Thursday, October 25, 2012


When you hear about something bad happening to someone else, you never think it will happen to you.  And if it does by chance happen to you, you want to believe that whoever harmed you would be punished by the justice system.  Before joining the Peace Corps, I heard about sexual assault cases but never thought I’d be one of the victims.  I was lucky in a lot of ways that things didn’t go worse than they did, but I still wanted the offender to be punished.

After the assault, it took the police over a month to catch the offender.  Once they did, I decided to press charges.  I was not only pressing charges to ensure my own safety but also the safety of the girls in the village.  My host sisters were terrified of this young man.  In order to press charges, I had to sit in a room next to the guy who assaulted me while I explained my story to the Commandant.  I was told I would go to trial any time in the next 6 months.

A week after pressing charges, a guy I knew from Nafadji passed me on his motorcycle and said that my trial date was the following Friday.  I was incredibly confused.  How did this random guy know my trial date?  I called the Commandant, and he said he still didn’t know when my trial was going to be.  Turns out the random guy was right, and I’m lucky that I bumped into him.  I didn’t get my Summons until less than 24 hours before the trial, and I had to travel to another region since there’s no court in my region.  Either they were hoping I wouldn’t be able to make it to the trial, or this was just another indicator of this broken and inefficient system.

My friend LaRocha traveled up to the neighboring region for the trial, and we went to court the following morning with a Volunteer Support Assistant (VSA).  Since the offender was a 16-year-old boy, the trial was in a juvenile court, which was closed to the public.  Before the trial, we were sitting on a bench outside the courthouse, and a woman came up and greeted me by name.  I thought it was odd that someone in this other region would know my Senegalese name, and I quickly realized that it was the offender’s mother.  She stood in front of me and removed her head wrap and then her shirt, and began bowing down to me topless, begging for my forgiveness.  I felt incredibly uncomfortable, and thankfully the VSA asked her to stand up and put her shirt back on.  As bad as I felt for this woman, she wasn’t going to change my mind about going to trial.

In the courtroom, I was seated at a rectangular table with the offender’s mother to my left and a translator to my right.  Across the table was a panel with the judge, procureur, juvenile program director, etc.  The part that still baffles me is that the offender was asked to stand behind my chair.  His hand was on my chair throughout most of the trial, gripping it tightly. 

The trial seemed to be going well, because the boy admitted that he was guilty.  The procureur gave a long speech about how this young man was a menace to society.  His crimes were getting worse (this is the same young man who stole a backpack out of my hut the year before).  He has stolen from others in the village and may have done worse things to the young women in the village.  The mother admitted that she couldn’t control the young man anymore.  It was obvious to me that this boy would be sentenced to a detention center.  At the end of all of the speeches, the judge announced that the offender would go back to my village with his mother.  What?!?

At this point, I was in tears and couldn’t believe my ears.  How could they send an offender who they referred to as a “menace to society” back to the village?  It made absolutely no sense.  Thanks to the help of some friends outside the courtroom, the procureur agreed to meet with us to explain the sentence.  Apparently they didn’t think that there were any spots open in a rehabilitation center, so there was nowhere else they could move him.  The part that angered me the most is that this man said to me “this is Africa, nothing works here”.  He blamed the faulty justice system on lack of resources and the nature of third world countries.  My friend asked the juvenile program director if he could call the detention centers that moment to find out if there was a spot since they hadn’t even checked.  His response was that “this is Africa, things are slow here”.  These cop out answers reflect the fatalistic nature of this culture once again.  No one believes they can change anything since everything is up to Allah to change.  They accept things the way they are, even when systems like this are clearly broken.

Lucky for me, I’m an American.  Once the U.S. Embassy and Peace Corps put pressure on the court, magically a spot opened up in a detention center.  But what if I wasn’t an American?  What if I was a Senegalese woman who had been sexually assaulted or raped?  After seeing the dysfunctional nature of the justice system, I may not have even bothered going to the police if I knew I wouldn’t have been taken seriously.

Things seemed to finally be falling into place.  I set up my new site in Saraya and was prepared to move in this week.  The papers for the offender to move to the detention center went through, and he is ready to move there.  But there’s a catch.  Tabaski, the biggest Muslim holiday of the year, is tomorrow.  Everything shuts down for the holiday, including the detention center.  The center closes, and all of the juvenile delinquents get to spend Tabaski with their families.  This means the offender was released back to my village unsupervised for the holiday.  This makes complete sense, right?  Let’s send all the criminals home for the holidays!

This justice system is broken, and the saga of my assault has been an exhausting one.  I’ve had to fight every step of the way to get justice, and I still am not sure if everything is going to work out.  As frustrating as this experience has been for me, I can’t even imagine what a Senegalese woman would have to deal with in a similar situation.  This system needs to be fixed, but I don’t know where someone would even begin.  Maybe the first step is that people whose jobs it is to provide justice need to believe that they can change the system.  If no one tries to change anything and people continue to use “this is Africa” as an excuse for faulty systems, then they are only reinforcing the system’s dysfunctional nature.  Instead of being stuck in this self-fulfilling prophecy, someone needs to break with tradition and do what is just.

Wednesday, October 10, 2012

Teaching Matrones and Bajenu Gox about Cervical Cancer!

To meet the prevalence study target of screening 3000 women for cervical cancer, a strong communication plan is essential.  In our strategic planning session between peacecare and the Saraya District Chief Doctor, it was decided that we’d train community health workers to lead health talks on cervical cancer to motivate more women to come out and get screened.

Over the past couple of months, I’ve been working with the regional midwife trainers to plan a region-wide cervical cancer training for skilled birth attendants (“matrones”) and Village Aunts (“bajenu gox”).  Village Aunts are community health liaisons, and there is usually at least one in every village.  These women have been trained in basic health education and occasionally lead health talks in the communities.  I worked with the head regional midwife to put together a curriculum for the training, and she created a powerpoint presentation.  The goal of the training was to provide the community health workers with a basic understanding of the female anatomy, cervical cancer, screening, and treatment. 

Two weeks ago, we did the training in all 3 health district capitals with skilled birth attendants and village aunts who came in from all the villages with a health post in the region.  Since it was only a 1-day training and most community health workers are illiterate, we wanted to keep the technical information to a minimum and include lots of pictures. 

Trainers: Fatou N'dour, Head Regional Midwife
and Ndella Diouf, Head Kedougou Midwife

The phrase in Malinke for cervical cancer translates directly to “the disease that lives in the birth place”.  This gives an idea of the level of technical information that could be taught.  Without a formal education, the big takeaways about cervical cancer were that women who test positive could die or not have children in the future if they don’t get treated.  This information has been enough to get women motivated to get screened, because in this culture, having a family is the highest priority.

The first training took place in Kedougou, and I was impressed with the number of women who showed up!  As tends to be the case here, the training started 2 hours late, but all of the information got covered.  Language was an issue since the lead trainer wanted to do the presentation in Wolof, and the majority of community health workers in the region speak either Malinke or Pulaar.  The slides on the powerpoint were also in French, and since most of the women were illiterate, they didn’t get much out of it.  There were some hiccups, but at the end of the presentation, the women told me that they learned enough information to do health talks in their villages about cervical cancer.  We plan to use these women as resources when we go out into the villages during our mass screening campaign.

It was great to see the women engaged in the presentation, and I hope the health talks they lead in the communities will give us a good turnout during the screening campaign!

Tuesday, October 9, 2012


The peacecare ( team has arrived, and we’re working in Saraya on the cervical cancer prevention project!

Development work is generally a slow process, and most volunteers wont see the results of the behavior change they’ve worked on during their service.  With the cervical cancer prevention project, I’ve been able to see the head midwives training other midwives and nurses in how to screen for cervical cancer, and I’ve watched them screen.  When we go to a village for a screening, we are not only able to educate the community about cervical cancer, but the midwives are able to counsel women who test positive and put them on a list for the cryotherapy treatment which will be coming in February.

Today, a huge theme of the day was sustainability.  The goals of both Peace Corps and peacecare are to implement sustainable projects and programs that are chosen by the community.  A major component of the cervical cancer prevention project is that it can survive without the support of peacecare and Peace Corps.  Head Midwives have been trained to train other midwives and nurses in how to screen for cervical cancer using visual inspection with acetic acid (VIA), and today we trained them to train other trainers.  With the high turnover rate of midwives and nurses in the region, it is important that incoming health workers can be trained in VIA. 

We’re in the process of beginning a prevalence study in the region, and working out the logistics of the study is complicated.  The goal is to screen 3000 women in the region in the next 6 months, and we need to have enough women who have tested positive by February to train midwives in cryotherapy treatment during the next peacecare visit.  The hospital is busy working on campaigns for many health issues, and getting cervical cancer on the docket is a challenge.  We also still need to train 30 more midwives in VIA before we can begin our mass screening campaign.  Organizing trainings and getting them done before deadlines has been a challenge.  Time works differently here, and it’s thought of as more circular than linear.  There’s not a high sense of urgency, and people tend to be very fatalistic.  If Allah wants something to happen, it will happen.  The idea that humans have the power to impact change is not a commonly held belief since most believe everything is up to Allah.  When trying to organize trainings and meetings, the laid back idea that “it’ll happen” is frustrating when exact dates can’t be set.  We need to get both midwife trainings and the campaign done before peacecare’s next visit at the end of February, so being the American that I am, I want concrete dates and a specific action plan.  Not having either can be frustrating.  I know it’ll all get done eventually though, and being flexible and patient is part of the Peace Corps experience.  Since the idea for the project came from the community, the local doctors and midwives are motivated to do the work.

An issue that came up in today’s meeting was how we plan to fund the prevalence study and the future of the cervical cancer prevention program.  The idea is that the funding would eventually come from the government in order to be sustainable once peacecare and Peace Corps leave.  In today’s meeting, one of the midwives mentioned that almost all of the funding that the hospital receives comes from outside sources (NGO’s and mining companies).  This begs the question, how sustainable are these programs?  We’re still working out the issue of funding and hope to come up with a solution that will allow for the program to be self-sustaining without our continued support in the future.

While sustainability can be hard to achieve, I commend peacecare for making it such an integral part of its work.  Many NGO’s will throw money at a project and then leave without a thought to whether they have created lasting development.  For example, a Japanese NGO built a state of the art hospital outside of Saraya.  This hospital is beautiful, and when you step inside and see the high tech equipment, you feel as if you’ve stepped into a hospital in the US.  The NGO funded the construction of the hospital and equipment, but it is up to the government to provide electricity and water to operate the hospital.  The hospital has been finished for almost a year now, and it is still not operational.  Power and water are a significant problem in Saraya, and I’m not sure when or if this hospital will ever open.  Every time I pass this hospital on my way in or out of Saraya, I think about how tragic it is that all that time and money went into building a hospital that can’t be used.  The question of sustainability is crucial before beginning a project, and that is something that peacecare does extremely well.

I’m really enjoying this peacecare visit to Kedougou, and it’s been great to get to know the new team members.  They’re a hearty group and have done a wonderful job of following cultural norms and staying flexible and open.  Tomorrow we have an off day and are planning to do some fun local activities like making tea and going out to the fields!