Wednesday, February 29, 2012

Back to the Big City

And by big city I mean Kédougou. With all the pre-election protests that were going on in the bigger towns and cities I've been staying in my village, Salémata, where it's been lovely and calm. Right before Election day I did a lot of hanging out under the mango tree, playing with the baby, making things out of paper, and listening to the BBC. (I would like to take a moment to thank the BBC World Service for existing.) As it turns out, voting during the first round of the 2012 presidential elections in Senegal went remarkably smoothly, even in Dakar, and I'm now allowed to come in to the Kédougou Regional House to check e-mail and stock up on oatmeal and all that good stuff.

My sitemate and I decided to bike in to Kédougou today. We've done it before, we left early in the morning and were expecting it to get hot (which it did) but to make it to the house before lunchtime. We were not expecting the little cloud of bloodsucking tse tse flies that showed up on the outskirts of village and stayed with us for about 45 kilometers (28 miles, about halfway to Kédougou). At that point, exhausted from trying to bike and swat flies at the same time, we stopped in the shade of a baobab tree. It was getting hot, and since we'd just been passed up by the transport van that we'd opted not to take, I was regretting having been so enthusiastic about the whole biking thing. Just then, while we were sitting in the dirt next to our bikes, looking sweaty and dusty and fly-bitten and probably more than a little pitiful, a beautiful pickup truck came along and stopped in front of us. The passenger opened his window (Air conditioning! Fancy.) and asked if we were volunteers. We said yes, and he said he worked with the Ninefesha Hospital, he knew the volunteer Kadjabi (our friend Meera) and that she did good work so since we were with Corps de la Paix we were welcome to throw our bikes in the back and hop in the backseat and come to along Kédougou. We were thrilled. And grateful.

Anyway, I made it to the house and now I'll be around the next few days, working on a few things and (inchallah) uploading some photos and catching up on the blog.

Saturday, February 11, 2012

PeaceCare: Part I

So, the PeaceCare team arrived in Kédougou about a week and a half ago and was made up of doctors, residents, a med student, and a couple communications people. (One of the doctors is from Callahan, CA, near where I went to summer camp, it's where we pick up camp mail and stuff, but it's a town so small that GoogleMaps doesn't quite know where it is.) We started out in Kédougou, where we did a lot of meeting-and-greeting and then the American doctors lead a refresher course for the Senegalese trainers.

The next day the trainers lead a refresher course for health workers. 

Training tools:
Speculums, models, and dictionaries. 
Of course, this is Senegal, so there was a nation-wide gas strike, transport issues, long power outages, equipment problems, disruptions in Dakar related to the upcoming elections, and so on. After much rescheduling, re-rescheduling, and re-re-rescheduling the team made it to Saraya.

Saraya is about as far from Kédougou as Salémata, where I live, but Saraya is a magical Malinke wonderland of paved roads, sidewalks, post offices, pharmacies, fancy boutiques, and vegetable ladies. (There's also a water shortage and since it's becoming a trucking route to/from Bamako there are also more semi trucks and HIV.)

The Saraya Health Center is the regional hub for the Saraya Health District, and we went out in teams to facilitate cervical cancer screening days in villages around Saraya. I went out to Bambadji, and it was really interesting trying to get around a village where pretty much no one speaks Pulaar, just Malinke. A lot of women came to get screened, which was great, and I bought a little bag of Youpis (like Chupa Chups) to give to their little kids while they waited. (It's hard for a kid to wail and eat candy at the same time.) Everyone was really nice (I'm assuming, if they were insulting me they were smiling while they did it) and I had some fun pantomimed conversations about lollipops. 

Back in Saraya, the hospital staff kept us very well fed, and also had an entire big freezer just for juice - red bissap, white baobab, green ditakh, yellow ginger, orange Foster Clark's... I really can't overemphasize how pleased I was with the rainbow of juices. 

Back to Kédougou

Blogging for PeaceCare

All the PeaceCare team members and the PCVs took turns writing entries for the PeaceCare Blog  and this is the thing I wrote for my day.

Saturday Feb 4th 2012
PCV LaRocha LaRiviere (ou bien Adama Souaré)

Today we woke up, greeted the family hosting us, and unsuccessfully looked for bananas on my way over to breakfast at the Saraya hospital’s housing area. We had an oatmeal can filled with village-style peanut butter, a plastic sack of hard boiled eggs, and a big pile of fresh loaves of tapalapa, handmade village bread. The water was on, so I sipped my instant coffee and filled our water barrels and watched a big class of kids doing their stretching on the basketball courts. The water went out after a little while, and the doctors headed over to the hospital for rounds. A couple of the Peace Corps Volunteers worked on translating and editing the team’s PowerPoint presentations, and there were a series of meetings were we mostly talked about meeting we’ve had and arranging for more meetings in the future.

Of course, it wouldn’t have been a day in Senegal without a massive schedule disruption. Unfortunately, last night there were two serious accidents involving multiple fatalities on the Kédougou road last night, and all senior members of the Kédougou medical staff were working on that past six in the morning. Obviously, getting on an early morning car to come to Saraya for a day of training and discussion was not going to happen after that. We did our best to salvage the day’s productivity, so we strolled over to the new Saraya hospital to ogle all the shiny fancy new things that JICA (Japan’s international development agency) has built and brought to Saraya. There were so many pristine rooms and pieces of equipment - a maternity ward with state-of-the-art birthing tables and little infant beds with sunlamps for jaundiced babies; a pristine specimen collection room, with the little wall-portal for passing cups back and forth; an operating room with brand new basins, lamps, and tables, capable of accommodating Cesarean sections and other surgeries; fancy facility maps with little red arrows declaring that VOUS ETES ICI. Sadly, the hospital won’t be able to begin seeing patients until the Senegalese Government finishes their contribution to the project, specifically building living quarters for staff, a morgue building, a driveway, and a low wall around the whole complex. It looks like construction’s starting on the wall, or a trench has been partially dug, but it may be awhile before the lovely new hospital is open for business.

After the tour wrapped up the group braved the mid-day sun and walked back down the (amazing, smooth, lovely, evenly paved) road to the current Saraya hospital. While we sat around waiting for lunch to be served Amish taught us all the “Zoo” game, which basically involves a lot of clapping and snorting and making funny animal gestures. Lunch was yassa sauce, made with diced onions, little bits of carrot, and small chunks of meat (beef? or maybe mutton?), over steamed rice. It was pretty good, but my favorite part, was the amazing selection of delicious juices. There was sweet, dark red bissap (like hibiscus) juice, thick, creamy baobab juice, light, spicy ginger juice, pale green kiwi nectar-ish ditakh juice, bissap with fresh mint, bissap mixed with baobab, and Foster Clark’s Orange, which is basically really strong Tang.

(PHOTOS: Ivy and the juice)

After all the juice and yassa I fell asleep for a bit, sitting up in the afternoon heat, and then spent the rest of the afternoon translating stuff from English to French. My netbook’s battery was running low, so I went inside the hospital’s living quarters to plug in, and people were watching a TV show about people with extreme gigantism and that disorder that makes children age horrifically rapidly. It was surreal but entertaining background noise, and I wrapped up my form translation just in time to watch Dr. Isaak Manga give a PowerPoint presentation on malaria in Senegal. After the malaria talk Dr. Nate gave a presentation on EKGs and the electrical goings-on of the heart. A lot of the jargon-heavy parts were alphabet soup to me, but it was neat to have a heartbeat explained in detail. After the EKG talk we headed over to dinner, which was lovely. They made the best thing, which is meat and fries and salad with dressing and tomatoes, and also more juice. After dinner we set up the projector and had a little outdoor screening of Babies, which went over really well. We’d set up plastic chairs for all the hospital staff, but when it was over and the lights came up we realized that during the movie a decent sized crowd had gathered to look on. Everybody loves babies!

Cervical Cancer and PeaceCare

So. Peace Corps is a federal agency of the United States' government. PeaceCare is a cleverly, if somewhat confusingly, named non-governmental organization (NGO) that works with American universities, current Peace Corps Volunteers, and local communities to set up collaborative, sustainable development projects. The project that they're working on in Senegal is focused on cervical cancer prevention through screening and treatment of pre-cancerous lesions. The focus of the project was chosen by Senegalese health care workers and community members; many people here have a friend or family member who died of cervical cancer because it wasn't detected until very, very late. Cervical cancer is a major cause of  morbidity and mortality around the world, particularly in places where Pap smears and the HPV vaccine (which is a good vaccine and boys and girls lucky enough to be living in places with advanced health care systems should all get) are not available, and I think it's a really good project. 

Map of Deaths from Cervical Cancer

Last year a team of American doctors came to Kédougou and trained a team of Senegalese health care workers to perform the Visual Inspection with Acetic Acid (VIA) procedure to screen for pre-cancerous lesions and to train others to perform VIA as well. Peace Corps Volunteers did a lot of the prep work, ran focus groups, planned logistics, and facilitated the trainings. The next steps will be to screen enough women to get accurate information about the prevalence of cervical cancer in Kédougou and to train local health care providers in cryotherapy to treat pre-cancerous lesions before they develop into cervical cancer. 

Now, another team of Americans is here to lead refresher courses, observe screening days, start discussing cryotherapy, and learn about health care systems in developing countries. Here are a few photos of the refresher course lead by Senegalese trainers at the Kédougou Regional Hospital

Peace Corps Cars

So, I had step throat, which was unpleasant but at least it didn't last very long. It started when my throat was all scratchy on lumo (market) day, but I just walked around the ladies selling bananas and pretty fabric and cheap jewelry and fried bon bon donut-type things, sucking on frozen sachets of bissap (kind of like hibiscus) juice and blaming the dust. By the next morning it was clear that I had strep so I called Peace Corps's Med Office and after a little back and forth and a lot of box-reading (Salémata has no actual pharmacy and apparently I am not allowed to take the AMOX 500 amoxicillin from the Health Center because it's made by some company in India with suspect dosage reliability) I took some of the antibiotics that I had in my med kit and went back to bed. It was weird and sad to realize that the health services that I'm always encouraging people to use are considered unusable by our medical office. It's also reassuring that I have my own med kit and that there's an office full of people in Dakar worried about my antibiotics. 

The AMOX 500 that I wasn't allowed
to take looked like this.
The next day I'd been planning on meeting up with Jubal and Jackie, a couple of my PC neighbors, and biking in to Kédougou (biking is fun, and also there was a nation-wide transport strike) but I really just didn't feel up to it. Luckily Pape (one of the Peace Corps support staff guys) was coming out to my area to do some site set-up prep work in a village called Dakately, and he was nice enough to drive over and pick me and Jubal up. Getting a ride in a Peace Corps car is wonderful, so much smoother and faster and less dusty than public transport or biking, I was really happy about it. 

We rode along to check out Dakately (lovely village, worst road ever) and were impressed by their lovely community gardens, enthusiastic people, fancy new health post buildings, and spectacular cell phone reseau (reception). Really, though, there are sections of the road that seem more like a boulder field crossed with a ravine and one part is very obviously going to just be a river during wet season. But aside from that it's delightful. 

MegaUpdate: January 2012 Edition

It’s been a busy few weeks (month?) over here. I kind of can’t believe it’s February. I knew (in general and in Peace Corps) about the whole time-speeds-up thing, but it still feels surreal.

In any case, January kicked off with a scramble to get our Work Zone stuff all squared away (basically everyone in and around Salémata told me what they’ve been up to lately and I wrote up a report), getting things together for a potential latrine project, and working on visual aids for nutrition causeries (health talks) at the Salémata Health Center.

Then, along with a few other PCVs, I headed up to Thiès for the Gender and Development (GAD) conference and Work Zone Coordinator meetings, followed by our All-Volunteer Conference (All-Vol). The idea behind All-Vol is that all of the PCVs from Senegal get together with delegations of PCVs from other West African countries (Mali, Guinea, the Gambia) to talk about projects and plans and chat it up about Peace Corps stuff. I had a good time, it was great to see other people from my training stage and to hear about what it’s like living in other parts of West Africa.

After All-Vol it was time to head up to Dakar to get ready for the West Africa Invitational Softball Tournament (W.A.I.S.T.). There are two categories of teams at W.A.I.S.T., those that play in the Competitive League (for people who play softball regularly, know the rules, and own gloves and bats and things) and those who are in the Recreational League (for people who are more concerned with having good costumes). 

My friend Rachel is on the International School’s Faculty Team, so she had to play against us, and we had a little Logger reunion – there are currently at least five University of Puget Sound graduates in Senegal, and all of them were on W.A.I.S.T. teams this year. 

Loggers: Rachel, me, Mac, Mika, Emily. 
After all the softball madness I spent a couple days hanging out poolside at my friends Rachel & Emily’s wonderful bungalow, playing with their cats and talking about babies – baby blankets, baby names, baby nannies, baby showers, baby onesies… It was adorable and Leah would have loved it. Then I had Peer Support Counselor Training at the Peace Corps main office in Dakar, which went well. A lot of other PC programs have peer counseling systems and I think it’s a really good thing to have for PCV support. After that wrapped up there were enough of us heading back from Dakar to fill up a sept-place back to Kédougou.

Peer Support Counselors 2012
(I'm top left, with the tall kids.)
Once I was back in Kédougou I went back to village for a few days, and it was really nice to sleep in my own bed, hang out with my host family (baby Fatou is getting so big!) and help out at the monthly baby-weighing stuff and vaccination day at the Salémata Health Center.

And then I got strep throat.