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Visiting Karang’s Post de Santé

On Thursday May 22^nd, I made a trip to Karang to visit the Post de Santé. The staff there was very welcoming. They showed me around and answered my many questions. These conversations have helped me get a better sense of how the health care system functions in Senegal.

I had initially thought that patients bought medicine as prescribed from nearby Pharmacies. Actually, it turns out that those pharmacies are privately owned, and that they therefore exist independently from the Post de Santé. I’m told that the Post de Santé could never obtain medication from pharmacies, because it would be far too expensive. Furthermore, the Post de Santé isn’t allowed to distribute strong medicines, like those available at the pharmacies. Instead the Post de Santé obtains its medication from another health structure in Sokone. Medication received by the Post de Santé is distributed—not sold—to from the Depot des Medicaments.

From my interactions with 4 staff members, including the Infermier Chef de Post adjoin and the Sage femme, I gather that each consultation and subsequently prescribed medication have a fixed price of 2,000 CFA. In order to give birth at the Post de Santé, women have to pay 5,000 CFA. As of November 2013, children under 5 years of age do not pay medical fees whatsoever. The government has promised to pick up the tab for this age group, but has of yet failed to deliver, putting significant financial strain on the Post de Santé. The Post de Santé’s finances are managed by a Committé de Santé, which in responsible for both medical costs and employee pay. In essence, the Post de Santé relies largely on patients’ financial contributions; the State is pretty much absent here.

Like Alassane at the Case de Santé, the Sage Femme and ICP adjoin see an overwhelming amount of patients each week. They are well educated and hold prestigious jobs, yet they too struggle to make ends meet. They have been nominated to this specific Post de Santé by the State, so their extended families usually live far away. They are technically entitled to housing on Post de Santé grounds, but right now the Sage Femme has to live in the city, because there is not enough money to build her a place to stay at the Post de Santé. She was tired the day we spoke. The night before, the guard had come knocking at her door around 3 am—a patient needed to see her.

Conversations with my work partner

Alassane, my work partner, is the ASC at the Case de Santé in my village. The services provided by the Case de Santé are as follows: health causeries, baby weighings with CARE group, prenatal visits, post natal visits, regular physical examinations, optimal nutrition cooking demonstrations, and house visits. Alassane and an elderly matrone care for a great many people, who come from many neighboring villages, attracted by the Case de Santé’s excellent reputation. He is a tireless worker, but both his time and access to medicine are limited severely. Alassane is paid as a function of the amount of medicine sold, in addition to the number of consultations and the number of injections made. But he does not have a fixed salary, and he struggles to make ends meet.

Each month, Alassane has about 40,000 CFA to replenish the Case de Santé’s stock of medicine. The order goes to the pharmacy in Sokone, a large nearby town, and the medicine is delivered to the Post de Santé in Karang. From there, the Post de Santé is responsible for distributing medicine to all the Cases de Santé under its supervision. Usually, though, the amount he pays exceeds the amount allocated by upwards of 10,000 CFA; further, he often gets fewer units of medicine than expected.

Recently, there has been an outbreak of chicken pox in the area. Chicken pox is very contagious in children under 14. It manifests as itchy sores on the body and fever. I never thought chicken pox was a big deal, but according to Alassane, it can be very dangerous for babies and infants. As I sit and talk with my colleague Ben, Alassane prepares yet another batch of skin cream: ¼ liter of oil, 4 hand soaps, 2 liters of boiled acacia leaf water. He tells me that it is very effective in soothing rashes and relieving itching. The other day, a young girl of about 8 came in with her mother. It doesn’t take Alassane long to realize that she has an advanced case of chickenpox. He wishes that her mother had brought her in earlier; he might have given her a shot to make her less contagious to other children. However, he later tells me that, thanks to ongoing education and sensitization, the villagers have started seeking out medical care at the onset of illness rather than waiting too long or opting for traditional care.

However, other sources of frustration are ever-present. For instance, he tells me that fathers are usually far less invested in their children’s care than mothers are. My own visits to divers health structures have certainly confirmed this trend; I’ve noticed that those seeking care are overwhelmingly female, with infants and toddlers in tow. This is always problematic, because men often have control over family funds here. Basic hygiene and sanitations practices are also largely absent, despite repeated efforts to educate the population. Most families do not use soap to wash their hands before eating, changing babies, using the bathroom, or cooking. Most simply rinse their hands in communal bowls.

Meeting with Work Counterparts in Dassalami Soce

On Monday the 19^th, I had my first meeting with my two work counterparts in Dassalami Soce. My official Peace Corps counterpart, Alassane, is the Agent de Sante Communautaire. Our Case de Santé serves three villages: Dassilami Soce, Boutilimite, and Saroujia. These three villages are all situated along the asphalt road that leads to Karang to the South, and Sokone to the North. I also hope to work with Ben, a manager at Pharmaciens sans Frontieres, who played an important role in the realization Venchele’s projects. He primarily works on an island called Djinack Bara, which is a 10 min ferry ride from Karang. He’s done quite a bit of work with the elementary school, and also built a Case de Santé there.

During this meeting, we went over the following topics:

• Projects to be initiated, continued, or bolstered in the near future.

1) According to Ben and Alassane, the latrine project is our biggest priority at this point. Most latrines in my village are not deep enough, and aren’t made well. Usually, people just cover them up and dig another hole when the first gets full. Obviously, this can pose some serious health risks, especially during the rainy season—when human waste is likely to come floating back to the surface.

We had initially found an organization wiling to finance it, but they estimated that each latrine would cost upwards of a million CFAs. Studies have shown that when locals also pay a portion of the cost, they are more invested in seeing the project through and are more likely to use the new infrastructures. The villagers have agreed to contribute 7,500 CFA per household; if we were to work with this particular organization, they would have to pay a lot more, and no one here has that kind of money. So now, we have to find another partner willing to shoulder the bulk of the cost, while requesting a reasonable contribution from the villagers.

2) Even though the Case de Santé is built, it still needs work. We’re hoping to have a maternity ward here; for now, I’m not sure if that means we’d have to build another building adjacent to the Case de Santé, or if we have enough room in the Case de Santé for a materity ward.

We also do not have access to running water; we only have access to well water here—and pulling water is hard work and time-consuming. So perhaps a robinet project would be a good idea.

We also don't have any electricity; as of now, we’re hoping that Pharmaciens sans Frontières will be able to help us get solar panels.

We also need to figure out how to maintain basic cleanliness in the Case de Santé. For now, the money to pay women to clean is coming out of Alassane’s own pocket. There’s no trashcan, and no way to dispose of medical waste.

3) Trash in the village is a problem in general. My village is pretty clean by most Senegalese standards, but litter (especially plastic, plastic everywhere) is still omnipresent. Ben said that he had already built a trash-burning oven in another village, and that it had worked really well. I’m not quite sure what these ovens look like for now, but I think it would look something like this: https://www.youtube.com/watch?v=6AJvTBeAUGY.

4) I have two schools in my village. In the French school, the children eat lunch on the floor, so Ben thinks it might be a good idea to build a cafeteria for them.

5) Eventually, the difficult subject of contraception or birth spacing will probably have to be broached. There are way too many children here; there’s a naming ceremony just about every day. For both financial and health reasons, fewer births are more advantageous.

• Ben and Alassane also gave me some really interesting advice about working and living in Dassalami Soce.

I was under the impression that the best way to find something to do was to ask villagers directly what the most pressing health concerns and needs are; my work partners suggested that, to the contrary, I should avoid asking such direct questions. Instead, I should be able to get a sense of immediate and long-term needs from indirect communication, everyday casual conversations, and direct observations. For example, I’ve noticed that my family members never wash their hands with running water and soap; usually, they use a communal water bowl to rinse their hands after eating (keep in mind that many people here, especially women, eat with their hands). I’ve also noticed that kids tend to eat unripe mangos. Both of these behaviors greatly contributes to the spread of many diseases, including diarrhea, which can be deadly in young children.

More to come, as soon as I have internet access.

Preliminary interviews and visits at Dassalami Soce

During VV, PCT’s became better acquainted with their site’s health challenges and infrastructures. The training team asked that we:

• Visit a health structure (health hut, health post, district de santé).
• Speak with at least one person who works at that structure and fill out the following information about that structure.
• Speak with at least one woman and one man in the community about health issues facing the community.
• Meet with at least one community health worker operating at the village level to talk about their activities.

During her service, Venchele worked with her community and Pharmaciens Sans Frontières to build a bigger and better equipped Case de Santé. As of now, the Case de Santé in Dassalami Soce is serving more than 1240 people; two nearby villages, Saroudia and Bouilimite, also come to get medical help there. In Senegal, the health system is organized as a hierarchy pyramid. Cases de Santé are at the very bottom of the pyramid; they are usually maintained by community volunteers, ASC’s, and Matrones. Cases de Santé report to a nearby Post de Santé, which is run by an ICP (Infermier/ère Chef de Poste). Health Posts report to the closest District de Santé.

The ASC (Agent de Santé Communautaire) at Dassalami Soce’s Case de Santé will also be my counter-part for the next two years. He speaks perfect French, so I was able to communicate with him from the start.

I initially asked him for the name of the District de Santé he report to (District de Santé de Soho). He then listed the names of the matrone and the health relais (or community volunteers) at my site.

The nearest Post de Santé is in Karang. During VV, I was able to go visit the Infermière Chef de Post there, and introduce myself to her.

In some circumstances, the Case de Santé can’t provide adequate health care to a patient, and must refer them to the Post de Santé. Most of the time, referrals occur if the Case de Santé doesn’t have the necessary technology or the means to treat difficult cases.

Patients who visit the Case de Santé must pay a sum of money to get treatment. Adults typically pay 2,000 CFA (about $4), whereas children pay 1,500 (about $3). There seems to be very little financial support from the government here. Pharmaciens Sans Frontières, has agreed to supplement the medical stock of the Case de Santé for the next two years, but it still needs to obtain medication from the Post de Santé. The ASC regularly sends money to the Post de Santé, which in turn supplies it with a regular influx of medication.

The Case de Santé is equipped to treat malaria (it is stocked with rapid malaria tests and ACT), diarrhea, respitory infections, cuts, ear infections, and skin infections. Soon, it will also receive a maternity ward with adequate sanitary measures and tools.

In addition to Pharmaciens Sans Frontières, a number of other NGO’s work in the area: World Vision, Child Fund, Jica, etc. They work on child nutrition, education, health, and hygiene.

I interviewed two community members, one female and one male, on major existing health problems in Dassalami Soce.

• The village Matrone told me that access to medicine and medical equipment were two major problems. She also said that the village tended to have water shortages, and that access to water was also difficult.

• The son of the Imam told me that water shortages, and access to water were major problems. He also said that, as of now, there is no reliable way to transport extremely ill individuals from Dassalami Soce to the Post de Santé in Karang. He thinks that the Case de Santé does not have enough medicine and medical equipment. Finally, he suggested that the Case de Santé’s lack of electricity is detrimental.

• The ASC was most concerned by lack of access to medicine, and by inadequate funds to buy them. He also thinks that the Case de Santé should have a reliably way to transport sick individuals from Dassalami Soce to the Post de Santé in Karang. He said that people in the community are poor, and can’t always pay the fees for treatment. Sometimes he defers pay, but he can only do this so often. Sometimes, people are never able to pay it back at all.

Mangroves in Toubacouta

The nearest PC regional house to Dassalami Soce is in Tambacouta, a village much appreciated by tourists for its ecological diversity and natural beauty. Its lush mangrove forest is a particularly unique feature. I wanted to learn more about this unusual forest, because it is an important magnet for eco-tourism here and because its population has declined over the years. CEDers and Aggies are more likely than Health volunteers to work on Mangrove-related issues, but I’m interested all the same.

I found a report produced for UNEP (United Nations Environment Programme) and WCMC (World Conservation Monitoring Centre) on Mangrove forests published in 2007. I think it provides a good overview of Mangrove status/distribution, their importance, associated biodiversity, and known threats to their population levels. It also delves into country-specific overviews.

Mangroves are unusual because they live between land and ocean in humid climates. They have evolved to thrive in frequently flooded area as well as in salty water. Depending on the water level, they can grow up to 40 meters. They need regular fresh water influx for substrate and nutriment replenishment.

They are a keystone species here.  They shelter a great diversity of animal species--such as birds, reptiles, and amphibians—and a number of medicinal plants as well. They also provide spawning grounds for fish and shellfish. Finally, they help generate nutrient-rich water, resulting in greater fishing yields for commercial fishers. Mangroves also provide relief to Senegal’s constant struggle against creeping desertification: they help trap the soil, so that it does not get washed away so easily.

 But the deltas’ resources, in particular oysters and timber, are currently being overexploited. There also seems to be quite a bit of illegal gathering of turtle and birds, among other things. Mangroves play a key role in sustaining the land, the people, and other living things here; however, they are not being exploited in a sustainable manner. The constructions of channels as well as habitat transformation for rice farming further threaten Mangrove forests here.

The owner of the Toubacouta house often takes PCV out on tours of the Mangrove forests on his boat. I’ve heard it’s worth doing. I’m also going to try to learn more about those medicinal plants. I’ve very curious about traditional medicine here.

http://www.unep.org/regionalseas/publications/otherpubs/pdfs/Mangroves_of_Western_and_Central_Africa.pdf

Project Development in the Peace Corps

The credit for the information in this blog post goes to Venchele Saint Dic. She’s been a goldmine of friendly generosity and professional advice since I first met her. Venchele, I can’t thank you enough.

One of the many things Venchele and I talked about during Volunteer Visit was project development. I don’t have any experience in this particular area, so I was eager to pick Venchele’s brain for advice. Here are the steps she listed in developing health projects.

1) The first step is crucial because it gives the entire process direction and purpose. Before initiating any kind of work, we as PCV’s need to access the needs of the community. 

There are many ways to access needs:

• Hold community meetings to talk about the needs of the community at large. The president of the CARE health group, the general secretary of the CARE health group at Dassalami Soce and the ASC should all be there. Other important community members, such as the village chief and the Imam, should also be invited and included in the discussion.

• Conduct one-on-one interviews with a diverse group of individuals (women, men, boys, mothers, farmers, matrons, Talibés, etc…).

• Engage in direct observation (e.g. litter on the road creating unsanitary conditions could be cleaned up)

• Use PACA (Participatory Analysis for Community Action):

As PCV’s, our ultimate goal is that our communities be able to improve their own livelihoods in a sustainable way, to insure that they will not need foreign aid in the long term. PACA is a collection of methodological tools a PCV can use in order to get to know a community better, which always involve active participation on the part of different community members.

There are four main PACA tools: community mapping, seasonal calendars, daily activity schedules, and needs assessment. Ultimately, the community itself should get a better understanding of its diverse internal needs and should have a clearer sense of what needs to be done in order to improve their community’s livelihood. I’ll be coming back to PACA in much more detail later on, especially once I get some hands-on experience with it.

• Conduct Household Baseline Surveys 

Venchele sent me the baseline survey that she administered to a diverse group of villagers during house visits between November 28^th 2012 and January 21^st 2013. Thanks to this survey, she got a better sense of mosquito net usage, safe water and latrine access, hand washing knowledge, equipped hand washing stations, maternal and child health, diarrhea, mother and child nutrition, family planning, and youth development on sexual education. She used this information to get a better sense of what projects she could work on, what her priorities should be according to the numbers, and which health challenges demanded immediate action.

 Obviously, there’s quite of bit of overlap between these different tools, and they are most efficacious when combined.

2) Once needs are identified, start looking for ways to meet those needs. 

Sometimes, a village can fix its own problems, because it has the necessary resources at hand. In this case, a PCV would identify which resources and individuals could be mobilized. Sometimes, another PCV can a source of knowledge and a link to another helpful resource or individual. Sometimes, help and support must come from an external source. 

A PCV could also research different organizations and NGO’s that cater to those particular needs, and establish a partnership with them. 

A) There are several ways to find the right NGO or organization.

• My APCD (Assistant Program Country Director, I think) has a ready list of organizations and NGO’s that work on specific health challenges in Senegal, and will provide references as needed.

• My ASC will be a great resource to me in general, and will most likely be familiar with all the organizations and NGO’s that work in the area.

• Other PCV can refer me to organizations and NGO’s that they have worked with.

• Internet research to get a better sense of what the organization or NGO does, and what their mission statement and goals are.

B) From there, a PCV can ask for a letter of reference from the APCD; this letter often lends credibility and status to the PCV, and makes it more likely that the NGO will want to work with him or her. The APCD will send the letter of reference directly to the representative. After this initial contact, the representative will contact the PCV directly. Alternatively, the PCV can call the representative directly to plan a meeting, but should probably avoid going into specifics just yet.

C)  Usually, the NGO or organization’s office is in a large city. It’s the PCV’s responsibility to travel to meet them there. At the meeting, she will want to introduce herself as a PCV, talk about her site, and what her project is. She’ll want to ask about the NGO or organization’s mission and work in the area thus far, and whether they conduct work in her region or whether they might be wiling to extend to her site. Now she’ll want to be more specific about what she hopes to accomplish, and about how her site could benefit from working with this particular organization or NGO.

D) Now the PCV will want to talk to her counter-part, so that they can organize a community meeting together. The purpose of the meeting is to inform the village of the opportunity, to include them in the decision-making process, to get approval, and to discuss the community’s active role in this new partnership. Important individuals to definitely include in this conversation is the ASC, the Imam, the village chief, key members of the CARE group; that said, anyone from the village interested in attending should be encouraged to do so.

E) Finally, the PCV can invite the representative to come and visit the site, to get a better idea of what needs to be done. This can be tricky, because a PCV has to respect the representative’s timeline and schedule. If they do agree to work with you, it’s a good idea to get written proof of the agreement; in the past, other organizations and NGO’s have agreed to do work at Dassalami Soce, but then never followed through. At this point, a PCV can work with the community and the representative to establish a realistic timeline for getting work done; they might even want to discuss possible follow-up projects further down the line.

Should the representative decide against working on your project, there’s nothing to do but start the research process again and find another source of help. Sometimes, the representative can point you in another direction, too.

It’s always a good idea to check in with counterparts, the APCD, and key community members regularly at all stages of project development.

Children on the streets

This blog post is about Senegalese Talibé (“student” in Arabic)—individuals seeking a Quranic education. I’m going off of my own observations and paraphrasing some of the PC Talibé manual (created by Hadiel Mohamed, edited by Steve Turnbull, Meera Sarathy, and Sarah Auyeung), but I want to say I don’t yet know very much about this particular topic either.

Talibés are boys between 4 and 20 years old who study the Quran under the direction of a Marabout, a former Talibé who has mastered the Quran. Parents from all over Senegal may send their children to study the Quran with a specific Marabout in a Daara (a Quranic school).

In the absence of nuclear family, Talibés may or may not live with host families. Before the age of 14, most Talibés are expected to beg for alms on the streets. They must give those alms to the Marabout, and often get punished if they do not reach a certain quota. They usually also have to beg for food and clothes, especially if they do not have a host family or if the Marabout does not use the money to care for them. After the age of 14, Talibés usually find an assortment of odd jobs to do and give the Marabout a share of the goods or money they procure. Talibés often have trouble finding work after they finish their studies if they do not become Marabouts, because they are for the most part completely illiterate.

I want to stress the difference between Talibés and beggars. A Talibé is any individual seeking a Quranic education. They are not necessarily homeless, or far away from their immediate families. They do not always have to beg in the streets. For instance, some children in Saint Louis attend a French school in the morning, a Daara in the afternoon, and return home to their parents at night. Beggars, on the other hand, must beg in order to sustain themselves on the streets. They do not study the Quran under a Marabout.

Talibés on the streets are easy to identify. They tend to wander the streets in groups with bright yellow begging bowls. I’ve seen them ask for coins and sugar cubes. I think Talibés in villages tend to ask for grains rather than money They look about 8 or younger, but it’s hard to tell: so many of them are malnourished and probably stunted. They usually wear dirty second hand western clothing, and usually just an oversized T-shirt at that. They come up to you with huge eyes and an extended cupped hand, both of which are pretty difficult to resist.

People here have utmost respect for Marabouts, but very little respect for Talibés. Most ignore Talibés completely, or push them away should they become too insistent. They’re paid about as much attention as the goats that wander around, foraging for food. My first interactions with Talibés were painful for me, because I didn’t feel comfortable giving them money. I knew that if you give money to one of them, you’d have to give money to all of them. I didn’t want to be corned by a clamoring group of children. What’s more disturbing, however, is how quickly you adopt the Senegalese attitude towards Talibés. I sometimes have to stop and remind myself that these are small children.

My most memorable interaction with Talibés took place at my CBT site in M’bour. I was sitting on a concrete slab on the side of the main road, chatting with my mother on the phone. Out of nowhere, a dead sparrow dropped out of the sky and landed at my feet. It took me a while to realize that an approaching group of Talibés had thrown it at me. Eventually, they started yelling insults in Wolof and throwing rocks at me. I got pretty angry, but I really had no idea what to do. I don’t speak any Wolof, and I wasn’t about to throw something back at them or hit them. I was definitely pretty angry, though. Eventually, I just walked away.

There is a Daara in my village that is run by a famous Marabout. It will be interesting to visit and get to know the boys there. I hope I’ll be able to work with them in some capacity.

I'd be happy to email a copy of the PC Talibé manual to anyone interested in learning more about these kids. 

Children and Infants in Senegal

This blog post is based off of preliminary observations, and I will hopefully be adding to it over time.

When it comes to children and infants, I’m most interested in how they relate to adults and in how adults relate to them.

At my CBT site, I lived with 5 younger siblings: Abdou (21 years), BaIsa (12), MaBintou  (8), BaSecou (6), and Mariyama  (4 months). My mother has had 11 children, one of which died years ago. Two of my younger brothers live with family in the Gambia, where they are currently learning English. My younger sister Jhara is 19, and lives in Dakar with her husband. Two cousins from the Gambia were also living with us during my time there. Molamine is 6, and Oumar is 12.

From my time with my family, I’ve noticed that the baby gets a lot of attention and affection from other family members. Abdou in particular takes great pleasure in holding her. The other children also carry her around, but more out of necessity: sometimes my mother is so busy that the other children must take care of Mariyama. Even my father, who rarely does any kind of household chore, will often coo at the baby and lay with her on a mattress in the courtyard.

The other children have a very different relationship with adults. Parents in America often have a huge role to play in their children’s intellectual and psychological growth. I remember endless conversations with my father about recent scientific findings, linguistic quirks, and natural phenomenon. Those were some of the best moments of my childhood.  Adults here will rarely have true conversations with their children. Children are expected to obey any direct order, do chores around the house, and run errands. The work is often physically demanding, such as dumping buckets of dirty laundry water outside. There is also very few physical displays of affection towards children.

People here hold their elders in high esteem, so anyone older than you can expect you to be obedient. My siblings obey without a word, or else.  (I do think my siblings are particularly well behaved, according to other new PCV’s.) My mother has rarely hit my siblings, but she certainly has harsh words when unsatisfied. From other volunteers, I know that some families can be far more violent towards their children, even drawing blood  in some cases. I have a friend who really struggled in situations like these during CBT. 

 If you are older, you can also expect that your needs will be met first and better. For instance, anytime I walk into the room, my younger sibling will give me his/her chair to sit in. Usually, the older siblings and men eat first around a large metal bowl, full of vegetables and fish. My mother eats with my younger siblings, not because she is not allowed to eat with the men, but because she is educating them on how to eat. They are never allowed to reach for vegetables and fish at the center of the bowl, but must instead wait for her to carefully portion food out to them. Their bowl tends to be less full of nutritious food, and has a higher proportion of rice.

My family at CBT owns a large compound, which they share with four or five other families. One family of Pulars has two young daughters who look exactly alike, Fatou (4) and Hadi (2). Hadi had never seen someone with such pale skin before, and she still cries whenever I get too close to her. Fatou, though, always came over to shake my hand several times a day. Despite the fact that she’s only four, she’s the one who made me feel most welcomed there. She has huge dark eyes, never says a single word, and always shakes my hand solemnly.

On one of my last nights at CBT, 60 women of the Danso and Gassamo family descended on Danso kunda (house). They came with gifts for Jhara’s wedding party and for her new baby’s Kulio (naming ceremony). Soon, the courtyard was full of laughter, dancing, singing, and drumming. All the while, money constantly changed hands. Under the tree sat a huge pile of gifts: fabric, large metal bowls, and plastic wash bins. The only strange thing there was the toubab sitting among them, adamantly refusing to dance.

Soon after I sat down, Fatou came up to me and started drumming her tiny hand on my knees. I picked her up and sat her on my lap, her head resting against my chest. After a little while, she started to get antsy, slid off my lap, and wandered into the crowd. I saw her take a few wobbly steps and vomit into the sand. A ton of adults were sitting around nearby, and yet none of them seemed too concerned. Her mother kept a watchful eye on her, but did not get up to help her. She pointed to the far end of the courtyard and told her daughter to go vomit there, so that she would be out of the way. Fatou did as instructed, and did indeed vomit several more times. She did so silently and tearlessly, which was incredibly strange as well as fascinating to me. She might as well have been peeing; it was just a different kind of fluid leaving her body. And a few hours later, she was running around again.

For me, this anecdote highlights some differences between Senegalese and American parenting. Parents here don’t seem to get alarmed when their children vomit, whereas parents in the US are driven into a frenzy. Senegalese parents probably worry when their children are sick for a long time, but won’t panic if their children vomit for a few hours. I wonder if children in the US are conditioned to cry and groan and recover more slowly by their parents excessive concern whenever they vomit or feel unwell. 

More thoughts to come, I’m sure.

My Volunteer Visit

3-6^th of April 2014          

VV is an opportunity for new volunteers to visit their sites for a few days mid-training. Usually, they are hosted by their “ancienne”, the volunteer they are going to be replacing. I was lucky to be hosted by Venchele Saint Dic at Dassami Soce.

I arrived the first day in Koalack with several other new volunteers in my work zone. I had time to rest at the regional house before Venchele’s arrival. The day before, we had talked on the phone to work out logistics. After pointing the gendarmerie out to me, Venchele took me out to lunch in Koalack. Over beef yassa, we got to know each other a little better. From the start, we realized that our lives and experiences are very similar in many ways.

After talking for several hours, we took a sept-place down to Dassalami Soce. I was able to meet my community counterpart, Alassane, for the first time. He’s the Agent de Sante Communautaire for Dassalami Soce and two nearby villages. We then walked over to Venchele’s compound. On the way we met many village people, including the village imam, his son, and a wife of the village chief. I also met my family for the first time: my mother Natoma, my father Almamy, my younger siblings, my uncle El Hajji , and his wife Awa. After an excellent chicken and spaghetti dinner, Venchele and I talked for a long time before finally going to bed.  I slept on a concrete bed outside under the stars.

On the second day, we went to buy tea as a gift for the family at the nearby boutique. We returned home to give the tea, along with the bananas I had bought in Kaolack, to the family. For breakfast, we had amazing fried eggs on tapalapa bread at a little hole-in-the-wall eatery next door. Then, we went to visit the health post that Venchele played an important part in building. Alassane kindly gave us a tour, and answered my incessant questions. When we were done, Ben from Pharmaciens Sans Frontières, gave us a ride to Karang. Ben is Venchele’s unofficial community counterpart. He was instrumental in building the health post as well as supplying it with adequate medical equipment and medication.

Karang, 20 minutes away from Dassalami Soce, is right on the Senegalese-Gambian border. Venchele showed me two fabric stores and one western clothing store. Apparently, the fabric here is good quality and substantially cheaper. She also took me to visit a papetterie, and to say hello to the Infermière Chef de Post at Karang’s Health Center. When we finally got back to village, Venchele and I talked for hours about things I should buy for installation, project management, resources, organizational strategies, and relationships in Senegal.

On the third day, we had another delicious egg sandwich. Venchele and Alassane took me on a tour of Dassalami Soce, including Sate Baa (the part of the village furthest from the road). I went to admire the village’s new mosque. I visited the French and Arabic school. We quickly dropped in on a Kulio (naming ceremony). Traditionally, on the morning of the Kulio, the men pray and the women make mono (millet or rice porridge with sugar, boabob powder, and peanut butter) in huge pots. I met the village chief, the president of the CARE group, members of the women’s group, and many other village people. I also met a potential Mandinka language tutor; he tutored Venchele and was like a brother to her. He invited us into his house for breakfast and gave me a first Mandinka lesson.

Ben, Alassane, and Venchele organized a meeting to introduce me to the villagers. After lunch, we prepped for the meeting by going over its most important objectives. The meeting was slightly nerve-racking, but I felt well supported by my “team”. Ben translated my French into Wolof, and Alassane directed the course of the meeting. I’m excited to be able to speak to them directly in Mandinka. All in all, the meeting went well. I have the blessing of both the village chief and the imam, so my work here can begin. After the meeting, Venchele, Alassane, and I went over the “Compte Rendu” of the meeting. Venchele and I then spent several more hours talking about perspectives: at this moment in our lives, I’m looking forward to my time in Dassalami Soce, while she’s looking back.

On day four, Venchele and I flagged down an Alhum to go to Toubacounda. Toubacounda has a beautiful mangrove reserve and exceptional wild life, which make it a popular tourist destination. The PC house here is located right next to a fancy hotel, whose owner gives PCV’s discounts and free access to the pool. Venchele took me on a quick tour of nearby eateries and restaurants. Back at the PC house, we met up with one of Venchele’s good friends here, an Ag PCV. We all went out to lunch together, and ended up having delicious chebujen at a hole-in-the-wall eatery. Soon after, Venchele and I took an Alhum back to the Koalack regional house for my last night of VV.

My thanks to Venchele for her incredible hospitality and support. She’s gone above and beyond to make sure that I had an enjoyable and informational stay. She’s also gone to great lengths to prepare for my arrival in village. I’m proud to call this formidable woman my friend.

End of PST self-evaluation

Beach (May 7^th 2014) 

Lessons Learned 

-Never depend on a single person for emotional support, never expect someone to be your sole source of knowledge. They won’t and can’t always be there for you, nor should they be.

-A teacher by any other name can still teach just as well. Prod to find out what people know, and show interest in whatever that is.

-Keep the professional and the personal separate—always in love, often in friendship.

-Don’t fret or fight over what you can’t control. But more often than not, you have options, you just haven’t found them or identified them as such yet.

-Listen to your gut, because it usually has something good to say.

-You’re in a new country, with new people, speaking a different language. Guard your soft and vulnerable spots; beware of easy intimacy; grant trust sparingly.

-When you feel flattered by someone, than they are usually flattering you.

-If you don’t talk, then you won’t speak Mandinka.

-All time is potential learning time.

-Know your limits, stretch them, and know when to let them be.

-Pace yourself, because the next two years will be a marathon. Treat yourself best of all.

-Your hut is your sanctuary. Treat, decorate, and use it as such.

-Remember that you’re here to work with the people, always with the people.

-Just because you don’t hear from people doesn’t mean that they don’t care and never think of you. But if you want to hear from them, call them.

-Set boundaries as needed for other people, before your own boundaries are infringed upon.

-Here in Senegal, you’re different, but not that different.

-People love to talk about themselves. Good thing you like to listen.

-You’ll need to learn some Wolof, so that you can at least yell at the Talibe when they throw rocks and dead sparrows at you.

-Don’t pretend you understand, because you’re never actually doing yourself any favors. Ask, ask, and ask again.

-You’re not stupid, you’ve only been here 9 weeks.

-Keep life new by doing new things everyday.

-First impressions are only first impressions; they don’t always give you a good idea of what the whole picture will look like some time from now.

-Check in, re-evaluate, and recalibrate constantly without any external prompting.

-Be brave, because there is no alternative.

-Keep your values and actions aligned.

-Set goals for yourself, and take deliberate steps towards them.

-Keep track of your accomplishments rather than your mistakes.

-Keep track of your spending.

-Small talk over ataaya is hugely important. Never underestimate it.

-Don’t compare yourself to others. It rarely gets you anywhere.

-When you succeed, your villagers succeed. On est ensemble. Remember that when people tease you for speaking such awful Mandinka.

On education and help in Senegal

CBT (2^nd of May)

I have moments when I feel as if the potential of young people in Senegal is being completely and utterly wasted.

During my counter-part workshop, I had an extensive conversation with a French elementary school principle posted in a Serere village near M’bour. During my Volunteer Visit to Dassalami Soce, Venchele and I had many a conversation about the French and Arabic schools in my village. During CBT, I’ve been able to make careful note of my host brothers and sisters’ activities. Together, these observations and conversations have started to give me a idea of the challenges facing the Senegalese educational system.

Parents in Senegal overwhelmingly choose to send their children to Arabic school over French schools. While attending Arabic schools may help shape children into virtuous human beings according to the Quran, they are inevitable dead-ends in terms of furthering children’s educations and bettering their career prospects. Sadly, even children who do initially attend a French school do not finish. Most drop out long before taking the BAC, especially girls. They are expected to help their mothers around the house, and those not married off by age 20 are few and far between.

There are moments when ever the best and brightest, those most likely to succeed, must set aside their dreams in order to meet their families’ more immediate needs. For instance, my language instructor says that he would love to go back to school; he’d want to be a doctor or an interpreter. But he can’t afford to be out of work, or to give up a secure job. Now, he has to take care of his entire extended family, and he’s pretty much alone in doing so.

He says that he is unflaggingly generous towards friends and family members, in both time and money. Even ex-girl friends, including those who have betrayed his trust, still call him for advice. And because he works for Peace Corps, people think he is a wealthy man.  Few, however, are ever generous in return. He says that he has only one friend in Gambia who has always come through for him.

Today found him critical of and disappointed by the people in his life. Like most Senegalese people, he deals with life’s downs through humor and immoderate amounts of teasing. Any signs of obvious frustration, particularly towards family members and close friends, is pretty rare in my experience.

I listen to him quietly, while my thoughts go haywire. They settle first on money matters. How could I help him? I can already imagine myself setting aside a monthly sum to send to him, or drawing funds out of my American bank, or even sending him money from the states 20 years down the line. Then, I wonder how someone so generous can be shown so little generosity in return. I see a tendency to accept kindness without reciprocating it in some of the new volunteers in my stage. It is definitely the source of many frustrations for me. In the end, however, I have to remind myself that there are many ways to be generous, and that I can’t possibly spend the next two years giving away my meager volunteer’s pay.  So for now, I’ll listen; later, I’ll go buy him a few of his favorite green apples.