A Fleeting Town

During the recent Meningitis Vaccination Campaign, I went with some hospital staff to Sanbaranbougou, a large gold mining town in the region of Kedougou. 

To give a bit of background, over the past ten years, a gold rush has significantly changed the landscape of Kedougou.  The rising price of gold led Western mining companies to begin mining exploration in the area, and migrants from all over West Africa flocked to Kedougou in search of gold.  Overnight, small villages transformed into booming shantytowns.

During the process of small-scale artisanal mining, miners use mercury to separate the gold from the rest of the silt, and the mercury is later burned off, emitting mercury gas, which the miners and other community members breathe in.  Long-term exposure to the inhalation of mercury leads to a wide array of health problems, including issues with fetal and child development.  Peace Corps Volunteers, Annē Linn, Patrick Linn, Karin Nordstrom, and Martin Van Den Berghe are working on a project to reduce mercury emissions through the use of retorts, which recapture the mercury vapor during burning, preventing the release of mercury into the air.  To read more about their project and the gold mining situation in the region, check out Annē’s blog: 

http://lineoverthee.blogspot.com/2012/12/the-price-of-gold.html

I had heard that Sanbaranbougou was the Wild West of Senegal, but I was still shocked at the level of chaos.  The transient community of miners, sex workers, and vendors live in and work out of crinting shacks.  Crinting is what we call thin woven wood fencing.  It is not durable, and most of the structures in the mining town have blue tarps over them to weather the rainy season.  Everything in the town seems to be fleeting, including the infrastructure.

Crinting vendor stalls stretch out into the horizon, selling everything from motorcycles to Biskrem cookies.  Going along with the culture of fatalism, Allah will decide your fate, and you never know if you will live until tomorrow.  This means that it is unnecessary to plan for your future, so as miners gain small fortunes, they spend them hastily on motorcycles and televisions rather than saving.  It’s frustrating to see the high rate of boys who drop out of school to work in the mines.  The allure of earning money quickly wins out over waiting until school is finished. 

As the hospital car pulled up to the vaccination site, I was disturbed by the culture of the transient community.  Traditional Muslims do not drink alcohol, and the first thing I saw was a man walking around town drinking beer at 10am.  The majority of the town is composed of young men, which may account for the high rates of violence in the community.  Unfortunately, there are no police to regulate the fighting and theft, which makes it a scary place to be after dark.  Sex workers are trafficked to the mining towns from Nigeria, and the mining towns have the highest rates of HIV in the country.  In this seemingly lawless town where anything goes, it does feel like the Wild West.

People filter in from other West African countries and other regions of Senegal, creating a confusing mix of languages and cultures.  Filling out people’s vaccination cards during the campaign was difficult since many people did not understand Malinké or French.  The lack of continuity makes it impossible to keep tabs on the community.  People are constantly moving in and out, and there’s no way to make sure everyone in the community has received a vaccination or has been tested for HIV.

Looking at it from a health perspective, Sanbaranbougou is a nightmare. When there are disease outbreaks, those living in large mining towns are more susceptible since they live in close quarters and tend to miss vaccinations and mosquito net distributions due to their transient lifestyle.  It’s a breeding ground for health problems that then make their way into the surrounding communities in the region.   For example, let’s say a miner contracts typhoid at the mines and then returns to his home village to visit his family.  He goes to the bathroom and doesn’t wash his hands with soap afterwards.  Next, he walks around the village shaking everyone’s hands right before they eat.  Three days later, a bunch of the people in the community now have typhoid.  Or maybe this same miner also slept with a sex worker who was HIV positive without using a condom and is now HIV positive himself.  He returns to his home village and proceeds to sleep with his 3 wives, and all of them are still breastfeeding their babies.  Now maybe him, his 3 wives, and 3 babies are all HIV positive.  The spread of diseases that usually would be contained to a village becomes a much larger problem when a transient community is spreading them to villages throughout the region.

When looking at how to improve health in the mining towns, a wide variety of questions arise.  How do you implement behavior change, such as the use of condoms or mosquito nets, in a transient community?  When no one feels a sense of ownership over the community, who is going to make it their job to ensure the health of it?  Unfortunately, there are no clear answers to these questions. 

After visiting Sanbaranbougou for the day, I was extremely happy and relieved to return to Saraya.  Visiting a transient town makes me appreciate living in a place where villagers take care of one another and there is a strong sense of community.  Thankfully I’ve heard there’s no gold in Saraya!