Thursday, March 22, 2012

Mid-Service Crisis

One year down, one to go.  This time in the service is notoriously hard for a lot of volunteers, since we’ve been here for what seems like a long time, but we still have another year to go.  Being in this country can wear on you after a while, and I’ve recently been feeling the “mid-service crisis”.

Some days it’s hard not to feel frustrated with everyday things that I used to have much more patience for.  Unreliable transport, rice and peanuts every day, hauling water, handwashing laundry, never really having privacy, living in a hut that never feels clean, screaming goats and children.  To top it off, it’s hot season now, and I sweat all day and all night long in the oppressive heat.  I can’t sleep in my hut, so I’m now sleeping outside at night.  Some days these things don’t bother me, but other days, it’s hard to get myself into a good mood.  I feel like I’m back to the beginning of my service when I was feeling that rollercoaster of emotions all the time.  It just feels hard to psych myself up for another year sometimes.

That being said, there are a lot of positives to being here as well.  It’s just difficult to escape the frustration that comes with living here for a long period of time.  To distract myself, it’s always fun to have adventures with other volunteers.  Earlier this month, some friends and I did a moonlit bike ride from Saraya to Kedougou on the smooth, paved 60k road.  We started around 10pm and got in just before 2am.  We rode along in different formations under the full moon, passing sleeping villages along the way.  Of course, we stopped for fun activities such as snacks, jumping jacks, and shirts-off-o’clock!  It was a beautiful ride!

Last week I taught my Care Group about germs and the importance of washing their hands with soap.  I don’t think I’ve ever seen my villagers wash their hands with soap.  Before eating a meal, most will dip their right hand in a communal bowl of water to “wash their hand” before eating with it.  During the Care Group, I explained what germs are and that you can’t see them.  The women seemed to understand the types of illnesses germs can cause, and we talked about contaminating other people.  In this culture, we shake hands with other people all day long, so we’re constantly spreading germs around.  To demonstrate to the women that the bowl of water does not wash away all the germs, I squirted some hot sauce on their hands and asked them to dip their hands in the water bowl.  Afterwards, everyone agreed that their hands were not clean and that there was still hot pepper on their hands.  After washing their hands with soap for 30 seconds, they said their hands felt clean.  By the end of the lesson, they all understood the importance of washing their hands with soap.  The frustrating part is that they all said that they are not more likely to buy soap now, because they say it is too expensive.  It’s not a priority for them.  Even though they spend the same amount of money on tea and sugar when they socialize, they still do not see the value of spending money on soap.   Behavior change is hard, and this is one behavior that I don’t know if I will see change during my service.  The positive part is that they are now teaching their mini-groups about hand washing, so knowledge about germs is spreading around the village.  Little by little, hopefully this will make some impact at some point.

I’m hoping this mid-service frustration passes soon.  After being here for a year, I feel like I see more clearly the reality of life here and have a more realistic expectation of what I can do during my service.  You begin Peace Corps thinking you can change the world, and slowly that spectrum shrinks and shrinks.  I don’t want to sound jaded, but I feel that I’ve lost my idealistic notion of what I could do here.  I’ve learned that I can teach people how to do things and that doesn’t necessarily mean they will ever do them.  I know that I can ask every compound where women should give birth, and they’ll tell me all the women give birth at the health post, when in reality they know their family’s women give birth at home.  A baby died last week because the mother never came to the health post for pre-natal visits, the birth, or after the birth, and she and baby were both very ill.  These situations are disheartening and add to my frustration. 

I think there has to be some switch in my thinking where I appreciate the small victories in my village more.  When the little kids faces light up when we do art projects.  When the women in my Care Group teach other women about health.  When the kids in the English club greet me in English.   I’ve got another year to go, and there’s still a lot I can teach and learn.  So I’m halfway through this marathon, waiting for that second wind to kick in, and I know it will.

Friday, March 2, 2012

ORS, Beignets, and Headhunters

For the second Care Group meeting, I taught about diarrhea and how to make oral rehydration solution.  I was impressed that every woman in the group showed up, and each woman had a list of 7 women in their mini-group that they will be teaching after our main group meeting.  Kaba has been a rockstar counterpart for the project and has made sure that each woman understands the group and that they each came to the lesson with a list of names.  I have an energetic group of women, and they all seem eager to learn and teach others.

I started off the meeting with a discussion about diarrhea, asking the women what it is, how it is caused, and how they can prevent it.  Everyone knew what diarrhea is, but there was some confusion about how it is caused and how it can be prevented.  I drew a cycle on the chalk board showing one person having diarrhea, then not washing their hands after going to the bathroom, and then eating out of a communal bowl and spreading it to other people.  This situation is very familiar to them since it occurs daily.  Getting people to wash their hands with soap is a battle I haven’t tried to fight yet, but maybe a topic for another meeting.  We also listed other causes of diarrhea such as drinking contaminated water, eating food that has not been cooked properly, etc.  To really explain the effects of diarrhea on the body, I made a diarrhea baby out of a water bottle.  The water bottle had a hole where the diarrhea would be coming out, and during the lesson, I unplugged the hole to show all the water that drains from the body.  On the top of the water bottle, I put a wet piece of cloth that represents the fontanel, which is the soft spot on the baby’s forehead.  The soft spot usually closes between 7-19 months.  When a baby is dehydrated, the spot sinks inward, which results in a sunken forehead.  When the water drained from the diarrhea baby, the cloth sucks inwards, showing the effects of dehydration.  The demonstration was a good visual example to explain to the women that the body needs to be rehydrated while having diarrhea. 

To rehydrate the body quickly, we made oral rehydration solution (ORS) with salt, sugar, and water.  The recipe we used was 8 spoonfuls of sugar, 1 spoonful of salt, and 1 liter of water.  The women know that for adults and large children, people should be consuming 3 liters of ORS each day.  I brought water, salt, and sugar to the lesson, and women took turns coming up to create the solution.  They passed the cup around and each tried the ORS and even started giving it to their children during the meeting.  One woman asked if she could take extra home to her family so she could give it to her other children.  At the end of the lesson, I asked the women to summarize the lesson so that I was sure that they would be able to teach their mini-groups the same information.  I was amazed at their information retention!  Some of them were able to teach the lesson and cover all the points that we had talked about, and this is without taking any notes!

Only a few days after the meeting, my Care Group ladies were coming up to me in the village to tell me that they had already taught their mini groups the lesson and that they had made some ORS!  I couldn’t help but feel proud of these strong female leaders in the community!  The Care Group is working, and I am so excited about the work we can do this year!

Another big success recently has been the English Club.  As I mentioned in a previous blog, the two English teachers in the village approached me to be involved in the English Club they were starting at the school.  This is the first English Club Nafadji has ever had, and the teachers are extremely motivated and enthusiastic to get the middle school students speaking English.  At our first meeting, about a hundred students showed up.  It was great to see the excitement and interest, but it was an overwhelming number of students.  We held an election to choose the officers of the club, and it was very chaotic.  At the second club meeting, only the officers came, which was more manageable group of seven.  One of the English teachers asked me to lead some English games with the group as an example of games that they could then lead in later meetings.  I pulled games from my days of teaching English in Thailand, and we had a lot of fun!  Ian was also in Nafadji visiting for the day, so he helped lead some games as well!  We played charades, splat, and hangman, and the students seemed to be having a great time.  I’ve also given the teachers a lot of American music, which they plan to incorporate into future club meetings.  It is so exciting and hopeful to see how motivated the English teachers are to make learning fun.  Along with learning English, they also want the students to explore issues of health and early marriage in the club.  This club is going to be a great way for me to be able to connect with the middle school students, and the teachers have asked me to be the go-to person for the girls if they have any problems they need to talk about.  They also would like me to lead a discussion on sexual health later on in the year.  There are so many possibilities for this club!

Ian and I are still working on our student relais training, and we just handed out applications to the middle school students last week.  Over a hundred students attended our informational meeting, and everyone wanted to apply to become a student relais.  We will be selecting 6 girls and 6 boys to take part in the 4-day training, and they will learn about sexual health, HIV/AIDS, family planning, early marriage, and opportunities for careers.  After the training, the student relais will be expected to lead talks with their peers and their local villages on the information they have learned.  They will become the point people at their school if anyone has any questions about these issues.  Ian and I will be collecting the applications this coming week and will then select the 12 trainees.  The training is scheduled to happen from March 24-27, and some of the Saraya hospital staff will be coming down each day to lead sessions.  The middle school students are very excited about this opportunity, and Saibo pulled me aside at home and told me how much he wants to be selected.  It was very endearing, because he told me how much he loves learning new things and how he has a great memory.  I really want to pick him!

As for daily village life, I’ve started making beignets with my friend Sadio in the afternoons.  She sells beignets each day, and I finally took her up on her invitation to fry up the beignets.  She has two adorable daughters who helped us as well.  Before I arrived, she had made the dough and sprinkled Moringa powder into the mix to make them healthier.  I balled up the dough and put globs in the pan as she turned the dough as it fried.  We made a huge bowl full of beignets, and of course I helped her taste them along the way!  It was a fun afternoon activity, but I later realized it’s not a good one to do right before a long run. 

As we were sitting around the dinner bowl one evening after I had returned from a run, Mbamoussa mentioned to me that I should no longer run on the road I usually run on.  When I asked her why, she told me that a Guinean woman had come to the village that day and told everyone about a premonition she had.  This woman is apparently clairvoyant, and she saw in the near future that a woman would get her head chopped off on that specific road.  The people in my village are very superstitious, and everyone was now telling me that I shouldn’t run or bike alone on that road.  This was coming at a time when I had been in village for close to 2 weeks and we had lost cell reception for 5 days, so I was feeling extremely isolated.  Now they were telling me I couldn’t even bike out of the village?  As weird as I thought the premonition was, I felt very frustrated that my family wouldn’t let me leave Nafadji unless it was in the car that only comes once a week.  When I told Sarr the story, he laughed out loud and told me I shouldn’t be worried about biking alone on that road.  He seemed to think the premonition shouldn’t be taken seriously.  I’m not sure what to think, but the last time I left village, I did it in a car instead of by bike.  If this belief keeps going, it’s going to become very hard for me to get to and from my village.  Although, Mbamoussa told me that if I traveled with a weapon, it would be ok for me to bike alone.  So I may start biking with a machete…

After a very productive stint in village, I’m getting ready to head up to the neighboring region of Tambacounda to run a Half Marathon this weekend!  One of the volunteers organized the race to raise money for girls’ education.  I’m excited to race since it’s been a long time.  Hot season is coming fast, so hopefully they provide plenty of water along the course!

Making beignets with Sadio, Bobo, and Aissata

Political Debates and Dance Parties

Being in Senegal for the presidential election has been an educational experience.  I can learn a lot about a country by watching their process of electing a president.  I remember when I was studying abroad in Paris, I was there for all the presidential rallies and when Nicolas Sarkozy was elected.  You see people unite around a political candidate and hear endless conversations about politics and what’s important to people in their country.  That being said, elections in France and those in Senegal are quite different.

President Abdoulaye Wade has been in office for 2 terms, beginning his presidency in 2000.  Initially, each term was 7 years long, but there was no limit on the number of terms a president could serve.  In 2001, a new constitution was adopted that reduced the presidential term to 5 years and set a 2-term limit.  The controversy with the current election is that Wade argues that his first 7-year term as president fell under the previous constitution, which did not provide term limits.  He believes that he should be allowed to run for another 5-year term, but much of the population disagrees.  On January 27, 2012, the Constitutional Court of Senegal ruled that Wade was allowed to run for a third term and that his first term did not count under the new constitution.  In response to this ruling, there have been many violent protests in Dakar.

When I arrived in Senegal, the Safety and Security Coordinator started warning the trainees early about the impending election this year.  We were told that things could get dangerous in certain areas and that we would be kept up to date on what areas we were allowed to go to.  So far, most of the violence has been in Dakar, and I have avoided going to the capital.  In Nafadji, my safety has never been a concern for me.  The people in my village seem to view the election as both a contest to see who can get the most free stuff from the candidates as well as an excuse to throw huge dance parties when the candidate’s representatives come to the village.  For example, President Wade sent a new milling machine to my village, and many of the candidates have been handing out money to encourage a vote in their favor.

I’ve talked to my host family about the election, and even though many of them are voting for different candidates, there has been no tension in the house.  If anything, it’s just been a way to make fun of one another in jest.  When I ask why they are voting one way or another, most of my family members cannot give me much reasoning.  It appears on the outside that the villagers care about politics since they have all been wearing the free t-shirts with different candidate’s faces on them, but when you start talking with many of them, they can’t tell you anything about the candidate on their shirt.  When any candidate’s representatives have come to the village, we’ve had huge dance parties where it seemed as though everyone in the village showed up, whether or not they supported that candidate.  I attended the Macky Sall dance party, and it did not revolve much around the candidate at all.  The villagers drummed and danced for about an hour in the woods at sunset.  During the party, the representatives and the village chief sat on the side.  By the end of the party, when the Macky Sall representative was finally going to make a speech about the candidate, people slowly started draining from the party.  Women had to get home to cook dinner, and children were getting restless. 

The educated workers in my village, such as the College teachers and the nurse, have very strong opinions about the various candidates.  These are people who have attended University and are from the Dakar region.  Every night at the health post, I’d walk in on a heated political debate.  These were the times that I felt I was really learning about why people were voting for the various candidates.  Although these debates got heated, they were never violent.  It was always friends voicing their opinions to other friends. 

There was so much hype leading up to the election that I was expecting chaos and unrest, and it turned out to be very anticlimactic.  People voted at the school and the situation was unnervingly calm.  The most shocking part for me was that people stood in lines to vote!  I’ve never seen people stand in lines here, ever!  Everything was very orderly, and there were supervisors there to make sure the voting ran smoothly.  Red Cross was on standby in case any fights broke out, but they looked extremely bored.

In the first round of elections Abdoulaye Wade got 34.8% and Macky Sall got 26.5%.  A second round of elections will be held on March 18th as a runoff between Wade and Sall.  Hopefully the second round goes as calmly as the first round!
Macky Sall Dance Party
Dance Party!

Peace Care, Valentines, and Salad

Note: This blog was written on 2-18-12.  I haven't had internet in a while, so I haven't been able to post blogs!

Peace Care is a nonprofit founded by Dr. Andrew Dykens, and its aim is to provide a better trained and more accessible health care workforce in all parts of the world.  To read more about its mission and work, check out the Peace Care website (!  A couple of years ago, Andrew contacted the Peace Corps Senegal Country Director, and was connected with a former Saraya volunteer to help form a project with the Saraya Hospital.  After talking with the community through various focus groups, it was decided that Peace Care would begin a cervical cancer prevention project.  Cervical cancer is a significant problem in Senegal, and the World Health Organization reported that:

"Senegal has a population of 3.20 million women ages 15 years and older who are at risk of developing cervical cancer. Current estimates indicate that every year 1197 women are diagnosed with cervical cancer and 795 die from the disease. Cervical cancer ranks as the most frequent cancer among women in Senegal, and the most frequent cancer among women between 15 and 44 years of age. About 12.6% of women in the general population are estimated to harbor cervical HPV infection at a given time and 43.6% of invasive cervical cancers are attributed to HPVs 16 or 18.”

Last January, the Peace Care team trained a group of midwives to do the cervical cancer screening using visual inspection with acetic acid (VIA), and we’ve been leading trainings throughout the year to train more midwives and nurses in VIA.  The plan was for Peace Care to come back after one year to do refresher courses in VIA and teach cryotherapy, which would freeze off the precancerous cells with nitrogen gas in the women who tested positive. 

The Peace Care team, made up of two family medicine physicians, an OBGYN, two residents, a medical student, a communications professor, and a public health student, arrived at the end of January to work on the cervical cancer prevention project.  Leah and Meera, Peace Corps volunteers in Saraya and Kedougou respectively, had been the leaders of the project on the Peace Corps end, and they have now transitioned me and Larocha, a volunteer in Salemata, into leading the project in the Kedougou region.  To transition the project, Larocha and I were with the Peace Care team for the entirety of their two and a half weeks in Kedougou and Saraya.

The Peace Care Team and the volunteers led a refresher course for the midwives and nurses in VIA.  Following the refresher course, we did cervical cancer screening in four villages in the Kedougou and Saraya health districts.  During these screenings, the Team would observe how the midwives and nurses were interacting with the women being screened and how accurate they were diagnosing the cervices.  Having the American doctors present for the refresher course and screenings really helped me further understand the procedure and the cervix.  I was in a testing room with a physician, and she was able to explain the results of the tests to me in English, which never happens here!  To learn the material in English instead of French made it much easier to more fully understand the process.  Along with the screenings, the communications professor and public health student led focus groups in the community to find out what the community knows about cervical cancer and what the general consensus is about getting screened.  Only one of the doctors who came speaks French, so the volunteers, including myself, were acting as translators in French, Malinke, and Pulaar.  I went around with the Communications team in various places and acted as a French and Malinke translator. 

The doctors had planned to teach cryotherapy during their visit, but unfortunately we had some equipment problems.  We received a liquid nitrogen tank from Dakar instead of a pressurized nitrogen gas tank, which is what we needed for the procedure.  The Peace Care team will most likely be returning in October to teach cryotherapy.  We had many meetings with hospital doctors and midwives to plan for the coming year.  Larocha and I will help organize another midwife VIA training in May, and we’ll continue to help in cervical cancer screenings in the region.  In October, we’re planning to do a mass screening campaign to increase the number of women being tested.  We may also begin to expand this project into the neighboring region of Tambacounda.

I learned a lot in the couple weeks I spent with the Peace Care team.  It was exhausting, but I feel that we are working on a very worthwhile project.  Talking with the doctors also got me very excited about a future in global health!  I’m planning to apply to grad school this year, so it was great to get advice on different programs!

After being away from site for a couple weeks, it felt great to come back to Nafadji.  I miss Sira a lot, but I’ve been having a lot of fun with the other kids on the compound.  For Valentines Day, I taught them how to make paper hearts, and we made Valentine’s Day cards for each other.  I’ve also started making word search puzzles for the middle school students, and they love them!  I’ve made some in English and some in Malinke, and the middle schoolers have competitions to see who can find the most words.  Whoever wins gets a piece of candy!

It’s salad season!  Women are growing lettuce in their gardens, and salad is becoming a common snack on the compound.  My family makes a delicious peanut dressing, and I’m hooked!  It’s so nice to see some vegetables for a change.  Fily took me out to her garden, and I was amazed at the rows of garden plots the women have created near the river.  I’m hoping the lettuce keeps on coming, because I’m getting used to having a salad snack after lunch now!

The two English teachers at the middle school recently approached me and invited me to be involved in the English club they’re starting.  I was impressed with their ideas for the club, and they have some fun ways of teaching English, involving lots of interactive games.  Today is our first club meeting!  I’m also going to be having my second Care Group meeting tomorrow, so lots coming up!