Maternal and Child Health Training: The Last of the Work Stuff

In March the maternal and child health training for "Neighborhood Aunts"that we've been trying to get off the ground for months actually happened, and despite some communications difficulties (the cell phone network went down for a week and a half) it went really well. “Neighborhood Aunts” are women who have been selected by their villages to serve as point people for disseminating important health information and encouraging healthy behaviors. Because they live and work in the community they are ideally placed to serve as health resources and can encourage healthy behaviors, such as attending pre-natal visits and seeking early treatment for malaria. 

For the most part, the midwives would lead a discussion or lecture, and then the women would break into small groups to practice leading health talks and having conversations about a given topic. Then, one by one, they would practice leading a health talk with the whole group, and the midwives would add or correct things as needed. The training was based on the "Neighborhood Aunt" curriculum laid out by the Senegalese Ministry of Health, and the schedule went like this:

Day One

·        Orientation and discussion of roles

·        The importance of advocating for ante-natal care

·        Pre-natal visits, attended births, post-natal visits, and miscarriage

·        Family planning and reproductive health

Day Two

·        The importance of advocating for child health (0-5 Years)

·        Vaccinations, seeking early treatment for illness and injuries

·        Community mobilization methods, implicating community leaders

·        Creating and managing community health funds

           

Day Three

·        Planning, implementation, following up, and reporting activities

·        The importance of the "Neighborhood Aunt"

·        Evaluation and distribution of monthly activity reporting forms

·        Review and closure

There were also group discussion about why maternal health is important, and the participating women spoke frankly and passionately about how women are often undervalued or seen as replaceable, and how that needs to change. They had the chance to ask all sorts of questions, talk about the reasons that people in their communities wait until the last minute to seek medical care, to discuss why some people are opposed to family planning, and to reaffirm the importance of having "Neighborhood Aunts" in a village.

The Community Center where the training was held is also where local youth can take vocational courses for trades like tailoring and catering, so the lunch and coffee break prep for our training also served as a practicum for a group of catering students. It was really fun to hang out during lunch and coffee breaks, both because the people serving the food were intent on showing off their skills and because all of the women were so obviously delighted at being served a fancy lunch that they didn't have to make from scratch themselves. I think it made them feel important, which made the training feel more important, too.

Once the chairs were rented, the radio announcements made, and the lunches all paid for, my main role was just to sit in the back of the room, taking pictures, occasionally holding fussy babies, and nodding approvingly whenever anyone looked over at me. About half the participants came from other villages, took three whole days out their lives, to attend the training, and it was great to see most of them really enjoying the training, asking good questions and taking their role very seriously. Best of all, the midwives were really pleased, and after the training wrapped up they talked and talked about how to best implicate the newly-qualified "Neighborhood Aunts" in their attended birth and pre-natal visit promotion activities. 

Chalk It Up

The wall of the Kedougou Regional House's kitchen hut features a large calendar, painted with blackboard paint and outlined in white house paint. Every month someone wipes it down and chalks in all the important upcoming events - birthdays, trainings, vacation dates, and holidays real and imagined. 

The House Calendar for April 2013

I like to do the calendar, and this is my last one, so I tried to make it count.

A few notes: COS = Close of Service, when people leave; VV = Volunteer Visit, when the new arrivals come to check out their sites; UAG = Urban Agriculture; AgFo = Agroforestry; True American Rainbow Party = We've been watching too many New Girl episodes lately.

Cups and Kettles

Diabou is now the second-youngest kid on my compound. She’s taciturn, obstinate, and small for her age. She doesn't like new people and refused to acknowledged my existence for my first three months at site. She has a big head and little arms and thick, slightly bowed legs, like a tyrannosaurus. She understands things just fine, but frequently pretends to have not heard when people tell her what to do, and she doesn't speak very often. When she does talk, it’s in this raspy, high-pitched little mouse voice, like a gravel-filled squeaky toy come to life.

Obviously, she is my favorite.

After the initial cold shoulder she warmed to me, and now we're friends. She sits on my feet when I'm trying to read, delivers little piles of mango leaves to my doorstep, brings me her peanuts to shell because she knows I don't like raw peanuts and will not keep a portion for myself.

She calls me “Ada” and she's taken to padding into my hut in the early mornings to perch silently on the corner of my bed and watch me boil water, attempt to sent texts, organize the junk on my table, whatever I happen to be doing. Sometimes after lunch I'll let her come in and play around, like this:

She spent about thirty minutes pouring water back and forth, seeing how high she could lift the pouring cup and swishing things around. She spilled a lot, but nothing disappears faster than water off a cement floor in hot season, so I didn't mind. Also, it was kind of mesmerizing, like a Rube Goldberg contraption.

Coloring

No matter where they come from, pretty much all kids like to draw and color, and while coloring they like to say “Look! Hey! Hey, look! Hey, look, look here! Look! Hey! Look!” until you look over and say “Oh, that’s great! Good job! You’re so good at coloring!” Also, there always seems to be a kid who gets all bent out of shape if another kid loses a marker cap or puts the crayons back differently, and there’s always a littler one who sneaks in to gnaw on the crayons and chew off the marker tips.

I really like that coloring has become part of my routine at site. Kids, mostly host siblings and neighbors, show up in groups of three to six and ask for the mat and books and crayons and markers, and then they're usually pretty content to just sit there and color for an hour or so. Then, someone's mom will call them home, or it'll be time to fetch water or help with dinner prep or play soccer, and they roll up the mat and return all the supplies.

All this coloring has largely been made possible by Troll, my friend and fellow Camp Unalayee alum, has been sending wonderful packages filled with band-aids, ointment, embroidery thread, paper, and markers. My friends and American family have sent paper and markers and all sorts of fun stuff, too, and I've given some of the art supplies to my host siblings and their friends, kept some in my hut for the little kids to use a few times a week, and stashed some in my trunk so I’ll be able to give them as a going-away present next month. 

End of an Era

With PCVs from my training group already heading back to America, the good-bye phase of my service in Senegal has started. I feel like it began in earnest in Dakar, the day I went to a fish-and-rice place known as the USAID Ceeb Shack (ceeb, pronouced “cheb,” means “rice” in Wolof) with PCVs Nic, Ivy, Marielle, Kayla and Annē. The USAID Ceeb Shack, located right by the Ngor beach and the USAID Dakar office, is renowned for friendly service and really good food, and only charges 800-900 fCFA (about $1.50) a plate. On any given day they’ll offer several choices, such as fish and red rice, fish and yellow rice, steamed rice with peanut sauce, onion sauce, okra-and-palm-oil sauce, tangy orange domeda sauce, or my personal favorite, chicken and wheat cous cous. I meant to take pictures of everyone’s plates when they arrived, but in our hunger and haste I forgot until everyone had eaten pretty much everything.

Though Nic and Ivy weren't actually flying out for several more weeks, Marielle and I were about to head back down to Kédougou and we knew it was the last day that we’d see Nic and Ivy in Senegal. There are more and more of those oh-this-is-the-last-time-I’ll-see-you moments, but adding the caveat “in Senegal” does take the edge off. It’s great to feel like we've all made it through our service, like we've all accomplished something together, and even though everyone’s going their separate ways it’s good to see people headed off to do interesting things. 

Fatoumata Bineta Souare

While I was away in Thiès and Saraya last month, my youngest host mom, Kade, had her third baby. I knew she was pregnant but hadn't realized that she was that far along, and was disappointed that I missed the baptism. Of course, I still brought some baby gifts over to her hut - a soft blanket, some fancy soap, a pretty new shirt, and a baby outfit in a little purple bag – and she told me that she’d wanted to name the baby after my mother in America, but when she was visiting everyone just called her “Neene Adama,” literally “Adama’s mom,” and so no one was completely sure how to pronounce or write her actual name, so they named the baby Fatoumata Bineta instead. Maybe next time, though, if she has another daughter.

(Father Sadat and big sister Diabou; new baby girl Fatoumata Bineta; mother Kade)

First Mango of the Season

The mangoes in Salémata aren’t quite ripe yet, but last week Katie O. and I walked over to the Bassari village of Ethiolo, where the mangoes have been ripe for a few weeks now. We went to greet our friend Tatiana’s old host family and to buy some souvenirs – the Bassari craftsmen make fantastic masks and figurines. Over the years the Bassari have been mostly converted to Catholicism, but they’ve retained a lot of their traditional animist culture and hold initiation ceremonies every spring.

On the way back Katie’s shoe broke, and she did what any Senegalese kid would do in that situation: root around for a bit of plastic bag, MacGyver it back together, and keep on walking.