Bringing Cryotherapy to Kedougou

As I’ve mentioned in previous posts, the cervical cancer prevention project I’ve been working on with the Chicago-based nonprofit, peacecare (www.peacecare.org), has been a major focus of my service. In case you haven’t read about it in other blog posts, I’ll give a little background. This project is the pilot project for the organization, started by Dr. Andrew Dykens, and the goal is to partner with Peace Corps Volunteers and a local health structure to create a sustainable program in a health topic chosen by the community. When the team did focus groups in Saraya a few years ago, cervical cancer was the health issue that they wanted peacecare to address. Peacecare doctors did a training of trainers and trained 2 midwives how to train others how to screen for cervical cancer using Visual Inspection with Acetic Acid (VIA). Since then, we have added some trainers and now have 4 women who can train the nurses and midwives in the region how to screen for cervical cancer. We’ve trained almost all of the nurses and midwives in the region how to screen, and the focus of the most recent trip was to train a few people at the hospital how to treat cervical precancer using cryotherapy. 

Before the peacecare team arrived, I had been in communication with the regional head doctor and the head doctors of each health district. They had chosen 3 people to participate in the cryotherapy training, including Fatou Traore, the head midwife in Saraya who has been involved in the project since the beginning. She has taken a leadership role in the project and has been at every training we have done for either nurses, midwives, or community health workers. The night before the peacecare team arrived, Fatou called me and said she had been summoned by the Ministry of Health to another region to lead a training. Now she would not be able to participate in the cryothearpy training. I felt so frustrated with the lack of control health professionals have over their schedules. You can plan a meeting months in advance, but if the boss tells a health professional at the last minute they have to go somewhere else, they have to go. This makes scheduling anything a challenge.

It was a setback, but once the peacecare team arrived, we were determined to carry on and do the 3-day training with the other trainees who were chosen.  Fatou sent a replacement trainee who came from a village in the Saraya health district, and she was motivated to learn. The CO2 tanks made it safely down to Kedougou, and all of the equipment worked!

The theory portion of the training, taught by Dr. Tracy Irwin, on the first day went well.  The three trainees demonstrated their ability to look at photos of cervices that were negative for precancer, positive for precancer, and those that had invasive cancer.  They learned how to decide if cryotherapy treatment was possible for the patient, and they did well during a photo test where they had to decide if the patient was positive for precancer and if the patient could receive cryotherapy.

The day before the training, Tracy mentioned that she needed some sausages for the practicum part of the training, so we went to the “Toubab store” and were able to find some. I was curious about how she was going to use these sausages, and when we began the practicum it made sense! Cryotherapy involves using a special gun hooked up to a CO2 tank and placing the gun tip on the cervix to freeze it for 3 minutes, thaw it for 5 minutes, and then freeze again for 3 minutes. Before the trainees performed the treatment on real patients, they practiced on sausages.

Ouli practicing on a sausage

In order for Tracy to certify each of the trainees, she needed to observe each of them performing at least 10 cryotherapy treatments. This meant that we needed at least 30 women who tested positive for precancer to come in for treatment. In December, Annē Linn and I helped the Dakar-based NGO, PREVENIR, do a mass cervical cancer screening at the Kedougou hospital. Our collaboration with PREVENIR allowed for us to treat the positives that they found during our cryotherapy training in February. From PREVENIR’s screening and other screenings the hospital had done in the past year, we in theory had enough positives for the training. Unfortunately, things did not go according to plan. All of the positives were called or given messages from their village aunt to come in during the 3-day cryotherapy training for treatment. Some of the women never came in, some of them were false positives, and some of them had lesions that were too big to be treated with cryotherapy. At the end of the training, the trainees were only able to do 2 cryotherapy treatments total, which was not sufficient to get certified. The trainees, volunteers, and peacecare team were all frustrated that the team was going to leave Senegal and no one would be able to perform cryotherapy in Kedougou.

We were all feeling discouraged when a woman came in for the last screening on our last day of training. She tested positive for precancer, and she was anxious to get cryotherapy treatment. The gratitude she expressed to the peacecare team and trainees who performed the treatment made us all remember why we were doing this. She had a huge smile across her face after the treatment and told us that health is the most important thing to her. If she doesn’t have her health, she doesn’t’ have anything. She recognized the importance of getting treatment for cervical precancer, and her energy and excitement about getting treatment re-energized all of us. We were going to make this work.

At the PREVENIR screening in December, Annē and I had met a Tamba-based gynecologist who performs cryotherapy. Since the peacecare team had to go back to the US soon, we thought this doctor could be a potential solution to our problem if he would agree to finish the training we had started. The team went up to Tamba to meet with him and discuss the possibility of him finishing the certification of the trainees. This doctor was on board and was enthusiastic about the possibility of cryotherapy treatment in Kedougou. Being from Kedougou himself, he recognized how far women would need to travel for treatment if they could not get it there. We are hopeful that we will have at least one of the trainees certified in cryotherapy in the next few months.

The rest of the peacecare trip involved a lot of strategic planning for the future. Organizing meetings with doctors here can be like herding cats with their busy schedules and lack of response to emails. Fortunately, we were able to get meetings with all of the head doctors, and we had some productive conversations about the future of the program. At this point in the program, peacecare is focusing on how this project can be sustained by the health structure itself when we phase ourselves out eventually. The local doctors and midwives renewed their motivation in the project, and both the volunteers and the peacecare team finished the visit feeling hopeful about the future of the project. The vision is to have cervical cancer screening and treatment available to everyone in the region, and we continue to get closer to that goal.

Working on this project has clarified for me that I want to continue doing work in women’s reproductive health. It has been an incredible opportunity to work with the peacecare doctors and local midwives and doctors on a program that I hope will be sustainable in the future. I can’t wait to continue doing further work in women’s global health as I begin graduate school in the fall. I was thrilled to find out recently that I was accepted to University of Washington’s Masters in Public Health in Epidemiology-Global Health Track program! I’m excited to pursue my dream of addressing women’s health needs around the world!

Visitors, Reflection, and Geriatric Gou

February was filled to the brim with visitors, conferences, and softball.  At the beginning of the month, I went up to Dakar to meet my amazing friend Caitlin and her boyfriend, Danny.  After not seeing Caitlin for over a year, it felt surreal to hug her at the Dakar airport.  Danny previously lived in the Gambia for a year, working with the law school in Banjul.  He and Caitlin planned to spend a week with me in Senegal and then head to the Gambia.  When you take into account how horrible transport is in Senegal, a week is not much time, so we had a busy week ahead.

We started off in Dakar visiting Goree Island and eating dinner at a delicious Ethiopian restaurant downtown.  Unfortunately, I had amoebas at the time so had no appetite.  Due to the amoebas, my 13-hour 7-place ride up to Dakar to meet Caitlin and Danny was one with many stops to run into the bush with an irritable stomach.  Thankfully I got on the right medication the day that we left Dakar to head down to Kedougou and started feeling much better.  We took a 9 hour 7-place to Tamba, and then another 4-hour 7-place to Kedougou, getting into the regional house at night.  After a long day of travel, we decided to relax in Kedougou the following day.  We biked to the Gambia River, visited the market, and played Settlers of Catan with some of the other volunteers.   It was fun to share the regional house culture with Caitlin and Danny.

The following morning, we squeezed into the back of a 9-place to get to Saraya.  We greeted the village and hiked into the bush to see Maimouna’s garden, and Caitlin and Danny spent the night in my hut.  

Danny and Caitlin walking to Maimouna's garden

Caitlin and me in Maimouna's garden

A couple of other volunteers loaned Caitlin and Danny their bikes for a couple of days, so we were able to bike the 30 kilometers to Nafadji the following morning.  I forgot to mention the terror of the tsetse flies to them until that morning, and the tstetsies made the ride much more stressful.  We biked in the heat while tsetse flies honed in and continually bit each of us.  Each bite is a painful sting, and then the bite swells up and itches for days.  On previous rides, I’ve thought that if the government could get a hold of them, they would make an excellent torture device.  I’m used to them at this point since I bike to Nafadji often, but it wasn’t the best welcome for Caitlin and Danny.  I felt bad about how painful the bike ride was, but luckily our time in Nafadji was worth it.

We received a warm welcome in Nafadji, and Fily killed a chicken for our lunch.  We blew bubbles with my kids and spent our day hanging out on different people’s compounds.  The village chief gave Caitlin and Danny local names, and Mansa, my host sister, was ecstatic to receive a namesake!  She danced around with Caitlin and showed off her new namesake to her friends.  It was amazing to be able to share my life here with Caitlin.  We’ve talked a lot through email and Skype over the past couple of years, but to actually be able to introduce her to my family and friends here and to connect those two worlds was incredible.

We got attacked once again by the tstetse flies on our way back to Saraya, then waited a few hours on the side of the road for a car to Kedougou and finally hitchhiked a ride on the back of a huge truck.  Transport on this trip was not comfortable, but Caitlin and Danny were flexible and kept their senses of humor along the way.  I think they got a good feel for what day-to-day life is like here.  We took some more 7-places the next day up to Kaolack and stayed in a nice hotel with a pool.  It was a relief to have a shower and a real mattress, and our celebratory dinner that evening was the perfect way to end the Senegal leg of their trip.  I was happy to have been able to spend time with Caitlin and to meet Danny.  It was a stressful week, but we had some good laughs along the way, and I feel honored that they traveled all the way to Nafadji to see what my life here is like. 

From Kaolack, I continued up to Thies for my Close of Service (COS) conference.  I was so happy to see my friends from my training group again since we’re spread out all over the country.  During the conference, we reflected upon our services and started thinking about readjusting to living in the US.  We have all come such a long way in the past couple of years, and I think we all share the sentiment that if we can do this, we can do anything.  I cannot think of one person’s service that has been without challenges, and it was powerful to have all of us sitting in a room together reflecting upon what we have learned.  At the conference, I also chose my COS date and will be flying home on April 23^rd!

After the conference in Thies, I took a bus to Dakar with my friends to attend the West Africa Invitational Softball Tournament (W.A.I.S.T.).  Each Peace Corps Senegal region comes up with a theme for their team, and this year, Kedougou was geriatric.  Everyone got into character and had fun yelling at people to get off their lawn.  We by far had the best costumes, but we did not win any of our games (maybe that was due to the fact that we were hobbling around the field).  I love how Kedougou has such a close-knit group of volunteers, and it was fun to all be together in Dakar.

Me, LaRocha, and Katie

Pat and Chip

Gou Crew

Right after WAIST, the Peacecare team arrived in Dakar, and we headed down to Kedougou for our cryotherapy training.  I’ll write more about that in another blog!  It’s been a crazy month, and time is passing way too quickly!

Guest Post: Dancing into the New Year in Nafadji

Written by Margo Goyette (Marielle's mom)

Host Mom Aissata and Margo

It felt so exciting to finally be in Senegal--to reunite with Marielle after so long and to be in Africa for the first time. Over the past year and a half, we had closely followed her blog, clicked through the many photos, listened to her stories and Skyped, but to experience it all firsthand with our whole family felt very special.

Even though we only had a week, we made the most of each day and took away some memorable impressions that will stay with us for a lifetime. We were very fortunate to wind up with a comedic driver named Pape (“Pop”) who crammed all five of us, plus our mountain of luggage into his modest Toyota pick up and patiently drove for nearly 13 hours from Dakar, all the way out to the southeastern corner of Kedougou. He somehow maintained a sense of humor while swerving down heavily pot holed dirt roads for hundreds of miles.

Pape and his truck

Senegalese humor was something we picked up on from Pape’s silly nicknames for a couple of our family members, to villagers who told us about “joking cousins” which apparently are people who have a “rival” family last name paired to their last name. So when you meet those folks you get to rib them by saying things like “You are my slave” or “I am your king”. We were given honorary Senegalese names by Marielle’s host families, however we did not have a chance to use the “You are my slave” lines on any of our “joking cousins”. We covered a lot of ground during our marathon drive. One of the highlights was visiting an animal preserve in Toubacouta where we observed rhinos, giraffes and warthogs up close from our truck. We also enjoyed a rare opportunity to walk with and pet a pair of adorable 9-month old lion cubs. 

Marc, Alex, Gabi, Marielle, and Margo

Marielle, Alex, and Gabi

Baby Margo and Margo

Getting a chance to learn about village culture and one of the dialects was also memorable. We put into practice the basic Malinke that Marielle taught us by greeting countless villagers and shaking many hands---her emphasis on the importance of greeting each and every person was not exaggerated. We were treated like honored guests and given a warm welcome by Marielle’s host families in both Saraya and Nafadji. In both villages we had a chance to sleep in thatched huts, eat native foods out of communal bowls and were treated like family members. I was especially thrilled to finally get a chance to meet my namesake, Baby Margo, in Nafadji. She is already over a year old now and mirrors the radiant smile and beautiful eyes of her mother Fily.

Helping Fily cook lunch

Our most memorable moment of the entire trip was a large dance party that was given in our honor on New Year’s Eve under the moonlight in Nafadji. Fily had organized the event and the dancing and singing were performed by the village women, while two male djembe drummers kept the lively beat going. The women sang in Malinke with beautiful harmony, substituting words to their familiar folk songs with words that honored and welcomed us--we had come from far, far away just to visit them, we were Marielle’s family, they were happy to greet us and our names were called one by one. As they poured their hearts out in song, each woman danced individually in the middle of the circle while everyone clapped to the drum beat.

Into the wee hours, feet were stomping furiously over the dirt, like a frenzied sprint with puffs of red dust wafting up into the night air. Arms flapped to the beat as if preparing to take flight. Other women would step in with their own spirited moves to challenge the dancer in the middle with hips swaying, feet pounding, and then they would step out and others would take the spotlight. Each of our family members were pulled in to take turns with our own dance moves and the women whooped with glee. At first I felt like a self conscious Toubab trying to catch the beat, but a spark finally caught and my feet just took off. Gabi and Alex added their own heat to the circle as they were pulled into the center and gyrated to the drum rhythms without reservation. The game changer happened when Marc began to swing dance and the women went wild. They had not seen this type of dancing before and many repeatedly pulled him back into the dance circle to try it. He spun each one around like tops and they thrilled to the unexpected speed and footwork. We learned that the men do not normally participate in dance parties, so it was probably a fun novelty for them to have Marc & Alex joining in. Both guys were pulled into the center of the circle frequently throughout the evening.

Marielle looked radiant and completely at home dancing and kicking up dust with these women. The bond that had grown between them over the past couple of years seemed clear. The singing and dancing were not just to celebrate our family’s visit, but it felt like their tribute to her and all that she’d done for the village. There was a surreal and visceral quality to the evening that transcended language and culture. We were deeply moved by it and the incredible love and warmth we felt from everyone in that circle. Long after we have returned home and gotten back to our routines, we are still talking about how that moment will always be remembered as one of our best.

Marc and the Nafadji Soccer Team

Gabi and Sira

Margo, Marielle, and Gabi with their red dirt tans

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!

Running Buddy

I often run in the evenings along a dirt road that goes out to a neighboring village.  It’s my time to think and be alone.  Running has always been my outlet and a way to keep me sane when life gets crazy.

Last night, as I ran out of my compound and onto the road, I bumped into my host dad who was walking our cow with his 10-year-old grandson, Tonto.  Tonto is a spirited little boy who loves playing with my soccer ball on the compound.  As I greeted them and ran by, Tonto turned around and started running next to me.  I laughed and figured he’d run with me for 100 meters or so and then turn around.  To my surprise, he stayed by my side, kept up a swift pace, and seemed determined to keep going. 

After 10 minutes, I looked down at his dingy flip flops and asked if he was tired.  Barely panting, he looked like he could go for miles and miles.  He kept up the pace, and finally after 20 minutes out, I asked if he wanted to turn around.  He finally admitted that he was exhausted and was ready to head back.  He told me that he had gone to school in the morning and had been in the fields for hours harvesting peanuts until he bumped into me on the road.  After another 5 minutes or so of running, he needed to walk.  Looking at the shoes he was wearing, I didn't blame him! 

As the sun dropped towards the horizon, we walked along the dirt road in the middle of nowhere talking about our lives.  He explained that both of his parents had died, which is why he is living on my compound with his grandparents.  Such a hardworking boy, he goes to school during the week, works as a mechanic on the side, repairing bikes and motorcycles, and he also raises pigeons!  The more I got to know him, the more impressed I was by this 10-year-old!

As we passed our family’s field, we saw a cow in the distance that had broken into the peanut fields and was eating the crops. Tonto and I started running after the cow trying to scare it out of the fields.  We laughed about it afterwards and he felt energized enough to run the final stretch home. 

This was his first time running for sport.  By the end, he said he was completely exhausted and would sleep well that night.  I showed him some stretches after our run, and he bragged to his uncles that he had run for 40 minutes.  This boy has got drive and likes to get outside his comfort zone.  I think I may have found a new running buddy!

Although I had been looking forward to some time to myself on that run, the high I got from sparking a passion for running in someone else was even better.  Tonto has a natural running ability, and it was so much fun to get to know him better. 

Something I’ve been struggling with after having to move away from Nafadji so late in my service is that I worry that my relationships in Saraya will never get to the level that my relationships in Nafadji were at.  They’re progressing little by little though, and I am starting to feel close to my new host family.  Now I know Tonto a little better, and I hope we can go running again soon!

The Missirah Dantila Pizza Party

Volunteers are always complaining about the monotony of village food   It’s rice and peanuts, peanuts and rice.  So why not make pizza instead?

In many villages, there is a large wood fire bread oven where the bread maker makes the “tapalapa” bread for the village.  During my recent trip to Ian’s village, Missirah Dantila, with my new Saraya site mates (Pat and Annē), we decided to attempt to make pizza in the oven.  Prior to returning to his village, Ian bought tomato paste and cheese in Kedougou, and we bought flour, yeast, onions, and sugar in the village.  The local bread maker graciously let us use his oven for the evening in return for a taste of our dinner.  Ian’s counterpart, Cheikh, was very excited about the project and joined in to make the pizzas.

Pat, our resident bread expert, showed us how to make bread dough with flour, yeast, and water.  While the dough rose, we biked out to the river to watch the sunset.  When we returned, Annē and I chopped onions by candlelight with a Swiss Army knife and caramelized them in a metal bowl on Ian’s gas tank burner.  Next, we heated up the tomato paste with water and added in some sugar and salt to cut the bitter taste.  Ian found some basil growing near the health post, so we chopped it up and tossed it into the sauce as well.

Ian, Cheikh, and Pat

While Annē and I were preparing the sauce, Ian, Cheikh, and Pat lit a fire in the oven to heat up the coals.  They rolled out the dough into 4 pizzas and flung them into the oven with a long wooden paddle once the oven was hot enough.  Cheikh was a natural at getting the pizzas far into the oven with the paddle.  Once the dough was cooked enough, Annē and I added on our tomato sauce, caramelized onions, basil, and cheese slices before sticking them back in again.

Adding the toppings

The pizzas were beautiful!  As Pat mentioned while we were biting into them, we would pay top dollar for these “artisanal pizzas” in the US.  It’s amazing what you can make in a village with the right ingredients!  We ate some of the pizza and shared the rest with the villagers on Ian’s compound.  Their reaction was hilarious.

We were so excited to share a taste of America (or Italy) with the village, but most of them took one bite and didn’t like it!  Since they are used to only eating a few ingredients in their food, these flavors may have been too complex.  Another issue that arose was that most people in the village don’t have a full set of teeth, so biting into a crunchy crust proved difficult.  There were a few exceptions though.  Cheikh was a pizza fan and talked it up to his friends.

Volunteers often feel guilty about eating things like pizza at the regional house since our villagers don’t have that option, but the irony that we found was that villagers didn’t even like it!  Maybe pizza is an acquired taste.  Regardless, it was fun to share a taste of our culture and to eat pizza in the village.  Now, it’s back to rice and peanuts.

Girl Power

Girls make up a vulnerable population in Senegal.  They marry and get pregnant young, and household chores take up the majority of their days.  For a girl to make it out of a village to attend the high school in the district capital is close to impossible. Between 6^th and 9^th grades, 97% of Nafadji’s girls drop out, and this past year, 13% of the 7^th grade girls dropped out due to pregnancy.  The last year of junior high (9^th grade) had only 1 girl in the class, and she has decided not to continue on to high school.  Young girls face strong pressure to get married and start families.

To address these issues, Awa Traore, Peace Corps Senegal’s Cross-Cultural Coordinator did a tour of some of the schools in the Kedougou region to talk about the importance of girls’ education.  I arranged for her to speak in Nafadji and went back there with her a couple of weeks ago.  24 girls showed up for the presentation, including the 9 Michele Sylvester Scholarship candidates.  Awa engaged the girls and had each of them talk about their dreams and what steps they were going to take to reach them.  She talked about what it takes to be successful and stressed the importance of knowing what you want and not stopping until you have achieved it.  She inspired confidence in the girls and had a candid conversation with them about early marriage and pregnancy.  The girls were honest with her that some of them had gotten pregnant or married young, and it is a hard cycle to break.  My 15-year old host niece who just had a baby was in the audience and could really relate to the pressures that Awa talked about, such as boys pressuring girls to become sexually active at a young age without using protection.  The cycle of teenage pregnancy is a hard one to break.  In my host family, my 30-year old host sister got pregnant at 15, and her daughter followed in her footsteps and also got pregnant at 15.  The girls in the audience were enthusiastic about their futures, and I hope that some of them are able to break the cycle and make it out of the village.

After Awa’s presentation, we presented the 3 Michele Sylvester Scholarship winners with backpacks full of school supplies, and all 9 Michele Sylvester Scholarship candidates had their school registration fees paid for this year.  Thank you to everyone who donated towards the scholarships!  You helped to send 9 girls to school this year, and this is a step in the right direction to fight for girls’ education!

On my new compound in Saraya, my closest friend is my 12-year-old host sister, Maimouna.  She is a smart, curious, and determined young woman, and I can tell that she is going to be successful in whatever she chooses to do.  Every night, we sit outside in the compound, and she asks me question after question about the world.  Her thirst for knowledge is refreshing, and like me, she wants to help women in the future.  She has asked me what an OB/GYN does and is interested in women’s health issues.  When I talk with her, she absorbs every bit like a sponge and asks me questions that no one else here has ever asked me before.  I really enjoy spending time with her.  She’s also athletic and loves playing soccer with her female friends.  Of course, she rarely has time for soccer since she is cooking, cleaning, or washing clothes during most of her free time, but I would love to form a girls' soccer team with the pennies and soccer balls my dad sent me last year.

Recently my mom sent me Bend it Like Beckham, an inspirational movie for girls.  Since Maimouna is interested in soccer, we watched the movie together in French on my laptop a couple of nights ago, and she loved it!  She was engaged throughout the entire thing, and she can relate to the family pressures that the main character experienced.  Throughout the film, she kept asking if Jess was going to get to play soccer and was so happy at the end when Jess was able to follow her dream.  That night, Maimouna asked if we could work on her soccer skills the following evening so that she could be like Jess.

Meeting Maimouna gives me hope for the future of girls in this country.  Seeing her determination at such a young age is inspiring, and I hope she never loses that!