Coast north of Dakar, Popenguine, where we found a house on the beach and were quickly befriended by a 60 year old French café owner Agnes and her 30 year old Senegalese husband, Malike. Ate lutte a la crème, a delicious Senegalese fish dish, and wine and crepes with ice cream. Found some djembe players and Owen and them energy-drummed and the beat called others in the island and we danced and swirled our arms and drank shots of sweet home-made orange-cinnamon rum – yumrum we declared – “To Universal People!” and more Senegalese musicians and artists came and Kat and I jumped and twirled more. We met the artist Gade, pronounced god, he told us it meant “the gatherer.” We went to his house to see his expressionist paintings made from cola nuts fermented and oxidized and talked about the citizens of the universe and gazed at his baobab trees sculpted from the soft clay of the cliffs nearby. We hung out at his house most of the day with Senegalese hippies; many of them live with him in Switzerland or help run the small art therapy program he operates. Went down to the beach and played with the café owners and their dog Pussy, tried to understand their strange but genuine love. Watched the sunset and waited for a car to take us to a club but it took too long and we sat at Gade’s wide round porch – what are we doing Owen asked? Watching the stars…
Hiked to the cliff in the morning on no sleep, the vistas over Popenguine were exquisite. Finally got to the shore and tried to make our way along the base of the cliff with the rocks and soft clay yellow ochre and burnt sienna and pale grey and alizarin crimson; we smushed and crumbled along in my too-big market flip flops (lost my Chacos in the waterfalls). The ocean sprayed us and licked the colors and it was so wildly passionate but soon the sea crashed at our feet, sending walls of cold sea water and I crouched to protect the camera bag. Now soaked, we realized there’s nowhere to go it seems – the waves are crashing vehemently on our disappearing path; maybe there’s a path on the Cliffside but as we ascend the rocks crumble ominously with each grip and all we find at the top is more climbing and prickly plants. We watched down below as a couple of nicely dressed African women try and the ocean crashes helplessly on them, soaking their leather bags and absconding with a shoe, leaving them hanging on. They make it past though, and we decide we need to try our chances on the shore. We climb down slowly dooni dooni, a boulder falls when I move my foot but we make it and saunter along the cliff walls and we’ve made it to the smooth beach again.
We made our way back to Dakar. At the bus station I hop over the driver’s seat of the bus I am leaving and as I get out the door the driver sees me and yells in Wolof. I ignore him, but how dare I, so he grabs my wrists and struggle as I yell; finally he lets me go I fall down to the ground and I stop myself from throwing the pile of rocks I have in my hand. Again, I am not alone but still even in the bright day sunlight I feel pained at his need for masochism and I still can’t understand why. Then comes the limp of desolation – how sad this misplaced anger, my helplessness, that evil energy. I walk off with my friends and the woman next to me hands me a scarf to wipe the dirt from my knees and I put my sunglasses on cause my eyes are filling up. But there’s too much love around me right now and all I find I can do is love the hate, that’s the only way to understand this I think.

Journey to Morocco
From Dakar I boarded a hazy 3am flight to Morocco to check on the same medical issues I had just talked about in Senegal. I boarded on autodrive and landed in Casablanca as the sun began to rise and the driver dropped me off in the mosaic covered Peace Corps office in Rabat. Went to the clinic to check out my stuff, thankfully everything was clear, and I was amused at having the visual inspection procedure done to me (I have a damn beautiful cervix, thank you) So I had the rest of the time of my medical evacuation to discover Rabat. Walked into my room to find a large curly man, another PCV in the other double-bed, bearlike and cozy and we immediately talked flowing encompassing spirit-energy, made up each other’s creation stories. Met some other Morocco volunteers and again felt immediate connections; we all have this common value system and passion, not easily shocked by cross-cultural oddness and American eccentrics, and genuinely interested in each other. Some of them invited me to the Moroccan-American ambassador’s house for a dinner party. We lit the Hannukah candles for the last night (he’s Jewish) and talked about the difficulties of development work. Spent days in the Medina, wandered around the spiced narrow markets eating olives, it reminded me of Jerusalem’s Old City. It smelled like coriander and dates and coffee, loud and wonderfully chaotic. Meandered through the Kasbah, the city-fortress on the sea painted bright blue and white with windy little corridors and beautiful wood doors.
On my last day another Mali volunteer was med evaced, we did some shopping in the market, and at night we caught dinner with some of the PCVs. As we walked back a group of Moroccan teens commented on her head wrap and dark skin and grasped her backpack. Freaked us out and were weighted down with the ugly feeling of pity. But remembered that this stuff happens even in America and people can be strangers everywhere. Flew back to Mali on another nighttime flight, grinning on the way to the airport at this quickly tilting lifestyle (do I ever want to give it up?), later though as I wrote I fell quiet as I sat and watched how small and far away people seemed; the vibrating sound of a mother shushing her child made me tired, glazed men with briefcases, all sad and waiting but so much alive. Arrived as the darkness was beginning to clear; the intense energy of the night, in its soothing questioning strangeness was disappearing in the Mali morning.

I’d be brimful of courage then. I’d be dripping with courage, and life itself would be just one big idea of courage, that would be the driving force behind everything, behind all men and things from earth to heaven. And by the same token there would be so much love that Death would be shut up inside it with tenderness, and Death would be so cosy-comfortable in there, the bitch, that she’d finally start enjoying herself, she’d get pleasure out of love along with everyone else. How wonderful would that be! What a production!

-Celine, Journey to the End of the Night

murals for all!

2010-12-28T12:53:00.001-08:00

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

2010-12-13T08:06:00.000-08:00

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'

2010-10-05T03:04:00.000-07:00

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!

2010-09-23T17:56:00.001-07:00

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...

2010-09-23T17:50:00.001-07:00

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

2010-09-23T17:41:00.001-07:00

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

2010-09-01T02:56:00.000-07:00

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

2010-09-01T02:55:00.000-07:00

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!!

2010-08-17T04:48:00.000-07:00

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)

2010-07-06T18:12:00.000-07:00

. 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

2010-06-17T17:23:00.000-07:00

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

2010-05-22T00:28:00.000-07:00

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

2010-05-21T09:27:00.000-07:00

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

2010-05-08T18:53:00.000-07:00

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

2010-05-08T18:45:00.000-07:00

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

2010-04-27T11:32:00.000-07:00

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

2010-04-27T05:07:00.000-07:00

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

2010-03-28T01:50:00.000-07:00

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

2010-03-11T07:12:00.000-08:00

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

2010-02-25T04:03:00.000-08:00

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?

2010-02-09T04:27:00.001-08:00

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

2010-01-27T08:37:00.000-08:00

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

2010-01-24T05:20:00.000-08:00

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.

Monsieur BonBon

2010-01-03T14:20:00.000-08:00

I'm back in Bamako after an incredible hike through Dogon country.
We took the 12 hour bus ride up to Sevrae and spent the night there. We ate ouijila, a huge ball of dough in curry like sauce, surprisingly delicious and a lovely deviation from rice and peanut sauce. The next day we headed out to Sam's village in Sanga. As we bounded through the sandy road, the beige sandstone huts reminding me of Jerusalem, we were accosted by the pleasant aroma of chives, one of their primary sources of income. The kelly green fields were quite a contrast to the sandy mountains, the only vegetation besides the tall thick baobab trees stubbornly pushing through the rocks, their bulbous fruit hanging off the almost bare branches like macabre Christmas ornaments. We all teemed with jealousy as we climbed up the cliff to get to Sam's house, located on a summit overlooking the green chive valley and streams, the
mountains looming in the distance. We slept on the roof and woke up each morning up to dusty sunrises.

We spent a few days in Sanga, climbing our way over to the marketplace where the women sold dyed indigo fabrics, mangoes and wood carvings. The Dogon mask festival was beginning, and it was strange feeling like a tourist as we bumped into groups of westerners. While officially Muslim, most Dogon people still hold fast to their traditional animist beliefs of spirits which they call "genies." Many of the houses had different mud decorations on their roofs, signifying each person's profession: medicine man, goat hunter, clothmaker. We visited the house of the "Oldest Man," who acts as an arbiter for disputes among villagers. The low ceilings prevented any man from standing up so that no man is above another, even in the heat of an argument.
Christmas night we watched a dance competition. Men and women in blue indigo robes spun and danced with the fury in the middle of a crowd of spectators. Still, it felt limp in contrast to the drum circles in my village, maybe less inspired in front of the crowd of spectators. Or maybe I just miss my village. Afterwards we had a huge Christmas dinner that Sam and her host family made at the Mayor's house, complete with a roasted goat on a huge spit, and millet beer. After dinner her villagers surprised us with a welcoming dance. Each quartier of the village presented themselves, dancing in line to the persistent beat while playing their wooden flutes. As they reached us they began to crouch down, holding a medallion of mirrors and white tile. Finally they would end up on their knees, offering the plate to us as everyone in the circle shook their hips and sang. After each neighborhood went they began to pass the medallion to each of us, and we followed suit in presenting ourselves to the villagers.

The next day we began our three-day hike. It began with a steep climb down the mountain, where Malian adolescents rushed to help us down the gaping drops and slippery rocks. We continued on to some of the villages in the cliffs. Each village seemed piled vertically on the side of the mountains, at incredible heights for daily hour long trips to get to water or food. Its amazing what people can get used to. Centuries of isolation from the surrounding cliffs with little water has proven the endurance of the Dogon people. Our guide explained that these villages were located among the higher cliffs where they could see approaching tribes that threatened to steal their goats or children. As we entered each village we were accosted by long-legged Malian children, their faces pale with the desert dust. Divide and conquer they would, following us with their well rehearsed French phrases asking for very particular items: "Monsieur BonBon?" (Mr. Candy?), "Cava Bidon?" (How are you, water bottle?), or "Madame Bici!" (Mrs. Pen!). After almost six months in our villages, we've become a bit jaded with the these children, after all we have our own village kids to take care of! And we're all more concerned about their protein intake then their sugar. Although we were happy to pass off our empty water bottles. We passed the various sacrificial spots, where goats would be killed for good health, or a potion of millet and baobab fruit are offered to increase the town's fertility. After 10 kilometers of hiking up and down the mountain we stopped exhausted for lunch, all 16 of us passing out on concrete slabs immediately afterward. We woke ourselves up for another 5k walk through the thick sand to our hotel. The church behind us was having their service - singing and dancing for hours. We slept on the hotel roof, freezing in the desert air.

The next day, despite our aching legs and blistering feet we headed out again. We began to feel better as we climbed, breathing the clean air. After passing a few villages on the way we reached the old Telem villages, which are roundish irregular stone dwellings carved into the side of the mountain. Its no wonder that the Dogon tribe, who overtook the Telems, believed that the Telems could fly when looking impossibly high homes on the almost vertical rockcliffs. The Dogon now use those cave-like dwellings as burial places, using rope to lower the bodies from the higher cliffs into the chambers. At last we made it to the mountain peak and sat watching the sweeping panoramic of the plateau below us.

Incredible. But I can't wait to get back to my village. I miss my home.

Bamako blues

2009-12-17T04:19:00.000-08:00

So we've been here at the training center for two weeks for our in-service training, and gnawing our hands off. The excitement of being with 60 Americans all day for two weeks quickly wore off as we realized with horror that there was no nap time! Barely even time for even tea between our packed schedule of technical lectures and language classes, field trips and administrative sessions designed to remind us that we are, in the end, owned by the government. But at nights we pitch a fire, and hopefully someone pulls out a guitar and harmonica as we sing soulful recreations of Beyonce and Outkast to the drum of an upside down bucket. Or maybe we spark up the hookah and toast some pumpernickel bread using a rake (we all could sure use the fiber), enjoying the comraderie of people who are just slightly crazy enough to live in a mud hut for two years in West Africa.
Luckily I've gotten out of the walls of the Training Center into Bamako a few times, where we dance feeling uncomfortably modest next to the blue eyeshadowed Malian prostitutes. Finally we head home to the sound of the 5am call to prayer, waking up at 9am to grab ice cream before heading back to sessions.
Even though I never felt the urge to see him in the US, a bunch of us decided to go to the Sean Paul concert, a fundraiser for Malaria prevention. It turns out Sean Paul is as bad in Mali as he is in the States. As he finally stepped on stage about 4hours after his promised arrival, the Gendarmes started to grow anxious looking at the rowdy crowd, and started to push us all. We moved like cattle, and in the rush I lost one of my shoes. Thankfully I found another on the ground, albeit an inch lower, and we hobbled our way to the exit right as a chair was thrown. A wise exit, and a warning never again to go to a big concert here.
And so as IST comes to an end, off I go to hike through Dogon country among the villages carved into the mountains.

A moveable feast

2009-12-04T04:16:00.000-08:00

While short, this week at site was chockfull of excitement. I came at the start of Seliba (Tabaski), a Muslim holiday celebrating Abrahams sacrifice of a ram instead of his son Ishmael (yes, the Koran places Ishmael, not Issac, in the knife's path - an interesting deviation from the Torah). In the days right before seliba, herds of goats and sheeps seemed to appear out of thin air: blocking the streets of the teeming markets, nipping at my feet on the bus ride to village, trying their best to get into my yard by gnawing my wood gate. As I walked into my host family's concession, the slaughter was already beginning. On a tarp over the sand I watched as the goat was killed, skinned and cut into intricate shapes, taking it apart with surgical precision. I'll spare you the details. Over the next two days I ate a myriad of interesting, seemingly inpalatable body parts. Out came entrails flavored with Maggi, tounge, pancreas and lung (?) amid peanut sauce and potatos, a very gluey hoof, and a majestic bowl full of grilled goat's head. The last was (alarmingly) delicious. Grotesque, yes. But there is some beauty to this idea of sacrifice, a long forgotten acknowledgement of our need to kill these beasts for our own life. Until now I never quite grasped the disconnect that is present in cultures where access to proteins and micronutrients is a daily given. When most of the villagers can afford meat only every other week, if that, each part of that animal becomes an opportunity for their children to grow strong (cue the Lion King's Circle of Life). Yes, here even the gluey hoof is useful and worthy of attention, and damn good protein. Killing with love.

The rest of my time was spent in the usual way. Mornings at the health center weighing babies, painting murals, or just chatting with the patients, health workers, or the usual characters that just, well, hang out. Afternoons hiding from the sun, reading or listening to the BBC on my shortwave radio, getting water, etc. Since the cold season is approaching (despite the 90 degree afternoons), in the evenings everyone huddles around the bonfires pitted in the middle of the yard, drinking their tea and listening to radio. The hilarity has been lost on me as my body temperature has apparently switched to Sub-Saharan mode. The other day, shivering in my sweatshirt, I looked at my thermometer, which was at an embarrasing 65 degrees. I am sure it is snowing in New York by now. I can't really understand that.

The other night, as I headed to my hut for my usual 9am bedtime (what else is there to do with no electricity?) I heard drums rumbling somewhere in the dark village. The next day the beating started again, and I finally discovered the donkiliyoro (dancing place), where the young village women and some men were gathered in a circle in celebration of an engagement. The women were feverously dancing in front of the three drummers, their hands thrown up behind their back and their torsos bent - birds of paradise in vibrant flower prints. The three men pounded their djambes (drums) with "snares" made of pieces of scrap metal, in front of a small bonfire which softened the drum, creating a deep bellowing sound. Soon, almost on cue, the three women would move out and a new group of girls would twirl in, dancing synchronously as the crowd began a call and response song. They danced and sang with such enviable ownership. This culture, these traditions are not the dusty cliche of their grandparents. It is theirs and they create it with each village dance, with the rhythms that have been drummed for centuries. The headwraps flew and panye (wrap skirts) adjustments were made as the party raged on through the night. I went back to my hut around 10pm, finally falling asleep to the rhythmic beats of the drums.

Running water

2009-11-26T01:03:00.001-08:00

A good month. It started with Halloween - the insanity of such a frivolous, fabulous holiday magnified by the bewildered Malians as we stepped out of the Kita house dressed as super heros, millet stalks, Bush taxis and a vertitable cast of characters. Kristen and I went as two mut huts, complete with a broom shoved on our heads for our straw roofs. Costumes slowly stripped away as the night blazed with dancing, plastic bags of gin and hulahooping. There is such a luxury that comes with letting your strange Americaness float comfortably among other Westerners, flinging off the awkwardness that cloaks you in village as you fret to cover your knees and respect the cekorobas (old men). Speaking of which, I heard a fantastic Malian proverb the other day:

"You can jump over the old man's excrement, but you can't jump over his speech."

After Halloween a few of us jumped into Bamako for a few days. I had an HIV awareness meeting to attend, and we tried our best to soak in the Bamako goodness: ice cream, diet coke, chinese food. The post Halloween party was still roaring there, and we spent most of our time at our friends house, talking amongst the carved watermellon jackolanterns and the persuasive call of the Mosque next door at prayer time. Heading back we bumped into a fellow Kita friend and hopped on the night bus back to Kita, where the three of us squished into a two sear row as goats wrapped in sacks whined on the roof above us. When I came back I discovered that my computer had contracted a nasty virus - too many dirty flashdrives. Its out of commission until I get back to Bamako for training in December.

Despite my anticipation at returning to village - laughable Bambara, annoying children and ego challenges looming ahead - I reached the pink tipped millet fields and friendly straw roofs with a sigh of relief. The relief was short lived as I ran straight to the toilet, beginning my two weeks of contemplating the ingenuity of the Bambara word for diarrhea, konoboli (running stomach). Between bathroom trips though I was able to begin the incredibly uncomfortable experience of my Baseline Survey. My humility soared as I asked the chief of the village if he had heard of STIs and, not realizing I was talking to the Imam (Moslim priest), I asked, amid a cloud of 20 children, if he knew where to buy condoms. Still, I left each family with a sense of purpose, and I am ingraining my purpose into this village as I try to understand what my role is here. A representative for the Women's Association came up to me and asked if I could help them create a women's garden, which should be an interesting project. Thankfully my site mate is an environmental volunteer, so hopefully we can get that project started together.

The usual sadness still greets me at the health center though. A woman 8 months pregnant finally coming in for her first pre-natal consultation, so weak due to her severe anemia her husband finally gave her the money to come. As we put her on an IV a grandmother holds her one year old grandson convulsing with cerebral malaria, and she is screaming "Oh Allah!" over and over through glassed over eyes. We try to put an IV in the child's tiny hands and feet but can't find a vein with his extremities bloated with edema, the body's desperate attempt to keep hydrated depsite malnutrition.

As my language becomes more coherent, I have finally been able to make friends here, a task that is harder than it seems as many people either see me as a bumbling awkward outsider who can't understand a word or are trying to see how much they can get out of me. I think I might pull my hair out if I hear "Where is my present?" one more time. Still, I try to remind myself that manners is as cultural as anything else. And with real friends I am starting to have some real conversations about living here. As Soliba and I discussed the difference in families in our countries, I tried to explain why it was not only okay but even (fully aware of my Western ethnocentricity) better to have less children (7 is the average for Malian women). She was incredulous when I told her that americans have 2-3 children on
average, and asked me:

"But what if one of your children dies?"

From an isolated point of view this logic seems flawless - the more children you have the more they can work for the family. This is also one of the values that is written in the Koran. And since almost a quarter of children die before the age of 5, this loss must be accounted for. My limited Bambara tried to
explain that children in the US dont die as often because their
parents have fewer children, and can take better care of each one. But
who am I to tell them to reject their culture, and how do they grasp
that they can slowly get themselves out of poverty by having less
kids? (this is arguably the key cause of their poverty and the world's
food crisis).

Such a sad reminder of this vicious cycle of poverty and tradition.
Poverty perpetuated by tradition, naivety.
(Is this their leaders fault, or the population that doesn't ask for better?)
A need for stability through tradition perpetuated by poverty.
(Is this our fault?)
This shouldn't be something anyone should get used to.

After two weeks and many bathroom trips I headed back to Kita and discovered that I have a stomach parasite. Not really a shocker. We spent a few days with our tutor under the guava tree as I got through the intense anti-parasitic medicine which made my water taste like metal. Me and my friend jumped on the 1am bus to a big Thanksgiving gathering with tons of other PCVs. We made 20 pies, killed 5 turkeys and filled a bucket with fruit salad, another with stuffing and mashed potatos. The next day, despite our food and whisky hangovers, 12 of us decided to head to a nearby waterfall. All of us somehow squeezed into a sedan, and I spent the two hour trip with the clutch awkwardly in between my thighs. When we passed the Gendarme (police) stop a few people climbed onto the roof, ducking renegade tree branches as we bounced through the path as if on a dried up narrow river bed. We teetered on the narrow bridge made of a few bamboo branches stuck together and hiked, following the sound of the water. The waterfalls were incredible. We climbed up the rocks, hoisting ourselves up with vines, and jumped off the rainbow tinted waterfalls into the shimmering pool 20 feet below. Beautiful.

Trip to the Banana groves

2009-11-04T07:33:00.000-08:00

2009-10-28T06:37:00.000-07:00

Yesterday was another torrential rainstorm. Fanta grabbed me with words of "old woman" and "fever," and we went to see the old dying woman. We met up with Sangare, the doctor, who gave the unsuprising diagnosis - malaria - which is literally ravaging our village this time of year during the rainy season. We found her under bright purple sheets sown with green flowers, her shallow breaths contrasting with the feverent pumping rain. When it died down for a moment, she got up and walked, shakily gripping the walls as we sat shelling peanuts. As she reached the nyegen she looked back vacantly as the wind played games with her green headwrap. Her grip on the mud wall seemed to teeter between worlds, her stare exhausted and vacant. The next day I went out to the peanut fields with Fanta and a few other women. Our hands and heads and backs were filled with gourd bowls, radios, water jugs and little girls. We sat under a tree and pulled the peanuts from the roots as we exchanged warm but confused sentiments about farming and the village. Our picinic lunch of fresh sweet milk with millet and cut cucumber was refreshing, and I finally felt welome into this community of strong women, even though they make constantly make fun of my smooth uncalloused hands and lack of a husband. We left as again the black clouds rolled in, and ran the last half kilometer to the village as the rain slowly crept up on our heads.

I returned after the fields to give my blessings to the old woman, and then went to sit with Nasira as she cooked dinner - peanut sauce and to (ground millet patties) over a mud fire pit. The next morning the old woman had died. Fanta had no tears as she told me - she went on pounding millet. Of course, she had eleven children, another wife and a husband to feed.

10/13/09 ? I am losing track of the days...

2009-10-28T06:31:00.000-07:00

Today I woke up after dreams of lying in Central Park listening to Belle and Sebastian with Gabby, a Starbucks white mocha frappaccino in hand. I was shocked to find myself under a mosquito net and a straw roof, listening to the donkeys morning wheeze. And there is no jarring sound like the donkeys first sounds in the morning - raggedly sucking in air in a tension filled shudder, and as soon as it seems like the poor malnourished beast's lungs have collapsed, it haws out a shrill choked exhale. Most of the day was spent in my usual way: mornings in the health center weighing babies, afternoon tea with the CSCOM staff, cooking lunch and studying Bambara as a crowd of aimless children stare at me, the evening tea and chat sessions followed by dinner with my host family. Still, I felt I was looking at my village through raw eyes, everything highlighted by the vibrant blue and yellow outlines that my anti-malaria medication fabricates. This is where I live? These are my neighbors, my friends, my co-workers? These straw huts with the swirling squash and cucumber vines - this is my home? What a strange, beautiful, simple world to be living in, so unlike the crisp, metallic New York! Even though the people asking me for money piss me off, the children laughing at my terrible Bambara is exasperating, and I haven't quite figured out how to successfully carry my water buckets on my head without getting soaking wet, its wonderful to live so intimately in this village. And despite the frequent loneliness that comes with being an outsider, and my (daily) efforts to get the children away who constantly swarm to my house (which is facing the school), I am amazed at how much I've integrated into the community in a month.

One thing I've been doing alot of is baby weighings at the CSCOM. During vaccination days on Mondays, women of the surrounding villages come, and I've tried to take this opportunity to weigh the 30+ babies there. In addition, almost daily children come to the CSCOM, for whatever reason, who are obviously malnourished. I've found that about 8 out of 10 children I've weighed are malnourished, either moderately or severely. Plumpy Nut, an ameliorated peanut butter distributed by UNICEF, has been a really helpful way to ensure that they are getting their daily protien and vitamin quota, which is so lacking in the typical Malian diet of rice and millet. But the French charts and guidelines are contradictory and confusing to me, and even more so to the other healthcare workers who seem to arbitrarily prescribe the peanut butter and make unconfident suggestions to the clueless parents. There is definitely something to the argument that literature and funding is great in terms of aid to developing countries, but taking the time to actually train the health workers in the rural villages is desperately needed, and inherently more sustainable than throwing money at a problem.

Where There is No Gynecologist

2009-10-17T06:02:00.000-07:00

Preventing cervical cancer in low resource settings
By Dina Carlin

"Women are not dying because of diseases we cannot treat...they are dying because societies have yet to make the decision that their lives are worth saving."
-Dr. Mahmoud Fathalla, former president of the International Federation of Gynecology and Obstetrics

In a country where female reproductive health is barely on the agenda, cervical cancer is an example of how modern medicine has stopped short in Mali, largely due to the low availability of resources. Each year there are 500,000 new cases of cervical cancer worldwide, and more than 80% of these cases occur in developing countries (1). According to the World Health Organization, cervical cancer is the most frequent cancer developed in Malian women, with 1,336 new cases each year. Meanwhile, 1,076 cases of cervical cancer in Mali each year result in death. These figures are projected to double in the next 15 years (2). While these statistics are sobering, cervical cancer happens to be one of the most preventable cancers with even infrequent screening. A household condiment, it seems, may be the answer.
The development of cervical cancer, caused by certain strains of the sexually transmitted virus HPV (the Human Papiloma Virus), has been strongly linked to socio-economic status. The increased prevalence of HPV in developing countries, as compared to rates in developed nations, is linked to a comprehensive list of factors, including access to sexual education, age of first sexual intercourse (25% of Malian women have sex before the age of 15), and availability of medical resources. However, the high incidence of cervical cancer is in large due to the lack of access to preventative healthcare. It is estimated that 21.5% of women in West Africa are infected with HPV, and this number has been climbing. In developed countries with fluid, accessible medical technology, the 'Pap' smear, a standard part of a gynecological exam, followed by colposcopy (laboratory analysis of cervical tissue) are well established methods to screen for HPV and precancerous cells. In addition, a vaccine that prevents two strains of HPV most frequently associated with cervical cancer has recently become widely available, albeit expensive. These efforts have led to sharp decreases in cervical cancer worldwide, with the exception of Sub-Saharan Africa. The high cost of these procedures, untrained and inexperienced healthcare providers, and the need for follow-up treatment create obvious barriers for impoverished countries such as Mali.
New procedures for diagnosing cervical cancer have been founded on the need for inexpensive screening methods that require minimal training and single visits to the health center. Since cervical cancer generally develops slowly, screening every 3-5 years, sources say, can have a significant impact in reducing mortality (3). While not as effective as the Pap smear, and certainly not as empirical as cytology, VIA, or visual inspection of the cervix with acetic acid (also known as household vinegar) is a groundbreaking alternative for the developing world. An alternative is VILA, visual inspection with Lugol's iodine, which is a slightly more expensive alternative. It involves only spraying the vinegar or iodine on the cervix, where the precancerous cells turn white in the case of vinegar, or brown with iodine. The simplicity of this procedure involves almost no equipment other than vinegar (widely available in most butigis) or iodine, and can be administered by any health worker.
Treatment for cervical cancer is key, as 95% of cases become fatal within two years. While treatment options vary, one of the cheapest, easiest and quickest treatments for cervical cancer is cytology, which involves "freezing" the cervix using carbon dioxide or nitrogen dioxide, killing off the precancerous cells. Most of the materials are locally available, the training is minimal, and the 15 minute procedure can be carried out by non-clinicians such as Matrons. In addition, it has a very low rate of complications, with cure rates of 85-91% (1).
So what do we do now? Since sustainability is key, working towards training healthcare workers such as Matrones to screen and treat cancer would decrease the impact of this highly destructive cancer. Finally, education and screening initiatives, with the aid of NGOs such as Prevent International Cervical Cancer Now (www.pincc.org) or the Alliance for Cervical Cancer Prevention would help bring the issue of cervical cancer to the national spotlight. Turning to simple and accessible technologies such as VIA and cryotherapy can create the foundation for effective preventative care in reproductive medicine. With all the tools available here in Mali to fight cervical cancer, it is time to decide to take action.

1 Sanghvi H., Lacoste M and McCormick M (eds). (2006). Preventing Cercical Cancer in Low-Resources Settings: From Research to Practice. Report of a conference in Bangkok, Thialand, 4-7 December 2005. JHPIGO: Baltimore, Maryland.
2 WHO/ICO Information Centre on HPV and Cervical Cancer (HPV Information Centre). (2009). Human Papillomavirus and Related Cancers in Mali: Summary Report 2009. [Accessed October 2, 2009]. Available at www. who. int/ hpvcentre
3 Sankaranarayanan,R.,Budukh, A. M. and Rajkumar, R. (2001). Effective screening programmes for cervical cancer in low- and middle-income developing countries. Bulletin of the World Health Organization. WHO.

En Brusse

2009-09-30T06:57:00.000-07:00

Well, my first two weeks at my village have gone by, and I know this will be so much more challenging than I realized, and so full of beauty, friendship and rewards. I am already losing track of the days in this web of the Brusse. Sometimes it feels like I can turn my head in so many directions and still find myself plastered to the same spot; the same children with the same illnesses, the same sanitation deficiencies and the same lack of expectations. The language of simplicity though, while from an outside view is banal, creates such complex layers of relationships. They use charcoal fires in lieu of covalent ovens, and gather around the shaky radio broadcast in the pitch black. And yet they are, as a whole, one of the most vibrant and happiest people I have known. It is cliche, but they have nothing but each other to care about.

Back here in Kita, the 9 of us met up to celebrate getting through the first hump of living off the grid. It is a relief in a way to speak english and feel comfortable in my American skin. It is sometimes difficult, at site, to remember that you are in fact capable of normal social interactions. There is no challenge to the ego like your 12 year old host sister asking you, day after day, if you washed. I gulp down the cynical urge to ask her how often she cleans herself (or just her hands) with soap - and anyway, sarcasim is a concept unsupported in the language here. Instead, I manage an agitated/amused giggle at my sister's strange brand of hospitality, pointing to my wet hair. At this point, I wouldn't be suprised if she asked me about my bowel movements. Privacy, personal space, alone time - these concepts dont quite register with Malians. Enthralled with the novelty of having a white person so intimately joining their space, I have found that the one time I can acutally be alone is locked in my hut, drowning out their calls to me over my wood fence with my headphones. Each day, as hard as it is to leave the safety of my cool mud walls and wonderful english books, I push myself out to wander about - yalayala - through the snakelike paths around the fields and huts, stopping here and there to have tea with the breadmakers, joke with the boutigi owners about taking them back to America with me, or draw animals and portraits with the children. Right now, the feverent rainstorms has made my village overflow with vibrant green fields, and the plants literally sprout out overnight and have drowned the "path" to my cell phone service spot: a little worn down clearing in the middle of the cornfields.

The other day I saw my first natural birth. It seems that almost all deliveries here are made in the middle of the light, dramaticly lit by oil lamp. Of course it is because these women must wait till their husbands get home to get permission to go to the CSCOM, and the state of being 9 months pregnant does not excuse you from pounding millet, chopping wood and pulling water from the well. I remembered this girl from her pre-natal consultation last month. She had just turned 16. She looked petrified, her eyes as big as moons as she yalayala'd around the room, her amniotic fluid dripping down her leg. When she was dilated, the matrone jumped on a table behind her and began pushing down on her belly with all her might, as her mother and her sister, each with an infant strapped to their backs, held her legs open above a jagged plastic bedpan. She was completely silent through the hour long process, the only sign of her pain were her tears gathering in a puddle on the floor and one or two grunts. After my matrone pulled the baby out, she grabbed him by the feet and hit and shook him, yelling "Kuma!" (speak!), laying him down to clear his passageways and pump his chest. The baby was alive, but was almost as silent as his mother. She hardly seemed happy or suprised, as if this was all she had expected; and here it is. Today, talking about my experience with my friend Dave, he pointed out how distinct the difference is between their access to healthcare and ours. If any one of us PC volunteers have any medical issue that surpasses the normal gamlut of moderate bacterial and parasitic infections, we would be shipped straight to Washington, DC. Not even the best hospital in the whole country of Mali would be able to provide the adequate healthcare that we not only covet in the US but expect. Here, in brusse, this woman was lucky to have access to a health center where they clean their tools with bleach - most of the surrounding villages near me don't even have a maternity. The beauty of the 360 vision you gain from living in this village web is you can understand the problems here from so many levels, and try to find solutions that doesn't involve throwing money at them.

And more than anything, it is so incredibly challenging establishing my place in this village with this huge lanugage gap. Most of the people in the village speak a different minority lanugage than Bamabara, called Malinke, and it is frustrating having to be led around like a child. But, I have found that art is an amazing vehicle to teach, and out of my restlessness I painted a mural of the food groups at the CSCOM.

Overall it is great, and I am learning that Mali is a country of contradictions - happiness in simplicity and misery in deficiencies, love and happiness through family and community and imprisonment by it. And I am happy I am here to create even the smallest bit of moderation.

Swearing In

2009-09-16T09:32:00.000-07:00

So as of Thursday I became an official Peace Corps Volunteer! After a greuling week of seminars at the training center and a very intimidating language exam (who knows how I passed...), we finally finished training. The swearing in ceremony was at the American Embassy, where we sat dripping in our Malian gear and pretended to understand the lovely French speech given by Madame Ambassador. The rest of the day was spent poolside at the American Club, where we got ready for our huge swearing in party. We all piled into a few clubs in Bamako (probably the most American thing about Mali), met up with tons of current PCVs, and were still roaring at 3am.
Right now I am in Kita, soaking up all the indoor plumbing, VHSs and market vegetables I can get before I plunge into my village. On Friday my sitemate Kristen and I will head to our nearby villages. While the thought of having to get by with my fractured Bamabara only with the only English speaker a few miles away is pretty frightening, I am so looking forward to finally making myself a home after living out of a suitcase for the past two months. Looking back on training, I am so struck by the unbelievable people I have met here -both PCVs and Malians - and am continually impressed by the immense value that volunteerism has in this country. Yes, it has been fun learning how to turn human urine into fertilizer, trekking to our boutigi for the occassional cold drink, and all crowding together to watch the occassional Flight of the Conchords off one of our laptops. But the dialouge I have had with so many volunteers and those who have worked with the Peace Corps had been one of such optimism. It is definitely energizing, and important to remember that even just sitting and having tea with my neighbors and comparing our cultures is progress. Dooni dooni (little by little...)!

End of homestay

2009-09-06T09:30:00.001-07:00

Today I said goodbye to my homestay family, possibly for good. Yesterday, we had a going away party outside my house as I donned the beautiful Malian dress my family gave me the night before. As much as I was burning to get away from the streets that flooded with rivers of sewage, smoldering trash piles and the incessant “Je-ne-ba!” (my Malian name) screams echoing wherever I went, it was surprisingly difficult to leave them. Amidst the chaos of bags and water filters this morning as all of us PCVs met at my concession for our pickup, I sat with my family as they told me how much they would miss me. Last night my brother Allou told me how I had “shown him the kindness of humanity,” and that he “now believes that people can work to do good.” He told me that he always thought of the white man as arrogant, violent and greedy, but that I have been an example of “true equality.” It was heartfelt and touching. This morning my mother Jeneba (my namesake) sat tearing – even with the few phrases I had strewn together in our sporadic conversations, we shared a wordless bond. My host sister Fatoumata hugged me as she ripped off all her jewelry and placed it on me, joking that I was going to take her adorable baby Abdul with me (I was tempted). I was really blown away by the openness and gratitude of these people who had bathed and fed me these past two months. This is truly a culture of endless, uncompromising affection. But I think when everyone is struggling to fill their babies bellies, there is no need for callous walls.

Baby weighing day

2009-09-06T09:04:00.000-07:00

So, I have been here for almost two months, and I cannot believe how quickly training has whirled by. As scared and unprepared as I feel to go alone to my site, I am amazed at how much I can convey to my family, and I am slowly beginning to piece together their conversations. Theres nothing better than being able to joke, a key social factor here among the different ethnic groups. “I be sho dun!” – “You are a bean eater!” Somehow, still hilarious 7 times a day. (Yes, the fart joke has its rightful place here in Mali).
The other day we did a huge baby weighing session in my courtyard, the 6 of us working in an assembly line, taking down the names of the crowd of women, two of us weighing the babies, and three of us counseling the mothers on their babies growth progress. 2 ½ hours and 130 babies later we put the last squirming baby into the snowsuit like balance roped to a vegetable scale. We compared their weight to their age, and separated them into the healthy green zone, the moderately malnourished yellow zone, and the life threatening red zone. Much to our surprise (and dismay), about half of the babies ended up in the yellow zone, and we tried in our best Bambara to tell them that they needed to improve their child’s protein and vitamin intake, as “their strength is little.” Still, there were about ten in the red zone, tiny things with shrunken in bellies and absent expressions. Those who were severely malnourished we sent immediately to the health center and urged them to improve their babies nutrition now. We also urged all of the children’s mothers in the yellow and red zone to return the next morning, where we did a huge ameliorated porridge demonstration with about 60 women. We showed them how to add protein and fruit juices to increase the nutrition of their carbohydrate dominated diet. As much as we tried, we still felt the large disconnect between the mothers and ourselves.

Site Visit

2009-09-06T08:58:00.000-07:00

This week I finally saw the village I will be living and working in for the next two years. We first stopped in Kita for a night, where the three current volunteers were waiting. We made a big Mexican dinner and wandered around the city for a bit, met all the officials and roamed through the market. The next day we climbed into a rickety blue van where we sat on rice sacks with about 20 other Malians (not to mention a few boys and hanging on the side and two goats on the roof). Slowly we plodded, as the tin roofed houses began to give way to straw covered huts, and soon those almost disappeared as we passed by rolling fields of mango trees and cornfields and wild African bush. Two hours later we arrived at our villages (not to mention the 20 minute tire change). My concession has two huts and a private gated area in between. Privacy is something I find I covet here, as everything is so communal even the concept of personal space is not quite understood. I met my coworkers at the health center and sat in on several prenatal consultations. It was shocking to see so many young women – 15, 17, 20 with a toddler on her hip – walking into the health center. It is difficult to detach myself from comparisons. At 22 I cherish my independence and the thought of a family seems far in the future. I wonder if these women find happiness in the communal family love that is so valued here. But I can’t help projecting my Western assumptions that a women deserves to do more than raise her 7+ children and live at the whim of her husband and his other wives. Or at least let them enjoy the last of her childhood!

8/7/09

2009-08-13T10:18:00.000-07:00

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.

2009-07-26T04:42:00.000-07:00

Back at the training center, I've never thought I would feel so grateful for wonders such as toilet paper, phone service, and fans. The last two weeks (has it really only been that long?) have been pretty real. As we came into our homestay village, we were greeted by the villagers who had set up a huge celebration in our honor. As we walked out of the van, they grabbed us to join their dance/drum circle, which was a great way to meet the villagers. The village I am in is relatively large, which has its advantages - namely a small farmers market and the occasional cold soda at our local Boutigi - but it also means that each morning there are hundreds of people yelling "tubabu" ("white person") as I walk to class, and I am usually followed by a cloud of twenty children - the Tubab parade. I am living with the Chief of the village (the Dugutigi), and my host family is incredibly accomadating and tries their best to speak with me in a sort of French-Bambara-English creole. I am woken up each morning to the donkeys and goats outside my door. I am quickly getting tired of rice with peanut sauce, or the dreaded "to," a millet ground into a stonelike mound and covered in slimy okra sauce. We try to do yoga most afternoons - authentic Bikram sweat yoga in the 90degree heat - and even managed a full sun salutation in the sweeping rainstorm. The language training is really intensive, but I am amazed at our progress after less than two weeks, and I can actually put coherent sentences together. Friday night our village had a great "soiree," with a dj spinning drum and bass and Malian techno through a generator. We tried our Tubab best, but were in awe watching the amazing rhythm of the Malian youth.
At training, we finally has some great sector specific training, which reaffirmed my purpose here in Mali. We learned how to weigh and measure babies to monitor their growth and nutrition. Child malnutrition is one of the worst epidemics here, and with a population where 50% are under 15 years old, it is desperately needed. Some eye opening statistics: 27% of children in Mali under 5 are underweight foor their age (10% severely), and 38% of children under 5 are underheight. Pre-natal and neo-natal health is also a real need, with a 10% infant mortality rate. We also put together a health survey in Bambara, which I will compile during the first three months at my village. Tomorrow we will go to Bamako, the capital city, and then back to my homestay village.

To the village

2009-07-14T06:43:00.000-07:00

So I am leaving my training site tomorrow and will be going to my homestay village, which is a bit outside of Bamako, where they speak the local language Bambara. I am staying in the village Chief's house, which will be both exciting and intimidating, since my Bambara vocabulary right now consists of four greetings. I will be in the village with ten other volunteers, and will be there until September 10th, when I will move to my permanent post. The homestay village is where I will get my intensive language and cultural training, and I will be completely immersed in Bambara.
These past few days have been pretty interesting. Right now its finally raining - its been hot and extremely humid the past two days here, so it is definitely welcome. Training has been great so far, but it really feels alot like summer camp, and I really look forward (with a bit of trepidation) to leaving for my homestay village tomorrow. The training has been really varied, and weve had classes on language, cross cultural and diversity issues, our technical field training, and even a two hour class on how to deal with gastrointestinal malaise (which is, apparently, inevitable). The training is mostly done by Malian Peace Corps staff as well as with current volunteers who are really trying to prepare us for life "en brusse" (in the village). Its undoubtedly been a learning experience - from the tragic fall of one of my Birkenstocks into the deep, dank neygen (toilet, aka a hole in the ground), to learning the polite way of eating with your hands around a communal bowl, learning how to fix a bike tire, and trying to understand the different gender roles and respectable behavior. Alot of our training is focused on how to be well integrated and respected in the community, as well as how to stay healthy an d safe. We had a cultural festival on Sunday, where the Malian staff and local vendors came and performed music, made food and sold some Malian clothes.
So tomorrow will surely begin the real culture shock, as I will be living and interacting with Malians, learning how to filter my own water, washing my clothes, and learning a language that I have had no experience with. As I will not have internet, I won't be able to post for about two weeks. Until then!

Je suis ici!

2009-07-10T17:44:00.000-07:00

So I've arrived here at the Peace Corps training center outside of Bamako, after a day (only?) of travelling. The Philadelphia orientation was brief but definitely brewed my excitement. After hours and hours waiting at the airports in Philadelphia and Paris, with our backpacks strewn across the terminal, irrecognizable from the mounds of sleep-deprived bodies (not to mention the 13 hours we spent in the air) all 66 of us landed in Mali. As soon as we stepped off the plane, the humid dusty air hit us (80 degrees even though it was after dark), and I felt that immense, excited jolt of realization that I was here to stay, for awhile at least. We waded through the chaos that is the tiny Bamako International Airport, which was just big enough to fit the people in our flight and the mounds of bags. We finally found our luggage, and were greeted by seasoned Peace Corps Mali volunteers who slightly intimidated us with their flawless Bambara. They threw our bags on top of several serious looking jeeps, we piled in the back, and off we caravaned Tomb raider style through the city, past the shanty towns and suprisingly clean metropolitan areas of Bamako. And here I am at the training center, which has electricity, fans and shower heads! What a luxury. Today we learned some of the interesting nuances of the Malian culture, including the intricacies of handshakes and the horror of using your left hand to do anything but, er, clean yourself. It really is amazing how much pride Malians take in their appearance; the women wear the most beautiful clothes everyday. I've started the malaria pills, which I swear is giving me some fun perceptual changes (extreme depth perception and color contrast after affects). The other side effects include "vivid dreams" and some other fun things. I will be here for a few days and then I go off to my "homestay" village where I will live with a few other volunteers with a host family for the next nine weeks before I am sent off to my village post. So far so good! More to come.

Purpose! Adventure! Movement!

2009-06-25T18:54:00.000-07:00

So here I go - I've never been much of a public writer, but I am sure that having a blog will be the best way to let all of you lovely people stay up to date with my adventures. Two weeks until departure, and its been quite a whirlwind since I found out five weeks ago. Theres been so much to do, so many people to see and moments to absorb and preparations to, um, prepare. I've been wildly packing for the trip, packing up my house, downloading books (thank you kindle/dad!), and bouncing from Long Island to Brooklyn to Manhattan. And through all of this I feel such immense excitement and a feeling of wholeness - I am ready to leave the academic world of "conscious inertia" as Doestoyevsky puts it, and move forward with action. So why am I giving up a comfortable, air conditioned life in NY to go and live in a developing country for over two years? Because I know that this one time in my life I have the freedom to live and work in a foreign country, and share my knowledge and interest in medicine with a population where it is not as easily accessible. I hope I can really make an impact on the healthcare in my area, and create a program that is sustainable and relevant. I hope I will better my French, learn a new language, paint, listen to Malian music, meditate, meet wonderful people and experience a new culture from the inside out.

So for those who would like to know a bit more about Mali (summarized mainly from Wikipedia and the Peace Corps welcome book):

Mali is a landlocked country in West Africa, bordered by Algeria, Mauritania, Cote d'Ivoire, Burkina Faso, Niger, Senegal and Guinea. It is about twice the size of Texas. Through it runs the Niger and Senegal rivers in the south, where most of the population lives. The ancient Ghana, Mande and Songhai empires controlled much of the trans-Saharan trade through the Niger river (many traded through the famous city of Timbuktu). The northern region is mainly comprised of the Sahara desert. Mali has a constitutional democracy which was established in 1992, and is considered one of the most politically and socially stable countries in Africa. The national language is French, but many of the population speaks Bambara. The population is mainly Muslim (90%), but there are small populations of Christians and traditional animist religions (and apparently a few Saharan Jews!). Mali is know for its music (check out Amadou and Mariam, they're good!). The Peace Corps have been in Mali since 1971.

If you want to know more, you could, well, look at Wikipedia yourself, or check out these other resources:

https://www.cia.gov/library/publications/the-world-factbook/geos/ML.html (CIA World Factbook)

http://geography.about.com/library/cia/blcmali.htm (a great map of Mali with facts)

http://news.bbc.co.uk/2/hi/africa/country_profiles/1021454.stm (BBC country profile)

http://mali.usembassy.gov/ (US embassy in Mali)