Examining Vaginas and Birthing Babies

Within the last week I’ve weighed babies, examined cervices, seen a birth, tested blood for HIV, and sat by the fire every night with my host family.  Sometimes I have to stop and think about how different my life is here.  Bizarre, but wonderful.

I did the baby weighing at the health post along with nutrition counseling for mothers with babies who were below the healthy zone.  It’s important that mothers only give their babies breast milk for the first 6 months, and I’ve found that a lot of women say they’re doing that but are not in actuality.  Kaba, the matrone, told me she caught a mother feeding sugary tea to her baby.  One of the men in my village told me that a baby recently died of malnutrition, so I want to make sure I’m able to inform mothers if their babies are underweight.  Infant mortality is high in my village, but I rarely hear about it.  During an intake interview with women for a recent cervical cancer screening, I had to ask the women how many children they had and how many times they’ve been pregnant.  I found that most women would report that about half of their children had died.  This isn’t talked about, but it is a harsh reality that needs to be addressed.  When I had a heart to heart with the man who told me about the infant who had passed away, he also told me that his first wife had died in childbirth.  During my baseline survey, I felt so optimistic about the maternal and child health of my village, but I am now finding that reality may not be as rosy as villagers would like to paint it. 

Three midwives came down from Saraya to do cervical cancer screening in Nafadji.  Earlier in the week, I told the presidents of the women’s groups about the screening, and they spread the information around the village.  On the day of the testing, I walked around the village, trying to get as many women as possible interested in being tested.  During the screening, I assisted the midwife with the screening by holding the flashlight on the vagina while she put vinegar on the cervix.  We both analyzed the cervices and gave the results to another midwife who did the counseling afterwards.  We screened 24 women, and hopefully will soon be able to provide cryotherapy treatment for those who tested positive.  I was worried that it would be awkward for me to be examining women who I know in my village, but it turned out to be fine.  Although I asked Mbamoussa to get tested, and her screening was slightly awkward for both of us since she’s my sister.  I was impressed with the amount of women who showed up, and the screening went smoothly.

With all the work I’m doing with maternal and child health, I’ve been really interested to see an actual birth.  I mentioned this to Sarr a few months ago, and he told me that I could help with one as long as the midwife was ok with it.  The midwife told me she’d call me when the next birth was happening, but somehow it never worked out that I was in village during births.  During the cervical cancer screening, I was in the maternity, and Khadidia, a pregnant woman, came in and was having contractions.  The midwife told her to go home and come back when they were hurting really badly.  She came back right as we were all going into the main health post area to eat lunch, and she lied down on one of the beds in the maternity.  After eating, I went back to the maternity to do an intake interview with a woman who wanted to be screened for cervical cancer, but the other midwives stayed in the health post to relax a little.

All of a sudden, I heard Khadidia screaming from the next room.  I rushed in, and the baby’s head had already started coming out!  Since I had no clue how to deliver a baby, I ran as fast as I could to Madame Diop and told her to hurry over.  By the time I got back to the maternity room, the baby was fully out.  I was amazed at how fast it all happened.  I worked as Madame Diop’s assistant and handed her different tools for cutting the umbilical cord and sewing up an area that must have torn.  We caught the afterbirth in a bowl and gave it to some village elders who came to pick it up.  It was incredible to see the baby girl enter the world.  She kept reaching out and grabbing the air, exploring her newfound freedom.  The birth was very messy and didn't smell great, but it felt so amazing to be apart of it!

Births here are so different from those in the US.  In a US delivery room, I picture a woman with a cheering section beside her, or at least friends and family waiting at the hospital to congratulate her.  This American woman is giving birth in a sterile hospital room, where supplies are readily available, and if anything goes wrong, there are the resources to get the baby out safely.  Painkillers are an option to keep the mother more comfortable, and a nurse takes the newborn to wash it and wrap it in a blanket.  The mother was not expected to bring her own cleaning supplies or sheets for the bed.  After the delivery, the mom is able to rest for a while in the hospital room. 

Here in Senegal, Khadidia came to the maternity just as she was about to give birth.  No friends or family were in the room with her, and the room was far from sterile.  I was racing around looking for a fresh pair of gloves and alcohol.  All the blood was wiped up with the pagne (fabric skirt) that Khadidia had arrived in.  I watched Madame Diop stick a metal hook in Khadidia’s vagina to sew up a tear, without any anesthesia.  After the umbilical cord was cut, the baby was placed on a table and wasn’t washed.  If anything had gone wrong, we were 90k from the nearest hospital that can provide a C-Section, and there are no cars in my village.  Directly after giving birth, Khadidia went back to her home with the new baby.  After seven days, there will be a baptism, where the baby will be given a name.  From what I observed, as long as there are no complications, delivering a baby is very straightforward.  Maybe all these differences I’m mentioning shouldn’t matter as long as the mother and baby go home safe and healthy.  It’s when there are complications that problems arise that the health post is not equipped to handle. 

The following day, the Saraya hospital car picked me up in Nafadji, and we went to Toubacouta, a small village in the bush, to do HIV testing.  We picked Ian and his nurse counterpart up along the way to go to the testing.  Ian and I did the blood tests, and we found a couple positive ones.  The Saraya team includes a social worker who provides counseling to individuals when they find out their serological status.  Fortunately, antiretroviral drugs are free in Senegal, but the treatment for resulting infections is not.  HIV status is not public knowledge, and the hospital is very good about not revealing those who tested positive.  Only a few people at the hospital even know who the HIV positive people are in the region.  The social worker seeks those people out to encourage them to take antiretroviral drugs.

Now I’m back in Kedougou and am about to start my journey home to the US.  Yesterday I biked to Saraya with my luggage strapped to the back, and my back tire blew halfway through the ride.  I flipped my bike over and changed my tire tube with tsetse flies attacking me.  As frustrated as I was, I knew I was on my way home.  Luckily, the second tube worked out and I made it to Kedougou in one piece yesterday.  I had a weird feeling of sadness as I biked out of my village.  I’ve been looking forward to going home for a while, but I really will miss my village while I’m gone.  It reminded me that I’ll be leaving for good next year, and that is going to be incredibly hard. 

Right now, it’s the “cold season” in Senegal, which means temperatures can drop down to 70 degrees.  I know what you’re thinking.  Anyone who thinks that’s cold must be insane, right?  But after adjusting to the climate here, I actually get goosebumps at night and need to wear a sweatshirt, and my family has been sitting around a fire every night before bed.  I have a feeling I’m going to freeze when I land in Seattle!

Tomorrow night, I’ll take a night bus to Dakar, and then the following night, I begin my 30-hour voyage home on 3 different planes with long layovers in between.  I’m so excited to come home for the holidays!  It’ll be nice to eat some good food and hang out with friends and family.  I feel like this trip home has been something I’ve been working towards for so long, since I booked this flight back in May.  I’ve counted down, and the idea of seeing my family again for the holidays got me through a hard time at the beginning of my service.  Now, it’s actually here!  Where did the time go?  I can’t wait to be home soon!

The Purducken

This post was written on 11-29-11 but I haven't had internet...

This Thanksgiving, we decided at the Kedougou Regional House to make an unconventional meal.  A few weeks before the big day, we were all sitting around, joking about the idea of making a Turducken, which is a chicken inside a duck inside a turkey.  Then someone decided to take it even further and throw out the idea of putting all those animals in a pig to make it even more epic.  And why not dig a huge hole and try cooking this masterpiece in the ground?  I thought it was a joke, but one thing Peace Corps volunteers love is a challenge. 

When I arrived at the house the day before Thanksgiving, Mission Purducken was in action.  All 4 animals had been bought and brought in from various locations.  The live turkey was sent down from Tamba!  All 3 birds needed to be killed, plucked, and cleaned.  That day, we prepared the 3 birds, pig, and stuffing and sewed all the birds inside the pig with wire.  The guys had dug a massive hole and gathered all the materials necessary to keep the coals hot for the 18 hours we were leaving it in the ground. 

Thanksgiving day was filled with lots of cooking, and we managed to make some tasty dishes!  We made mashed potatoes, green bean casserole, stuffing, and gravy.  I attempted to make a cranberry sauce substitute with bissap flowers but failed.  Apparently bissap flowers don’t cook the same way cranberries do, so I tried adding cherry jello mix to stiffen up the bissap juice with no success.  Luckily there were other dishes that worked out well.  Some other volunteers made a carrot cake, cheesecake, and apple pie for dessert.  I was amazed at the food you can make with limited resources!

Around 5pm, we dug up the Purducken!  The guys laid the giant pig down on some tarps outside and began carving into it.  I think my favorite part of the day was when a few of the guys were cutting pieces of meat off to put in giant bowls to serve later, and we all formed a circle of stools around them, waiting for handouts!  They’d throw us some meat and stuffing as we hovered like vultures. 

After piling mountains of food into our bowls, we all sat around the porch, stuffing ourselves.  Since the main staple of our diets here is rice, I think we all went into protein overload!  Just like the end of any normal Thanksgiving, we fell into food comas and clutched our full stomachs, complaining that we ate too much.  The Purducken was a success!

The following day, Ian and I decided to venture off to a small Bassari village in the mountains to check out the crafts they make.  It was Black Friday, so of course we had to go shopping!  We took a Niokolo 90k to Salemata and then biked a hilly bush path out to Echelo, the Bassari village.  One of our friends lives in Echelo, but she was in Dakar for Thanksgiving, so we made the trek out there on our own. 

We had a wonderful time in the village, which had such a different feel than any village I’d been to.  Since Bassari’s are Christian and animist, they have a different lifestyle than Muslims.  After seeing some unique crafts (jewelry, masks, etc), we went over to our friend’s family’s compound for dinner.  For dinner, we were served an amazing chicken and squash dish, and I was in heaven!  As some of you know, I have an obsession with pumpkin, so I was very excited to eat squash!  When we were finished eating, the men reminded us to thank the women who cooked the meal.  That was the first time I’ve ever heard a man suggest that women deserved praise after cooking a meal.  In Bassari culture, women seem to hold much more power in the household, and they are treated with more respect than I’d seen before.  The villagers seemed more complimentary of women and praised virtues instead of pointing out all the faults in them.  Granted, this was only one night in the village, but it seemed like a very positive environment to live in. 

Since the villagers aren’t Muslim, they drink alcohol and are known for their delicious honey and palm wines.  After dinner, we sat around, drinking tea and palm wine.  Ian whipped out some mango gummy bears to share with the group, and we sat around the hot coals, chatting into the night.  The following morning, we rose early and biked back to Salemata to catch a car back to Kedougou.  All in all, it was a fun adventure!

Now I’m back in Nafadji in my last stint in village before I head home for the holidays!  Projects are in motion!  I have 10 enthusiastic women signed up for my Care group, and our first meeting will be in January, when I return from vacation.  Ian and I are working on our cervical cancer screening and are hoping to hold it in both of our villages next week.  We’re also working on a project to train middle school students to become health experts who can lead health discussions with their peers at school.  After we request funding for our project, we’re hoping to hold the training in the spring.  We’re still waiting on our funding request for our matrone training, but we should hear back about that soon!

The babies are getting bigger!  With four circulating around the compound, holding babies has become a common pastime.  We all take turns getting peed and pooped on, since there are no diapers here.  I gave each new mom a baby mosquito net where they can zip the baby into a netted enclosure.  They’ve been using them as places for the babies to hang out during the day to keep the flies off of them.  I often walk outside to find the four baby mosquito enclosures lined up on a mat with the babies inside!

It’s nice to be back in Nafadji!  Tomorrow morning I’ll be weighing all the babies in the village while Sarr does vaccinations, and this Sunday, I’ll be heading to Saraya to do the radio show.  A couple weeks ago, we did a fun radio show explaining what Thanksgiving is!  We described it as a “Toubab Tabaski”.  Probably too soon to talk about colonization, right?

I hope you all had a wonderful Thanksgiving!  I can’t wait to see friends and family in Seattle soon!!! 

My Namesake

On the morning of Fily’s baby’s baptism, my host mom pulled me aside and revealed to me that Fily was naming her baby after me.  I couldn’t stop smiling and felt so honored that she would name her firstborn child after me.  Unfortunately, no one here can pronounce Marielle, so my host mom said they would like to use my mom’s name.  Luckily, they can pronounce Margo and loved the name.  The baby is now named Margo Aissata, but we all call her Margo.  I call her “toxoma”, which means namesake in Malinke.

My family explained to me the importance of a namesake.  This baby is going to be extremely close to me for the rest of our lives, and whenever I come back to the village in the future, I’ll always be connected to Margo.  For now, being a namesake means I get to spoil Fily’s baby a lot! 

Attending a baptism in Nafadji was such a different experience than the baptism I attended during training in Mbour.  It was much more laid back and felt warmer to me.  A group of women met at our compound and went out to the center of the village with Fily and the baby to perform some traditional rituals, such as dipping the baby’s head and toes in water.  They had a mysterious mixture of leaves and other things in a bowl that they emptied on the ground, and then they stepped and broke the wooden bowl.  They said many blessings and ritualistically dropped the razor behind Fily’s back through a cloth 3 times.  After those steps were finished, we all headed over to another compound where a huge group of village women had congregated.  We laid out a mat and a woman shaved the baby’s head as the women sang a song.  They crushed up a kola nut and fed part of it to the baby. 

The women at the ceremony were full of energy and joy, and they danced around me out of excitement that I had received a namesake.  Everyone gave me blessings for my namesake, and Fily seemed so happy to finally be able to leave her room!  It was a beautiful ceremony, and afterwards we headed home to have a delicious chicken lunch.

Having Fily name her baby after me made me feel so close to her and my family.  Even when I leave my village at the end of my service, part of me will still be there.  I feel so moved that Fily has given me this honor. 

I told my mom that there is now a baby Margo in my family and she was touched.  I can’t wait for the two to meet when my mom visits me next year!  Every time they talk about baby Margo, I smile at how funny it is that I’m all the way in this tiny village in Africa and my mom’s name is now a part of my life here.  It’s nice to have a little piece of home here. 

The Mbamoussa Dilemma

As I mentioned in my last post, a couple days before Tabaski, Mbamoussa had not given birth yet.  She was lying on the floor of Fily’s room all day and didn’t look good.  I called Leah to ask her if she thought it might be better for Mbamoussa to stay with her in Saraya so she would be closer to medical care since both Sarr and Madame Diop were gone for Tabaski.  We talked about it and agreed that would be best if I could convince Mbamoussa to leave the village and figure out transportation.  Getting anywhere from my village is always a challenge, since the Niokolo only comes once a week.

I walked out to the area where the French doctors were camping and explained the severity of the situation.  They agreed with me that it was not safe for Mbamoussa to stay in Nafadji since delivering twins can be complicated.  2 of the doctors were heading to Saraya in a car and told me they were leaving in an hour.  So I had an hour to convince Mbamoussa to leave her family 2 days before Tabaski, the biggest holiday of the year.  I felt incredibly stressed out.

I raced back to the compound and hurriedly explained in a mixture of French and Malinke that I was concerned about her safety and the lives of her babies.  I told her that I thought she needed to leave because she would be in danger if there were any complications during the birth.  She seemed hesitant to leave her family, but she agreed to go.  I think she knew I wouldn’t have said anything unless I was very concerned.  She quickly packed a bag and I gave her money for any medical care she may need.  One of the female elders in the village, Aissata Damba (my namesake), showed up with a bag and was prepared to travel with Mbamoussa so she wouldn’t have to be alone.

The French doctors dropped the two ladies off at the Saraya hospital, and the doctors there took one look at her and started talking about sending her to Kedougou.  Saraya had medical staff but did not have the capacity to do a C-section.  Kedougou has the only hospital in the region that can do a C-Section, and that is 90k away from my village.  In Saraya, the doctors noticed that Mbamoussa had a fever.  After doing the test, it turned out she had malaria!  This is her second case of malaria this season.

Leah went with Mbamoussa in the ambulance car to Kedougou, where Mbamoussa was treated for malaria and monitored closely.  Leah stayed with Mbamoussa on Tabaski so she wouldn’t have to be alone, and around noon on Tabaski, I got a text message that Mbamoussa’s water had just broken.  She gave birth to 2 healthy baby girls without any complications.  I arrived in Kedougou the following day to visit Mbamoussa and meet her twins.  They are adorable! 

Aissata stayed with Mbamoussa up until she returned to Nafadji after Tabaski.  Seeing this elderly woman stay so close to Mbamoussa’s side showed me how tight the bonds of the village are.  They don’t leave each other alone in times of need.  Aissata missed celebrating Tabaski in the village to be a companion for Mbamoussa.  It was heartwarming to see that she would go so out of her way to support a fellow villager.

Mbamoussa now has 9 children and is only 30 years old.  The doctor told Leah that if Mbamoussa gets pregnant again, she could die.  I plan to talk to her about birth control and possibly mention this to her husband as well.  He cares about his wife and would not want to put her life in danger. 

The day that I forced Mbamoussa to go to Saraya, I was very unsure about whether or not I was doing the right thing.  Taking a pregnant woman away from her family for the holiday seemed so extreme.  It made me wonder what my role was supposed to be as a volunteer in this situation.  I never want to boss people around, but no one in the family seemed to be thinking about the future.  They didn’t seem to care that both the nurse and midwife were gone and that Mbamoussa was overdue to give birth.  My gut was telling me that she needed to go, but I kept second guessing myself.  Working with Leah on this was amazing, and she gave up celebrating Tabaski with her Saraya family to be with her namesake, Mbamoussa, in the hospital.  It’s lucky that Mbamoussa did go to Saraya, because otherwise we never would have realized she had malaria.  In Kedougou, she was able to get the care she needed to safely deliver her babies.

Everything worked out in the end, and all 4 babies are safe at home.  What a relief!

Babies and Bubbles

Sounkharou and Fily both gave birth to baby girls!  Early yesterday morning, I got a knock on my door, informing me that Fily had just given birth to a healthy baby girl.   I ran over to Fily’s room to congratulate her and to see the new baby, and she already had a room full of visitors.  It seemed as though all the women in the village stopped by the compound yesterday to see the baby and give blessings.  In the morning, all the female village elders came to the compound and dug a hole and buried what I think was the afterbirth and put a rock over it.  I tried asking why they were doing that but it seemed like a personal tradition that they didn’t want to answer questions about.

Apparently when you have a baby here, you are quarantined to your room with the baby for a week.  Fily was very disappointed since she’s going to have to celebrate Tabaski (the biggest Muslim holiday of the year) in her room.  She still insists on tressing my hair tomorrow though.  The whole family has been really good about hanging out in her room with her, even though it’s insanely hot in there.  Last night, we ate dinner in there with her and shelled peanuts for a while. 

Sounkharou had her baby and baptism while I was in Thies for a Summit meeting, so I met baby Samiyo when I got back to Nafadji a couple days ago.  Since there are no diapers here, getting peed on is inevitable.  The first time I held Samiyo, she peed all over me.  Now I’m hesitant to hold the babies for too long if I don’t want to get showered on. 

Mbamoussa, who is expecting twins, still has not given birth, and she was due before both Sounkharou and Fily.  I can tell that she’s getting very frustrated, and I’m worried about her delivery since Sarr and Madame Diop are both away for Tabaski.  Randomly, there is a team of French doctors who are in my village for a week giving out free, expired medicine to the villagers.  Sarr and I are both very unhappy with these people since giving out medicine is not sustainable development, and the medicine is expired.  They gave expired medicine to Mbamoussa, and Sarr was furious with the doctors since she is very fragile right now.  The one good thing about them being here is that they came with a car, so I may try to see if they can drive Mbamoussa to Saraya so she is closer to a hospital in case she needs a C-section.  I’m anxious for her to have the babies safely so I know all the babies are out safe and sound. 

Bubbles are the new craze on my compound.  My grandma sent me some bubbles for the kids, and they went nuts over them.  It was so much fun to watch how excited they got and how amazed they were by the bubbles.  After the bubble liquid was gone, one of the little girls asked if it would work with soap.  I poured some of my liquid dish soap in the bottle with water, and sure enough it worked well!  So now bubble time is turning into a daily ritual on the compound!  The elementary school kids fight over the bubble wands, while the little ones try to chase the bubbles down to pop them.

Before I returned from the Summit meeting, I called Mbamoussa to let her know I was coming back to Nafadji the following day, and when I got back, her son Saibo had started pulling all the weeds in my yard!  The little girls, Adama, Asu, and Fanta Founee helped me sweep my room and haul buckets of water back to my hut.  It felt so good to be back after traveling for over a week.  I love the kids on my compound!

Before I left for the Summit meeting, I went out to the fields with the entire family and we harvested peanuts.  It was an exhausting day but such a fun experience.  We sat around pulling peanuts off the plants and chatting.  By the end of the day, we were all covered in dirt, so we had a nice bath in the river. 

My baseline survey is finally done, and I analyzed the results.  My survey covered 571 people on 51 compounds.  Here are some of my findings:

·      *  53% of the population does not have a working latrine

·      *  Of the population surveyed, there is 1 latrine for every 19 people, and the ideal is 1 latrine for every 10 people

·      *  67% of the population does not wash hands with soap every day

·     *   100% of those surveyed knew what Moringa is and 82% grow it

·      *  100% of families said the mothers breastfed their babies until at least the age of 2

·      *  96% of women said they attended prenatal visits while they were pregnant, and 100% of families said their women gave birth at the health post

·      *  In the past year, families reported that 380 people had had malaria in the last year, which is 67% of the population surveyed.

·      *  Health post records show 251 Nafadji villager cases of malaria in the past year, confirmed with positive malaria tests

·      *  It was reported that 87% of the surveyed population sleep under a mosquito net

·      *  Out of girls of school age, 21% dropped out of school, and 91% dropped out to get married

·      *  Out of boys of school age, 8% dropped out of school

There’s a lot to work on, but I was pleasantly surprised by the maternal health and nutrition responses.  I had no idea that so many people in my village grew Moringa, and if they are making leaf sauce out of that, they’re getting lots of vitamins and iron in their diets.

I’m starting to do work which is exciting!  Ian and I submitted a grant proposal to fund matrone training for 5 women coming from small villages in our health zones.  These villages do not have a trained birth attendant, and it would greatly help the maternal and child health of the communities for them to have trained matrones.  I also just met with the matrone in my village, Kaba, and she agreed to be my counterpart for the Care Group that I plan to start.  We’ll be choosing 10 women in the next couple weeks to be part of the group, and the group will meet once a month to be trained in a health issue.  After the training, each woman will be expected to teach 7 other women on different compounds whatever skill they learned.  At the end of each month, the entire village should have learned the information taught in the Care Group training.  Ian and I are also planning to organize cervical cancer screening in Nafadji and Missirah Dantila before the holidays.  Lots to do before I go home for Christmas!

Tabaski is the day after tomorrow, and my host dad told me that we’ll be killing 2 sheep for our family.  I got a new complet made in Kedougou, so I’m ready to celebrate!

Beware of the Genies!

Whenever I take a car along the road to Kedougou, I always see the Spires off in the distance near the Guinean border.  The pointy rock formations screamed ADVENTURE, and after talking about it for months, a few friends and I finally made plans to attack the mountain!

Ian and I biked 30k along narrow, overgrown bush paths, dodging vicious tsetse flies along the way, to meet up with Ben and CJ in a small village near the base of the mountains.  We left our bikes in that village and hiked up a rocky hill to get to an even more remote village to camp out for the night.  Prepared with tents, tea for the villagers, and food, we asked the village chief if we could spend the night.  He had an area cleared out for us to set up our tents, and he took the rice we brought and asked some women to prepare it for our dinner.  All was going according to plan, and CJ and I decided to find the forage (village water pump) to fill our bottles with water before it got dark.  As we looked around for the pump, we started feeling little drops of water on our heads but thought nothing of it.  A little boy agreed to lead us to the forage (which we assumed was in the village), so we followed him along a trail.  All of a sudden, rain started dumping from the sky and we saw lightening flashing above our heads.  The little boy started running along the trail leading out of the village, and we followed after him, hoping we could grab some water quickly and make it back to our tents.  He kept running further and further outside of the village as the wind roared around us, blowing tall grasses over us as we tried to stay on the path.  Drenched from the rains, CJ and I looked at each other, debating whether or not to continue, but we had already gone this far and were already soaked, so why not?  After what seemed like an eternity, we finally made it to the forage, quickly filled our bottles (with sulfur smelling water), and booked it out of there.  As we were sprinting back towards the village, all of a sudden, it sounded like 3 shots were fired as light blew 3 holes in the tree right next to us.  I ducked and froze out of shock, thinking that we were being shot at.  CJ screamed that it was lightening and told me to keep running.  By the time we made it back to the tents, I felt like my ear drums were blasted out from the boom.  That was the closest I’ve ever been to lightening, and I never want to get that close again!

The benefit of all that rain was that we all got a shower, which we were not going to get otherwise, and we didn’t smell very good after our long, sweaty bike ride!  Around dinnertime, we were called into one of the huts for our meal.  We were served a bowl of fonio (grain similar to coos coos) with a delicious leaf sauce.  It wasn’t enough to make us full, but we were satisfied with the meal.  A few minutes after we had finished, another woman walked in with a bowl of dinner for us.  We thought we were completely lucking out with 2 dinners!  Then another bowl arrived, then another, and another!  5 dinners in total!  It seems as though every family in the village cooked a meal for us, and we couldn’t even finish the last one!

That night, with stomachs full of rice, we talked to the villagers about the Spires.  We were told that genies inhabited the top of the mountain and that it was dangerous to go.  We told the villagers that if the genies did not accept us, we would leave the mountain immediately.  Truthfully, genies weren’t really our top concern.  Our main concern was having enough food and water for the journey.  Between the 4 of us, we had 7 liters of water that was to last us at least 24 hours.  Foodwise, we packed some cooked rice in a ziplock bag, 2 energy bars, some cookies, 2 cans of sardines, 4 halves of soggy village bread (moist from the rain storm), and 3 unripe mangoes the villagers had gifted us. 

Bright and early the next morning, we chugged all the water we had and refilled at the forage (which didn’t seem as far away this time) to prepare for the trek.  Since there is no trail up the mountain, we were bush whacking the entire way with a machete, trying to aim for an opening between 2 of the Spires where we believed it would be easier to climb. 

After a few hours of intense hiking uphill through thick jungle, we finally reached the base of the rocks, but the rock faces were too vertical for us to free climb.  We knew we had to move further east in the bush to reach the point where we had heard we could climb.  So we backtracked and kept hiking, growing more and more hungry and thirsty as we trekked in the sun.  Once again, we reached the rock, but it was not the right climbing point!  Frustrated, we had to decide if we were just going to camp there or keep searching for the right opening.  All of us agreed that we wanted to keep going.  After a soggy sardine sandwich and some cookies in the shade of some trees, we picked up our backpacks and kept moving.  Hiking for another hour led us to finally reach the point we had heard about!

After some sketchy free climbing to the top of the mountain, we made it!  Standing on the top, we could see for miles and miles.  Mali, Senegal, Guinea.  It was a spectacular view and definitely worth the effort.  We found some shade and ate our sour mangoes, which tasted glorious.  Running very low on water, we tried as hard as we could not to think about our thirst.  We set up our tents in some tall grasses in between two Spires.  Before we went to sleep, we passed our water bottle around and each took a couple sips, looking forward to the sulfur forage the following morning.  So far, no trouble from the genies.

Before coming on the trip, we had heard that another group of volunteers had done the climb a couple years ago.  That group camped at the top just as we were, and they got attacked by swarms of bees in the morning and had to be rushed to the hospital.  With that in mind, we were a little worried when we saw a few bees the night we got to the mountain. 

Around 6am the next morning, it seemed as though all 4 of us awoke at the same time as we heard a constant buzzing outside the tent.  The bees!!!  After talking for a while, we decided we had to leave the tents eventually, so we ventured out.  As we packed up our stuff, a few bees landed on us, but no stings.  Thanks genies!


On our way down the mountain, we somehow stumbled across a stream and were overjoyed to be able to fill our water bottles.  We made it down the mountain quickly and without any problems.  Full circle, we ended our journey at the water pump and washed ourselves and rehydrated.  To celebrate, we treated ourselves to a victory half an energy bar.  All in all, it was a wonderful adventure packed with genies, bees, dehydration, spectacular views, and lots of laughs.  Just a typical Wednesday in Senegal…

Made it to the top!

Cervical Cancer Screening

I’ve seen so many cervices in the last week!!!  I helped lead a 5-day cervical cancer screening training for midwives and nurses in the Kedougou region.  There were 9 students, and they were required to pass a written and photo test before they could be certified to do cervical cancer screening on their own.  I went into the training not knowing much about cervices, but along with the trainees, I can now distinguish between negative, positive, and invasive cancer results.  We looked at a lot of example photos of each type, and the trainees would go up to the projected image and explain what the result was and their reasoning for their conclusion.  They also got to practice inserting the speculum into a plastic vagina and spraying vinegar in.  After 4 days of intensive all-day training, they were ready to go out and test real women at a health post.

Testing a woman for cervical cancer is easy and doesn’t require a lot of supplies.  You insert the speculum into the vagina to examine the cervix.  Next you put a cotton swab of vinegar on the cervix and wait for 3 minutes.  After the time is up, you can look inside the vagina with a flashlight and know by looking at the cervix whether or not it is positive or negative for precancerous cells, or if the woman already has an invasive cancer.  Women in villages do not go to the doctor for an annual checkup or pap smear, and early detection of cervical cancer is extremely important.  Having cervical cancer screening in a village can help women find any problems early and seek treatment.

We divided the trainees into two groups, and each group went to a different village to do the cervical cancer screening.  I went with one group to a village not far from Kedougou and was surprised at how much I was able to participate.  Initially I helped the trainees get demographic and health information in Malinke from the women being tested, but soon I moved into the screening room to help with the test.  I held the flashlight to help the trainee examine each cervix, and I was asked for my opinion to verify the cervical status.  A trained nurse was also there to verify results as well.  Being in this medical room and looking at women’s cervices felt so surreal.  We got a great turnout at the health post, and I realized how many women are interested in their health.  A woman from their village had died of breast cancer, so the village was very cognizant of what cancer can lead to.  Before the testing began, we explained what cervical cancer is and why it is important to detect it early.  It was an amazing experience to be part of this training and see women being tested first-hand.  Looking at real cervices, I learned so much more than just looking at the pictures of them during training.

Nafadji just got a new midwife, and she participated in this training.  I plan to work with her and organize a cervical cancer screening in my village and possibly Ian’s village as well.  Nafadji has never had a cervical cancer screening before, so it would be great for the women here to be able to find out their cervical cancer status.  I’m excited to work with the new midwife, Madame Diop, on maternal health issues in the village. 

After a week in Kedougou, I’m back in Nafadji for a while.  It’s nice to have a slower pace here after being in training from 9-5 every day last week.  The kids on my compound love drawing every day, and each morning I am greeted with “Aissata, dessin, dessin!!!”  “Dessiner” is “to draw” in French and they use “dessin” in Malinke as well.  Thank you to everyone who has sent me art supplies, because the kids have gone nuts over all of it!  A couple months ago, I gave them blank paper and pens and told them to draw.  They had no idea how to draw or what they should be drawing.  Since children in the US start drawing at a young age, I assumed children here knew how to draw as well, but I found that they need a little guidance.  They started off trying to copy whatever I was drawing, and then they asked me to tell them what they should draw.  Now, they’re finally getting creative with it!  Although they do ask me every few minutes “Aissata, regarde” to get my approval.  Art projects have been a fun activity on days where not much is going on, and the kids really look forward to it. 

We have a seasonal river that runs just below Nafadji, and women have been using it to bathe and wash clothing and dishes.  Fily invited me to go down to the river to bathe with her and Diabou one evening.  I felt uncomfortable bathing in the river when people are frequently walking along the road right next to it, but I agreed to go in a bathing suit and swim around for a bit.  Right before sunset, I walked to the river with my sisters, and they bathed in the river as I swam around with a bunch of kids.  It was funny being in the situation, because I think I pictured this scenario of women bathing in a river when I came to Africa, but now it didn’t really feel as foreign since I know all the people involved.  I also had just gone running right before we headed to the river, so it felt amazing to be in cool waters.  It was a fun evening activity! 

Right now, Ian and I are working on a project to get matrons (midwives) trained for 5 villages that don’t have anyone trained in birthing babies.  A couple weeks ago we biked out to a remote village to talk with the village about electing a woman to participate in the 6-month matron training.  It was great to be able to meet the woman they chose and to see the village’s enthusiasm for getting a trained midwife.  Women in villages with no health post give birth at home, and oftentimes there is no trained individual to help with the birth.  I’m planning to meet with another village this week to have them elect a woman for the training as well.  It’s a project that I think will have a big impact on maternal health in the villages that do not have easy access to a health post.

I’m at a point where I’m beginning to do work and have so many ideas for projects that I don’t know where I should start.  This week I’ll be writing up an action plan that will cover the projects I’m interested in doing in the next year.  It’s exciting!