Cervical Cancer Awareness Training

Along with a few other Volunteers, I've been helping out with an ongoing collaboration between Peace Corps Volunteers and an NGO called PeaceCare that is aimed at improving cervical cancer prevention and treatment in Senegal.  

We've been coordinating trainings for local health workers intended to raise awareness and improve understanding of what cervical cancer is and what resources are available to prevent ant treat it if it develops. The training that happened in my village was lead by a trainer from the District Hospital and the local midwives. They gave a presentation and then lead discussions with Community Health Workers and Community Liaisons, or "Neighborhood Aunts" as they call them here. They talked about on anatomy, the basics of cancer and cervical cancer, testing, treatment and barriers to care, and then discussed ways to broach the topic with people in their neighborhoods. My role was to arrange all the things that make a meeting happen: announcements, renting a room and chairs, borrowing a projector, hiring someone to cook lunch, and handle things like reimbursement for transport. 

Despite the language barriers - the District trainer spoke only Wolof and French; most of the local women only spoke Pulaar - the women had really valuable, engaged conversations. The midwives and the head of the women's groups did a lot of translating, I drew some basic reproductive anatomy illustrations, and everyone was impressively attentive. Many of the local women aren't literate, but I noticed that several of them had carefully copied the anatomy drawing into the notebooks that had been handed out, which really made my day. I didn't talk much at all, but I learned some interesting vocabulary ("cervical cancer" was translated as "the sickness of the stomach of the mother of the baby") and as women got more comfortable they started telling stories and jokes, some of which I even understood. It was really heartening to see how many people showed up - traveling even short distances can be such a pain in rainy season - and very encouraging to see how interested and responsive people were to the issues being discussed.

And then, just after the training was all over and I was just beginning to get a little self-congratulatory about how well it had gone, several things happened in rapid succession. First, I realized that there was a hole in my pocket and the key to the rented room had fallen out at some point during the day and after quite a bit of hurried searching I had to accept that it was lost. Since there's no back-up key I promised to pay to have the locks changed and then set about cleaning up and returning the rented chairs to the other side of village, but because the car had already gone over to the market and we couldn't call it back because the cell phone network suddenly went out a helpful neighbor kid and I had to carry the chairs, stacked on our heads, up and down the ravine that now runs through the center of our village. On the last trip I slipped and scraped up my shin, ripping my pants and making my eyes tear up a little bit.

I still had to run around to collect all the receipts, grab my backpack from my hut, and say good-bye to my host family before heading off for several weeks (for project work and summit) and my ride back to Kédougou was getting impatient. Once they saw I was bleeding and upset, though, everyone was really, really nice about having to wait a few extra minutes.

So, now I'm in Kédougou working with a couple other PCVs to finish up prep work for the PeaceCare team's upcoming visit and things are going pretty well - lots of unexpected schedule changes, but that's par for the course here. As you can see from the photos, even after just a few days, my scrape is healing up quite nicely. I'm very pleased with my immune system. 

Transport

Transport is usually the worst and most unpleasant part of living in Senegal. Unless you're well-to-do and have your own car and driver the "public" transportation system is made up of a chaotic, ramshackle network of privately owned beat-up buses, rusty jumbo-vans, smaller-but-equally-rusty vans and mini-vans, pick-up trucks, horse/donkey-drawn charette carts, and safari cars. It's expensive and unpredictable (cars leave the garage as they fill up, so you wait three minutes or nine hours), the guys in charge of cutting tickets are usually loud, aggressive, and will often stretch the truth to pressure foreigners into buying tickets, and the baggage guys frequently try to extravagantly overcharge people (last time I went from Tamba the guy tried to charge 2 000 FCFA for a bag that should cost 500 FCFA) but they also tend to relent pretty quickly when you tell that that you've been here before and you know the price.

A typical transport receipt 

Each city has a "garage," which is just a big parking lot where cars and buses park and wait for passengers. The garages in Dakar and the other big cities are sprawling and hectic, filled with vendors and ladies selling ceeb u jen, but the mayhem is somewhat organized. There are garage managers, and the guys in charge of selling tickets who make sure that cars get passengers and leave in the proper order. In the smaller cities, like Kédougou the garages are smaller, slower-paced, and more manageable. In a mid-sized village like Salémata the "garage" is just a bench in front of a sandwich shack, with a guy who sits around, making tea and writing out little ticket stubs. (I happen to glue all my travel tickets, baggage stubs and other paper miscellany into my journal, so at this point I have a comprehensive catalog of the kinds of hand-written receipts that there are in Senegal.

We don't get many nice transport cars out in Salémata on account of our road being rough, dusty, unpaved, somewhat washed out in a few places, and 80 kilometers (about 50 miles) long. It gets worse once the rainy season starts; the road gets muddy, occasionally floods completely by the bigger bridges, and we don't get very many cars at all.

A sept-place and a green van in the Salémata Garage

The nicest vehicle in the Salemata Garage that morning

I got lucky with this car because it had decent-looking tires, the engine sounded ok, the uplostery was still pretty much intact, and it had been painted pretty recently. The interior (below on the left) looked pretty nice. The photo below in the right is of the Salémata garage and main street, where the weekly lumo market happens on Tuesdays. There weren't many people around this morning (which is partly why I felt comfortable taking photos), just people stopping on to buy bread and boutique owners sweeping garbage into little piles and lighting little trash fires. 

I only had to wait for about an hour and a half, which really isn't too bad. The car also didn't stop that many times to pick people up along the way, so it never filled up to the point of being ridiculously over-capacity. They also let me hop out right in front of the Peace Corps house (conveniently right on the road in from Salémata) and that made things easier, too.

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.

Village Etc

Yesterday I was (painfully) reminded that biking in flip-flops is a terrible idea. My foot slipped and I scraped my big toe, not very badly but I will be wearing shoes for awhile.

Now I'm headed back to Salémata, and will be back to town in a week or so, after my Action Plan community meeting is all done.

UPDATE: My toe is healing up very nicely. Again. 

Birthdayapalooza

On August 1st, 2011 I turned 28, Marielle turned 25, Switzerland turned 720, and a good time was had by all. On July 31st, after the SeneGAD meeting, a bunch of us came in to Dakar and got all cleaned up.

I had a little beer to celebrate...

We all went out for fancy pizza and it was delicious. Ben and I shared one that was half "H&M" (merguez sausage and garlic) and half "Hammam" (caramelized onion and goat cheese, no idea how they chose these names), Nic and Ivy split something similar, Sarah ordered a calzone, and Nathaniel opted to slaughter his own pizza.

Afterwards everyone went out for beers, and Marielle came thisclose to pulling off the opening-a-beer-with-another-beer trick. 

Sharing a birthday (and a delicious birthday cake) with Marielle was great because she is awesome, as you can clearly see. 

On August 1st, our actual birthday, we all went out to Ngor Island. It's a tiny island along the northern part of Dakar, and for about a dollar you can take a 3-minute ride out to it in a pirogue, which is exactly what we all did. 

Even though it was overcast, it was warm and the waves we beautiful. Emma enjoyed the view of the coastline, and Kayla, Ivy and I had a nice time strolling around the cliffs. 

It was a good day for fancy fancy coffees. Ben treated Emma and I to cappuccinos and tiramisu, and then a little while later we treated ourselves to beachside Nescafes.

It rained for a little while, but it was hot, so we swam anyway, doing our best to avoid all the plastic bags and bits if junk floating around in the surf. We looked at a bunch of sea urchins and little fish, and after successfully clambering around on all sorts of slippery rocks, I stubbed my toe walking out of the water and wound up making a little bandage out of a piece of my skirt-towel-fabric. Then it was naptime, and then we hopped in a boat back to the mainland.

After showers at the regional house it was time for N'ice Cream, more espresso, and then out for Thai food at the Jardin Thaïlandais, and it was fantastic. Really just amazing. (When we sat down I was saying they should tell the waiters it's my birthday and maybe they would give us a free dessert, and then was so wrapped up in how lovely the food was that I actually completely forgot about it and so was genuinely surprised when there was a candle and singing with my caramelized bananas.)

AND THEN the next day Marielle and I went into town with Kayla and her visiting friends, to check out a giant fabric market, eat more ice cream (I was not such an ice cream person in the US, but lately my love for cold things knows no bounds), and go on the trampolines. 

Kayla and her friend Sabrina decided to reenact the Scar/Mufasa (Mufasa!!) fight scene from The Lion King. 

Obviously, it was a pretty epic few days, and I'm extremely lucky to have such wonderful, fun, photogenic people in my life. And not just in Senegal - when we stopped for internet and I read all the birthday messages I may or may not have teared up a little bit right there in the CyberCafe. Many, many thanks to everyone for being so great ~ 

Sick Day.

I was sick yesterday. Also the internet went down, then the power went out, and I spent the entire day at the Regional House, looking green and lying on a mat while my fellow Volunteers brought me juice and ORS and checked on my (mild) fever.

I'm feeling much better today, and will most likely go back to village tomorrow. 

Less Pleasant Things

Life as a PCV in Senegal is not all beach parties and fancy outfits. For example, I've had a mild-to-moderate stomachache all day, there's some sort of heat rash cropping up on my sides (lovely, huh?) and I'm pretty sure everything about me permanently smells like sunblock, sweat, or some combination of the two. I install in Salémata tomorrow (!!!) and am eager to settle in, set up a routine, and adjust to the new climate.

In less gross news, my left pinkie toenail is growing back nicely! I will try to be more careful with it this time around.

Teeth.

So today I am in Dakar because I had a dentist appointment, and it went really well. Last week I bit down hard on a little rock that was mixed in with the rice and fish and veggie bits, and my tooth has been slightly sore ever since. It seemed like a good idea to have someone take a look at it before I install in Salémata, since from there it's a two-day trek to get back up to Dakar and the Peace Corps dentist.

Luckily, the dentist took a look, tapped around a bit and told me that my tooth had taken a big shock (with the enormous power of the jaws) and that the ligament had a little inflammation, but as long as I leave it to rest for awhile it should be fine. He put some cinnamon-tasting stuff on it, told me to have a bonne installation, and sent me on my way, much reassured. 

I'm feeling much better!

But I'm going to post some photos of my missing toenail anyway.

Ça va la tête?

I've been very into hat-wearing lately (since my part burns horribly if I don't) and it's been working out really well except for the how the brim sometimes interferes with my peripheral vision. Last week, on my way to the village health post with Hilary (my fellow Health stagière) I walked under a sign. Or, I would have, but I couldn't see that I was slightly taller than the bottom of the sign, and I smacked my head on it. Pretty hard. And once Hilary had verified that I hadn't given myself a concussion she laughed and laughed and laughed, and I though that was the end of it. 

Then, yesterday afternoon, in a different part of town, we were walking back from class and a guy I don't know called out hello and then asked "Ça va la tête?" which means "How's your head?" and also "What is wrong with you?!" I must have looked confused, because he continued in French, said "Don't you remember when you hit your head? You hit it really hard, did you forget?"

I had not forgotten (apparently no one else has either) and Hilary got to have another good laugh.