Only skin

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. 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

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

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)

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

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!

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

Call me Djeneba

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

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

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

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

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

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

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

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

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

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

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

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

Continue reading the main story
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There has been no official comment from the Mali authorities.

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

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

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

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

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

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

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


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

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

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

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

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

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

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

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

Hey, leave those clits alone!

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

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

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

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

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

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

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

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

A book, a book...

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

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

Cervical Cancer Screening Campaign

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

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

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

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

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

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

This must be the place

Feet on the ground, head in the sky…

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

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

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

Africa is Sexy

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

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

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

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

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

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

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

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

the air conditioned (nightmare)

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


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

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

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

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

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

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

stranger in a strange land

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

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

Golddiggers

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

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

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

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

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

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

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

Cervical Cancer Screening Formation in Kita

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

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

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

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

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

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






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A pain in the ass

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

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

freefalling

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

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

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