Saturday, August 4, 2012


Diabou, my 15-year-old host niece, is having a rough year.  She seems to be the bad example of every health problem I’ve worked on in my village.  While training to be a Jeune Relais, she learned about reproductive health and the dangers of teenage pregnancy, only to reveal that she herself was pregnant.  During the malaria training she received, she learned that pregnant women who get malaria would become anemic and could go into early labor.  This rainy season, she has gotten malaria twice.  The second time, while she was hooked up to an IV at the health post to receive treatment for malaria, she went into labor 2 months early.

I had heard during our malaria training that malaria could induce early labor, but experiencing it with a member of my host family was surreal.  Since she was only 7 months pregnant, no one was expecting the baby anytime soon.  I was hanging out at the health post while she was receiving her IV treatment, and all of a sudden, the matrone came out of the room and said she was delivering the baby.  I was very out of the loop and rushed over and was handed a bag of bleach to carry into the room to clean things up.  When I walked in, the new baby girl was already out.  At the naming ceremony a week later, Diabou revealed that she was naming her daughter Kaba after the matrone.  Both Diabou and Kaba are healthy, but Kaba is the tiniest baby I’ve ever seen.

Baby Kaba

Diabou and Kaba

At the age of 30, Mbamoussa not only has 9 children but is now a grandmother.  Family planning is a significant problem in my village.   Last week, I did a lesson on Family Planning with my Care Group.  To gather information before I led the lesson, I talked with Kaba about which methods of family planning are the most common in the village.  We talked about birth control pills, shots, and the implants that are inserted into a woman’s arm.  All of these methods are affordable, but the roadblock to family planning is the husband.  Most husbands forbid their wives to use any methods of family planning, and this stems from a misunderstanding about birth control.  Many men think that if their wives start taking birth control that they will never be able to have children again.  This fear is so great that some men become irrational.  A woman in my village got the implant put into her arm, which can last up to 5 years.  Her husband found out and became furious.  He wanted to punish whoever inserted the implant into his wife’s arm.  The midwife who moved away from our village is the one who inserted it last winter, but he wouldn’t believe that it was someone who was no longer there.  He first blamed Sarr, the nurse, and then Makhan, the community health worker.  When he realized it was neither of them, he turned to Kaba, our skilled birth attendant.  She does not have the training to be able to insert the implant, but he irrationally is convinced that she is the one to blame.  He has threatened to take her to the police.  This situation is convincing me more and more that I need to organize a health talk with the men in my village about the facts of birth control.  Since most men refuse to use condoms, women go from one pregnancy right into the next, to the detriment of their health and the babies’.

It turns out that this same angry husband forbid his wife from being a member of my Care Group.  Back in December, when the women’s group presidents were electing women to participate in my Care Group, his wife was elected, and he pulled her out.  No one ever told me this.  I never realized that being a member in my Care Group was a controversial matter.  That seems to be the way of the village though.  Now that I’ve lived here for over a year, issues are beginning to surface that I would have never expected.

If you ask most people in my village if Female Genital Cutting (FGC) is practiced, they will tell you that it was abolished and doesn’t happen anymore.  I believed this to be true since I had no evidence to the contrary.  Recently, I was having a conversation with a man in my village who used to work for Tostan, an NGO that has done work to end FGC.  He informed me that no one in my village cuts girls, but families bring their daughters 6 kilometers to the neighboring village to have them cut.  This past month, a group of girls were taken to this neighboring village to get cut by an older woman who has been cutting girls for a long time.  Many people in my village recognize that it is a harmful practice, but the older generations do not seem to have changed their behavior.  If this man had not chosen to be honest with me about this issue, I could have gone my entire service without knowing that this was going on.  People tend to tell me what I want to hear, and the longer I'm here, the more I question what I’ve been told.

One health issue that is no secret is malaria.  This time of year, it seems as though everyone has it.  My friend Ian started a project in his health zone where he trained health workers in 5 villages to test for malaria and distribute malaria medication.  Every Monday and Friday during the rainy season, these health workers will visit every compound to test and treat every sick person for malaria.  For the first day of the project, Ian invited me and some other volunteers to shadow a health worker during their morning rounds of the village.  I biked out to a small village of 200 people to follow the health worker around to every compound, testing and treating the sick.  I was shocked at the level of malaria in the village.  Every compound we went to had people who were sick with malaria.  Since we visited every person in the village, in theory, every person who had malaria that day was given medication.  If people start taking malaria medication within the first 24 hours of symptoms, they cannot transmit it to other people.  The goal is to lower the rates of malaria in these communities, and I think the project is off to a great start!

On a lighter note, rainy season has brought lots of fun activities!  I’ve been going out to the fields with the women to plant corn and peanuts.  Mbamoussa’s women’s group went out to plant corn the other day, and we made a day of it.  We hiked out into the bush with bowls of lunch on our heads, carefully avoiding a snake that slithered across the path about 10 feet in front of us.  We hacked weeds for a while and then took a lunch break.  After lunch, all of the women lined up in a row, and we walked in parallel lines, seeding corn, singing, and gossiping as we walked.

Planting Corn

Heading home with sticks to cook dinner

Now that the rains have started, women have started hiking out into the bush with their laundry to wash their clothes in what I thought was a seasonal river.  Recently, Fily and Mbamoussa invited me to tag along, so I grabbed my bucket of dirty clothes and some soap and we headed out into the bush.  We kept walking and walking and passed the dry seasonal riverbed.  Finally after what seemed like ages, we arrived at a puddle of water, and I realized that this was where we were going to do laundry.  The “puddle water” looked to be teeming with parasites, and I was not confident that this would clean my clothes.  Fily assured me that all the women of the village have been sharing this puddle and cleaning their clothes.  We washed our clothes alongside other women, as this tends to be a social event.  I’m anxious for the seasonal river to fill up, because this puddle water was very questionable.

The upside of integration is that I feel very close with my community, but on the downside, I’m uncovering the seedy underbelly of Nafadji.  Secrets are coming out, and there’s a lot of work to be done.

1 comment:

  1. All this stuff would make a wonderful book. Each blog seems full of interesting nuggets and surprising insights into your world. You really have done a wonderful job of helping us understand why the work you do is so important. We are very proud of you.