Monday, November 10, 2008

Fund Peace...Not War!

A petition to increase funding for PC ...

MorePeaceCorps Petition to President-elect Obama!

With the election of Barack Obama as the 44th President of the UnitedStates, the National Peace Corps Association and its MorePeaceCorpscampaign has launched an on-line petition urging support for a bigger,better and bolder Peace Corps. The petition is addressed toPresident-elect Obama, and will be presented to the Obama transitionteam. We also plan to use the petition as a way of showing criticalstate and congressional district support during meetings in the comingmonths with Capitol Hill lawmakers.
The next six months mark a critical point for action on theMorePeaceCorps campaign. Get started RIGHT NOW by signing the petitionand getting at least ten other people you know (family members, friends,colleagues, etc.) to sign. You can also forward this petition to othersyou know overseas, as a demonstration of the global interest forMorePeaceCorps.
Take action right now, right here:

Instant access to the latest & most popular FREE games while you browse with the Games Toolbar - Download Now! Sue Forster-Cox, PhD, MPH, CHESAssociate ProfessorHealth Science Dept.New Mexico State UniversityPO Box 30001, MSC 3HLS1335 International Mall, #327Las Cruces, NM 88003-8001575-646-2183575-646-4343 (fax)
No exercise is better for the human heart than reaching down to lift up another person. Tim Russert

Wednesday, October 29, 2008

MOVIE Online!

Hello everyone,

Finally, the Peace Corps, SeneGAD and Peace Only Productions film, Elle Travaille, Elle Vit! (She Works, She Lives!) Check out the whole video at

This is the film I've been working to promote in Dakar that USAID/PAEM has picked up and I held a screening at the US embassy for. (I worked on the subtitles and am now in charge of its distribution in Senegal).

The other film we just finished, Tree Nurseries in the Sahel, should be uploaded sometime next week. Though that one does not have subtitles, the art and music are still fantastic!

Enjoy! And please, let me know what you all think and if you have any ideas about people who might be interested in obtaining a copy or showing it. And spread the link around! We want to maximize coverage.

Wednesday, October 1, 2008

Holly's Cause


Hello all!
So as many of you know, I have a Peace Corps Partnership project going right now to build two classrooms for the school in my village. I'm trying to finish raising funds by the beginning of November so we can start construction as soon as the rainy season is over. The project is a great cause, and every penny donated will go towards helping the students of Cour Bambey to be able to take pride in their school.
To donate, visit Please please please, forward this to any family and friends you think might be interested in donating.
For more information about the project or my village, feel free to email me at
Thanks so much!
Holly Packard

Monday, September 29, 2008


October 1, 2008

Dear Family and Friends,

Asalaamalekum! I hope this finds you happy and healthy. Since moving to Senegal in 2007, I have been performing my primary assignment as a rural health education volunteer, in Kanel, in the Matam region. I am also involved in many secondary projects, including SeneGAD, Peace Corps Senegal’s Gender and Development advocacy organization.

SeneGAD is a network of Peace Corps Volunteers (PCVs) (of which I am a board member), that develop resources and programming that emphasize gender equality. SeneGAD encourages volunteers to incorporate GAD work into all Peace Corps projects, including the Michele Sylvester Memorial Scholarship, women’s health and leadership conferences, and youth clubs. We hope that these events will inspire the participants, bring attention to issues of gender and development and provide a springboard for future SeneGAD efforts.

The Michele Sylvester Scholarship Fund was founded in 1993 in memory of former Peace Corps Senegal Volunteer Michele Sylvester, who was committed to girl’s education. Initially, the scholarship benefited two village-based girls, but thanks to generous donations and fundraising the number of recipients has increased to forty girls for the 2007-2008 school year. After receiving the 25,000 CFA ($50) scholarships, each girl is partnered with a PCV who mentors and follows the girl’s progress throughout the school term.

PCVs are also encouraged to start youth clubs, an opportunity to educate and empower young people in the community. Often, groups make and sell crafts, learn about proper hygiene and nutrition, or undergo leadership training. Above all, these groups offer a safe place to discuss the challenges of growing up in Senegal and inspire young people to be active citizens.

Every year, SeneGAD raises money through a semi-annual auction and rummage sale and yearlong calendar and cookbook sales. As part of this year’s effort to expand SeneGAD’s visibility and increase programming, we are seeking additional support from friends and family back home. For $50, you can reward a hardworking middle school girl with a Michele Sylvester scholarship; for $20, you can sponsor a youth club.

Please send contributions to:
Friends of Senegal and The Gambia, ATTN.: Daniel Theisen, SeneGAD, 428 Bowleys Quarters Road, Baltimore, MD 21220. Friends of Senegal and The Gambia will forward proceeds to SeneGAD.

If you know of any others who might be interested in SeneGAD's mission, please feel free to share this letter with them. If you have any questions please contact me at:, 221. 77.257.1479, or the SeneGAD representative: Awa Traoré, SeneGAD Advisor,, B.P. 299, Thies, Senegal, 221.77.654.16.53.

Thank you in advance for supporting SeneGAD, and helping us achieve our goals and aspirations for gender equality in Senegal. I wish you and your family continued peace and good health.


Caitlin Givens

Work pictures updated

I have updated the pictures in my Picasa web album called, Work!
To find my pictures go to the sidebar and find the links, then click on the one labeled
"Cait's Senegal Pics"

There are pictures of some of the cool work stuff that I've been busy with in Dakar over the past several weeks. Please take a look and enjoy! And be sure of course to check out Jac et le Takeifa, the cool band that we're working with. I know you will all really enjoy their music.
I hope to write a more substantial blog entry soon, I know these have been unsatisfying, but know that no news = good news, and that I'm as busy as can be and enjoying myself thoroughly.

Ramadan ends this week, and then as soon as this next film screening is over I am FINALLY making the trek back up to the desert (until the first week of november when I have to come back down to Dakar. Sigh.) I can't wait to see my family and friends at site. I'm beginning to wonder if all of the baby clothes I brought back (thanks mom) will even fit the right babies anymore?

Film Screening #2 October 7th

Peace Only Productions, SeneGAD, and PEACE CORPS Senegal


Tuesday October 7th, 2008
3 pm
American Center, Mbacke Building, Dakar

Please come join us for the screening of Elle Travaille, Elle Vit! (She Works, She Lives!). Produced, directed, and edited by Peace Corps volunteers with funds from the US Embassy and SeneGAD.

She Works, She Lives! is a documentary that explores the role of women in Senegalese society and highlights the importance of girl’s education in particular. Each of the five women interviewed for the film come from diverse backgrounds and followed distinct paths to get to where they are today. Some of them come from small villages while others come from urban environments, some from supportive families and others from less supportive families. But at some point in their lives, each of these five women realized that she had the potential to be more and to achieve more than what was expected of her. This documentary looks at the histories of these inspiring women, the feelings they have about their work and their upbringing, and their hopes for the future of Senegalese women.

Concessions will be available. Donations to SeneGAD are welcome.

Sunday, September 21, 2008

Film screening Sunday September 28th

Peace Only Productions, SeneGAD and Peace Corps Senegal



Sunday, September 28th 2008
7:30 pm
Club Atlantique

Please come join us for the screening of Elle Travaille, Elle Vit! (She Works, She Lives!). Produced, directed, and edited by Peace Corps volunteers with funds from the US Embassy and SeneGAD.

She Works, She Lives! is a documentary that explores the role of women in Senegalese society and highlights the importance of girl’s education in particular. Each of the five women interviewed for the film come from diverse backgrounds and followed distinct paths to get to where they are today. Some of them come from small villages while others come from urban environments, some from supportive families and others from less supportive families. But at some point in their lives, each of these five women realized that she had the potential to be more and to achieve more than what was expected of her. This documentary looks at the histories of these inspiring women, the feelings they have about their work and their upbringing, and their hopes for the future of Senegalese women.

Following the film, there will be a brief Q&A session with the director, PCV Barry Pousman. Concessions will be available for purchase. Donations to SeneGAD are welcome.

Saturday, September 20, 2008

I'm sorry it has been so long!!

Hello everyone,

I just wanted to drop a quick note to say that I am so sorry I have neglected my blog for so long. I have heard from some of you who are very disappointed that I haven't written in 3 months! (Yikes!) I thank you all for being such avid readers though and for caring so much about my adventures! Unfortunately, this is just a little note saying that I am fine and that I am simply too busy to write these days! My to-do list is longer than my arm, and my blog has to be pushed to the bottom of that list because I've got deadlines. Sorry.


I am doing very well adjusting back to Senegal. I am currently working on some exciting film projects in Dakar (as a producer!) and have received a Fulbright-Hays Grant from the US Embassy for this current film that I was invited to produce for fellow PCV (and director) Barry Pousman. It is a tree-nursery making guide for school children. (See the website below!)

I am now the Director of Public Relations for his production company, Peace Only Productions, Check out our current projects! We have our first public screening next week of our documentary Elle Travaille, Elle Vit! (She Works, She Lives!). I'm coordinating the whole event at the Club Atlantique in Dakar, which has proved to be a huge undertaking, with lots of embassy staff, RPCVs, and NGO reps, in attendance.

I am also applying for another grant and holding a Girls' Health and Leadership Conference in November with 60 invited participants from various middle schools in the region.

I am doing a zillion other things that I am just as excited about and am LOVING being so busy. I had no idea I would love PR work so much. I've found a love of the administrative side and it feels great to be so busy again.

I do miss you all dearly and it was wonderful to be home for so long and to see so many friends and family (however briefly). The months are going quickly and my service is up April 13th 2009, so only about seven more months. I cant believe it. It has absolutely flown by.

I promise promise promise to try and write a real entry soon.

Monday, June 16, 2008

The Flood

The Flood
Why I now know for a fact that scorpions really can climb walls
How I almost got electrocuted

I am sitting in my hut. It’s 11:38 am and I am cold because it is only a fabulous 82 degrees. How is that possible you might ask? After all, it is June 16th and I live in the Sahel desert. Well, rainy season has officially begun and last night we had a downpour to be remembered. Around 3:30 am I woke up with a start as I usually do when the wind picks up. I sat up wondering, “okay, is this a sand storm? Wind only? Sand and rain? Or just rain?” Since I never really know, I have fashioned my bed so that I can literally take down my net, fold up my foam pad and haul inside in 10 seconds or less. You have to. Because at night, when you can’t see the ominous black cloud of a sand storm, or the rolling gray clouds of a rainstorm you have to be ready for anything.

Despite the almost full moon, the sky was pitch black, and I couldn’t see a single star. I could tell the clouds were rolling in fast though. Then the lightning started. There was so much lightening at times it looked like daytime. So I got inside just in time for the golf ball sized raindrops to start thundering down on my tin roof (in case you’re wondering, yes, it’s very noisy). I set up my bed inside on the floor and fashioned my net back up in some awkward but functional manner. We don’t really have many mosquitoes yet because there have only been a few sparse rains, and there are screens on my hut doors, but I use the net mostly for protection from other bugs. I delude myself into thinking that it will also keep me from spooning with scorpions.

I put cups around my room to catch the biggest leaks and nodded off to sleep reveling in the glorious cold wind that was blowing in my open back door. I have learned to fall asleep through almost anything so the ridiculously loud storm was actually kind of soothing.

Around 5:30am I woke up annoyed because I was being splashed. I thought maybe the leak had moved and was hitting me directly in the face.


It took me a few seconds to realize that my entire foam mattress was soaked through and I was literally laying in about an inch of water! The water splashing on me was splashing up from the lake that was now my floor. And there I was, sleeping right in the middle of it.

Since the power was out (Alhamdoulilah…more on that in a second) I flipped on my headlamp and went out to my douche to investigate how so much water could have possibly flooded my room so quickly. It was pouring in from outside, high enough so that the small cement lip from my douche to my room was like a breached levee. The water in my douche was ankle deep. I waded around in it, tried bailing some of it out down into my pit latrine. Then I realized that wading around in dark water with my history of scorpion visitors and toads, during a lightning storm was probably not the wisest of ideas.

I went back inside and used my two foam pad mattresses as sand bags because luckily the water had not yet reached anything valuable: my clothes, or computer, or flute or papers etc. All of which I keep in metal trunks and elevated so there really was no worry there.

Water was coming in from everywhere though. It was literally leaking through my walls and down from the side of my roof, from the douche and from the leaks. But here is the scary part (Mom—skip to the next paragraph). Often it’s really hot in my room during rainstorms so I like to turn on my standing fan. Since the power usually goes out during storms I’m in the habit of plugging it in and leaving the button pushed in so that as soon as the electricity kicks back on I have a nice breeze to sleep to. Well, when I woke up, the cord to my fan was submerged in about an inch of water. And since I was also laying in the same water….well, you can figure out what would have happened if the power had come back on….
Just gives me the chills thinkin’ about it.

Not really knowing what to do, I waded my way through the mud to my family’s house and knocked on the door. My mom and niece Faama came to investigate. They made some disapproving noises, agreed that all my valuables were safe and told me we’d just deal with it in the morning. I spent the next 2 hours trying to sleep with my family in the big room of their house while my little brother snored, my niece kicked, and my dad prayed.
Yeah, that didn’t happen.

At first light I ventured into my room to assess the damage. The wall to the outside, facing the wind and storm was soaked through. My mattresses were sopping wet and heavy, but luckily there was no damage to my stuff at least. My douche still had a good two inches of water. I started the mind-numbing task of sweeping the water out of my room, with a straw hand broom, setting my mats out to dry, and draining my douche. Luckily my little nieces and nephews woke up early and came to my rescue. Kids here are so awesome like that. They are so eager to be a part of anything that I literally didn’t have to do any of the work. They swept out all the water, helped me hang stuff out to dry, and drained my douche, all the while telling me “hey Binta, stop it, get out of the way, don’t do that, let me.” So awesome. My contribution was to make jokes about swimming in our new lake while making fake swimming motions, and perhaps going for a boat ride around our now totally flooded neighborhood.

So remember how I had been wading around in the water that night cracking jokes to myself about floating scorpions? Well, guess what? Yep. Found one. And it was very much alive, yellow, the size of my hand, with a black tail, and inches from my face! I didn’t even notice the d*** thing! I was so focused on sweeping the water out of my douche through this dumb little hole that it wasn’t until my niece screamed SCORPION! And pulled me back that I looked up and there it was, on the wall hovering just above the very hole I was sweeping water out of. Perfectly placed to strike me on my face or hand. Nice.
That’s 2x lucky in one day.

Now, to be fair, we did get a TON of water last night. 115 milimeters! Which is crazy talk for the desert. But the reason why my room flooded was because my family is building a new room onto their house and there is a HUGE pile of sand pushed flush up against my douche. So the hole in the wall that usually allows the rainwater drain to the outside was totally blocked up. No water could get through so it accumulated until it was higher than the lip of my room and then flowed in freely. That along with the leaking tin roof and the sopping wet walls meant a flooded hut.

I was mildly annoyed with my flooding until I took a look around our neighborhood and assessed the real damage. People’s homes actually collapsed, boutiques were flooded and all of their goods ruined, another boutique collapsed and all of the dirt paths are now rivers of filthy stinky water. The huge lake that has accumulated in the trash field next to my house is threatening to engulf the entirety of the 3 squatter houses in the field next door.
(See pictures from my newest album “Rain!”)

As a health volunteer I am absolutely dreading the consequences of this monsoon. That field, is full of trash, animal and human feces, animal corpses, bugs, filth, toads, schistosomiasis, and who knows what else. And what was the first thing I saw? Can you guess? Children swimming in it. Luckily my family and most people know that this is just horrible so Binta’s husband (who has now moved back from Dakar) screamed at them to get out. If I see them in it again I am going to go talk to their mother and explain to her why it is absolutely one hundred percent unacceptable to let her children near that water. But it’s going to be difficult considering it’s literally at their front door. And well, it’s the closest thing they have to a pool. But I know they will be washing their clothes in it, and probably using it to wash their dishes too.

What I’m waiting for is a cholera epidemic, and if not that dramatic than at least an incredibly high incidence of malaria in our neighborhood. Uhg. People better start using their mosquito nets again immediately. They tend to stop sleeping under them during the hot season claiming that “there aren’t any mosquitoes” or “The nets are too hot.” Which are both ridiculous excuses, but so prevalent from about April through June. Of course last year my 7 year old nephew did get malaria during said hot season, but you know, whatever, God brought that right? It had nothing to do with the fact that there’s MALARIA and he wasn’t sleeping under a net? Nope. Of course not. That’s crazy talk.

It’s not that I get angry, I just care so much about everyone in my town. It literally is like having 10,000 children. Or at least several hundred, because I have the know-how, the motivation, and it’s my job to educate people about how they can stay healthy. So when big obstacles like this stand in my way, my anxiety level skyrockets (which makes my ears ring uncontrollably I’ve discovered ever since the ear infection) and I fret constantly.

The day is heating up fast though, so maybe most of the shallow puddles will have dried up by the end of the day and the rain will stay away for a little while. In the time it took me to write this entry, it’s already shot up 5 degrees.

Stuff I have learned because of this flood:
Don’t leave electrical appliances plugged in and on in hopes of a cooler night’s sleep.
Keep all baggage elevated and in impenetrable containers
Children make great house keepers
Flooding your room is a great way to evacuate all bugs, lizards, and scorpions from the premises.
Not only can scorpions climb walls, they can apparently float.
I am lucky that nothing was damaged, and there is always someone worse off.
Now I know exactly how cholera and malaria epidemics begin.
The hundreds of toads now accumulated around our lake of trash are the loudest SOBs I’ve ever heard.

Here’s hoping when I’m home for vacation that the monsoon of the century doesn’t occur. I don’t think my little hut could take any more.

Tuesday, June 3, 2008



Finally, after over 4 weeks in Dakar and 5 weeks away from site, my ears are pretty much completely healed. The ringing has stopped almost entirely, (at least enough so that I don’t notice it most of the time), and the pain is gone. I can still tune into the ringing at night, and if it’s really quiet I can tune in during the day. The official term is Tinnitus. I’ve done some research and it can be caused by inner ear infections. So this whole thing wasn’t totally uncommon or out of the ordinary. It happens to people all the time. I just hope that eventually my ears heal enough that it stops entirely. Fingers crossed.

Loud noises still bother me a lot more than normal, and so do some vibrations, like when trucks pass by. I had a CT scan and everything is totally normal, and the ENT did a hearing test and I am happy to report that I still have perfect hearing so no permanent damage Alhamdoulilah! His theory about why my ears aren’t back to normal? Stress. For which he prescribed me vitamins to help me sleep. Hmm. I disagree. I think it has much more to do with the fact that my immune system was shot after I had amoebas and other GI illnesses, and constant congestion/allergies from the desert that it literally took an entire month of intense rest to recover from what normally would have taken about a week. Though there may be some truth to his theory because the ringing is noticeably louder when I am over tired, or anxious.

I got off medical hold this week, but then stayed around in Dakar for a conference and am currently helping to translate a documentary that our Peace Corps GAD committee is producing (more on that later). Then it’s up north for a regional retreat for the new volunteers who have installed in our region and THEN it’s back to site. I have been away for SO long, I can’t wait to get back. I really miss my family, my work, and my routine. I have missed the entire month of May. Granted it is the hottest month of the year so it’s not the worst thing ever to have missed out on the desert heat for a bit. I have kept myself occupied by translating our radio show skits from Pulaar into English and soon to be into French, so that we can begin a huge health volunteer resource library. And now I am working on this documentary about women’s empowerment.

What baffled me about this whole process though is just how incredibly long it took me to recover. I’m hoping that it will just take a little longer and soon my ears will be as they were before. So for those of you who have been fretting about my health and well-being, Thanks. I’m really okay and doing everything I can to heal myself entirely.

P.S. A cockroach just ran over my computer screen as I’m uploading this at the internet café. I’m pretty sure it actually came out of my bag. Yum.

Tuesday, May 13, 2008

Med update

It’s been 2 weeks since I went to the regional house to recover from my ear infections and I’m still in Dakar. The pain in my ears is gone (mostly, except for painful pangs now and then), but the ringing hasn’t stopped and I’m really sensitive to loud noises and some vibrations. I’m due back to the Ear Nose and Throat Doctor tomorrow for a check-up. It’s possible that the ringing will eventually just fade away. Fingers crossed. But for the time being it’s just a really subtle high pitched constant ringing (sort of like how your ears feel after going to a loud concert). Some sounds are painful and make me cringe a bit, but other than that I’m back to normal. I’ll be in Dakar until the end of the week for my mid-service medical exam and then it’s back up to site finally (inchallah!). Because of the trauma to my ear drums though I may now be more susceptible to infection so I may be put on some kind of allergy medicine for the remainder of my service to keep the congestion down and the infections away. Anyway, I just wanted to post an update because I got a lot of concerned messages from people after my last post and I wanted to let you all know how I was doing. So thanks for the concern. After a nice long rest down in the lovely eternal springtime weather of Dakar I’m doing much better.

I’m still just hoping the ringing in my head will stop.

Tuesday, May 6, 2008

Ill health

I’ve been sick with various illnesses on and off for about the past 3 months. Nothing majorly serious, but the anxiety that comes along with being really ill, weak, dehydrated, uncomfortable, in sweltering heat, and so far from medical care makes even the mildest discomforts terrifying.

It started with the amoebas in February and then various other GI tract stuff, and now a full head double ear, soar throat, sinus infection that knocked me out and had me sent to the regional house on PC medical orders, with threats of a trip to Dakar.

I don’t think I paid enough attention to my health and my compromised immune system during and after I had amoebas which was why this last head infection got so out of control so fast. Under normal circumstances if I was healthier, eating better food, not physically exhausted and living in 120 degree heat, I probably wouldn’t have given ita second thought and fought it off within a day or two.


As soon as I was done with my last regional house quarantine (beginning of April), I went straight to help with training and then came up with new trainees for ten days where I played hostess to the 6 of them and got sick again immediately afterwards.

It started as a very painful sore throat and figuring I just needed to rest, I gave it the weekend. But by Monday morning I could barely talk and had white spots and infected tonsils so I called med, and was started on heavy antibiotics with instructions to rest and pleas from PC med to get to the regional house, to which I replied, “no, I have a lot of work to do” trying to make up for the 10 day hold I put on my work in order to help with training. But that night I was awake half the night with horrible ear pain and was essentially deaf in one ear. Great. So I doped up on decongestants hoping it would unplug with enough Sudafed and spent the day doing our radio show, being miserable, doped up on cold medicine and antibiotics.

Woke up the second night in excruciating pain in my ear neck and jaw and my ear draining fluid slowly all night long. Called med first thing in the morning and was told to get immediately to the pharmacy to buy a different anti-biotic and get to the regional house asap, and be on hold for a trip to Dakar.

I told myself I just had to get through my work for that day (2 important meetings I had been waiting a long time for) and could head to the regional house the next day. I went to the pharmacy first thing in the morning to buy the Augmentin only to discover that my town’s pharmacy was closed. Why? Because it just so happened that that day, all PRIVATE (yes, private, you read that correctly) pharmacies were striking. What were they striking against? For? I have no idea. They are a private business, how can they possible strike? The majority of their owners probably didn’t know either, they just heard the radio announcement.

Now if the public pharmacies at the health posts were worth anything this wouldn’t be such a problem. But they are stocked with almost nothing. I went to one at a regional hospital and all they had was painkillers. They didn’t even sell antiseptic or gauze. Private pharmacies are really the only option.

While I was standing there one of the midwives from the health post came over and asked the pharmacist to open up and sell meds to her sick patient, but he refused. I hoped there were no births that day, because the posts don’t have their own supplies, patients have to have friends or family go next door and buy everything they need including: IV catheters, gauze, etc. As my teacher friend said, “some people will probably die today because of this private pharmacy strike.”

I know we complain about our health care system in America all the time, and it’s the subject of all of our favorite academic journals, but you know what, we’re pretty damn lucky if you ask me.

Walking away from the pharmacy, I was in total disbelief and feeling weak, and miserable but trudged through my first meeting and collapsed during the afternoon in my family’s house. Within 3 hours my other ear also plugged and was painfully pulsing. I was out of ibuprofen and still on the wrong antibiotics. I was so dizzy and off balance that I could barely walk. It was 115 degrees and I was miserable, in SO much pain and getting scared with how rapidly it was progressing. I called med in tears from the pain and got my closest neighbor (in the regional capital) to find an open pharmacy and buy my antibiotics, meet up with me in our nearest town that afternoon and bail with me to the regional house in the evening. This meant driving after dark, but it was so worth it.

As soon as I was on my way and met up with her and had the correct anti-biotics and Ibuprofen in my system, my anxiety started to melt away. Though the 7 hours it took to get to the house were miserable (waiting at the garage for 4 hours for the car to fill up) and then the drive, being in a cooler climate (it’s 200k West) with the comforts of the house, were totally worth it. Med called me first thing in the morning and tried to convince me to go to Dakar that day so that I could see an EMT the next day, to rule out permanent ear damage. I asked to hold off a few days, as I was feeling a bit better, and thought that getting in a car in the heat for a minimum 9 hour haul would make things even worse. So we agreed that I would be aggressive with the pain meds, the anti-biotics and hot compresses all over my head and we’d see how I was at the end of the weekend.

I spent those few days at the house laying around with hot compresses, sucking down soup and tea (still had the sore throat) and trying not to fall over (from dizziness and no balance cuz of blocked ears). By the weekend if I was not seeing significant improvement I had to get in a car to Dakar to see an EMT.

A few days later the pain was mostly gone, but the ringing in my ears was making me crazy and they were still plugged up, but not draining. The worrying part for me is that our PC med officer was concerned about permanent hearing loss/damage.

The whole thing just got so out of hand so quickly. It was like I had no immune system to fight off the infection. And I guess that makes sense because I never really got a chance to “catch up” before I took off working again. That, and I’m sure the dusty, windy, hot desert climate wasn’t helping my respiratory system much.

So on the weekend I hauled down to Dakar, and I now have to spend over a week here, waiting to make sure I get totally better. I went to see an ear nose and throat embassy doctor specialist who was wonderful and very nice. I am now on heavy antibiotics, steroids, and various nasal sprays and eardrops. My ears are still ringing, and sounds are muffled. Most of the pain is gone, but it comes once in awhile in horrible pangs. Yuck. I’m so frustrated and tired of being ill. It’s maddening to have to stay here when I have so much work that I want to get done in my town. But I’m going to be aggressive about getting rest and I want to get totally better. PC med is forcing me not to go back. My old self, (when I had an immune system that was worth anything) would just have pushed through it and gone back to site and kept on working, but I have had it with not feeling 100% and I think aggressive resting is the key. So I’m following up with the Dr. on Monday and I really hope the ringing, pain, and inflammation is gone by then. It’s starting to make me a little batty.

In any case, the whole thing was/is a little scary. Not because I ever felt like my life was in danger, but just because I felt so vulnerable and uncomfortable and without resources to make me feel better. So now I’m just waiting to see if the damn ringing in my ears will go away. I hope so, because it’s driving me slightly batty.

I now know to be more aggressive about my health and give myself greater windows for rest and recovery. And that even though it’s a haul, it is worth the trip to the house/Dakar just to get away and take the time to be healthy. Because as I’m always telling my elementary classes, if you don’t have your health, you don’t have anything.

My new goal is to stay healthy for the next two months until I can get back to America and have a month of R&R. It’s kind of a sobering thing to realize that I’m not invincible and that a hit to the immune system is something to take seriously when you’re living out here isolated and under rough conditions. Maybe I’ve just gotten so used to never feeling 100% that I’ve gotten lax and forget how hard on your system living the way we do really can be? Or maybe it’s just a fluke, but either way I’m going to be much more careful from now on…and cross my fingers that I don’t have permanent ear damage.

That, and thank my lucky stars that I have access to a proper, alternative form of medical care.

Tuesday, April 29, 2008

It's really hot.

The hotness.

It is so hot.
It is so hot that…

My bar soap has liquefied.
My hut is a boulangerie.
My bucket water is too hot to wash my hands with (one of my trainees actually burned herself when using the loo).
I have visions of jumping into my family’s freezer.
The egg that broke in the plastic bag cooked slightly while in my purse.
You can’t touch anything metal.
Children can no longer go barefoot.
I wake up at midnight in a puddle of my own sweat.
I’m drinking almost 3 gallons (yes, gallons) of water every 24 hours.
We are making applesauce in a Nalgene bottle using only sunlight.
The World Meteorological Organization said that “ for the week of March 21st, Matam, Senegal (next to me) was the hottest place IN THE WORLD).
I’m looking forward to frying an egg on the concrete in my shower.
I daydream about instigating mass migration to the coast.

And finally…

My thermometer read 136 F at 4pm yesterday (in the sun) and it’s only the end of April. In case you’re wondering, May is the hottest month, which means that yes, it will actually get hotter.

As a COSing volunteer recently texted me,
“This place is so hot it doesn’t deserve to be inhabited.”
I agree.

New trainees

After almost a year at site and adjusting to solitude, this past month I’ve been around people nonstop. Immediately after Amanda’s 12-day visit, I was supposed to host a study abroad student at site. But because I was so ill I couldn’t leave the regional house (literally couldn’t be away from a toilet for more than 30 minutes…gross right?). I was with volunteers most of that week and then went straight to Thies to help with the training of the newest group of trainees the following week. Then I rode back up with them after several days and hosted them at my site for 10 days of “Demystification” or what is now called Community Based Training. They took language classes, shadowed my work, saw the schools, dipped mosquito nets, helped in a garden, and basically were exposed to all the elements of life as a PCV.

It’s so strange to feel like the seasoned, experienced volunteer when I still feel so unsure and infantile sometimes. I cannot believe how quickly the past 13 months has gone by! I’m already starting to plan my next step post-Senegal. I wonder now if the other volunteers felt that way when I came in last year?

It feels great to be able to talk endlessly about my experience though. The trainees have endless questions and it’s so encouraging to hear myself talk about my work, my family, my community, and all the little mishaps and hiccups I’ve been through that seemed so horrible at the time but that now just don’t even phase me. And their energy has fueled me. They are fresh and have new ideas and come with all different skills, and experiences and I am learning from them just as much as they are learning from me. And they are opening my eyes to things in my own town that I either didn’t know or didn’t notice before.

I also realize how far I’ve come, and how much I have learned, about Senegal, about the Peace Corps, about myself, my community, and other volunteers. And how far my Pulaar has come! I had forgotten what it felt like to not be able to communicate beyond the simplest greetings. I had forgotten the tears, and frustrations I went through in language training. With the newbies here I have realized how much I’ve grown and how invaluable this experience has been. I feel so proud of myself, for getting this far, for surviving, and well, for really doing pretty well. And of course I’m sure that I will not truly realize how much I’ve changed until it’s over and I am in another job, community, and country.

It feels good to be able to lead the new trainees through what can be such a scary and uncertain first experience at site. This new stage is just wonderful. They seem to be so relaxed and flexible and willing to jump into anything and go with the flow. My group of trainees are just the best! (Yes, I do hope they read this and smile). I’m so impressed with how they take the heat and the discomforts in stride. I mean, there are 6 of them (plus a trainer) staying in my compound and my tiny “boulangerie” of a hut (as the trainer nicknamed it). The heat is stifling (mid-130s in the direct sunlight, about 118 in the shade), and they are just learning the language. They seem to really already understand the value of a smile and the ability to laugh off minor annoyances. And while I know how tired they are they are making valiant efforts to practice their Pulaar as much as possible and integrate and spend time with my family and friends even though they’re exhausted.

I feel as if I’ve known them all forever. I guess that’s the nature of the Peace Corps though. You are thrown into such an intense experience with strangers and expected to become instant friends/family, and you do. You really only have each other to rely on. While there are others at home to provide a listening ear to cry to, at the end of the day, your site neighbors, and your stage mates are your best support network and no one will truly be able to understand the challenges we go through unless they too have been through it.

I think that this is my worst fear/anxiety. That even though I have such a supportive community of family and friends at home, that I will always feel slightly misunderstood, or that I will never fully be able to share the profound impact the Peace Corps has had upon me. And I need to accept the fact that I probably won’t. Maybe this has been on my mind a lot more because I have been surrounded by others, but I think it’s more likely that I am getting close to my vacation at home and I’m starting to get nervous about it, about being home, and the reverse culture shock. At the same time, I’m worried about having NOT changed enough. Like I’m holding myself to too high of a standard.

Maybe I just have too much time to think.

It feels great to be starting a new chapter of my service. It’s exciting that part of that new chapter is helping other volunteers find their way and embark on their own “toughest challenge they’ll ever love.” I’m still thrilled that I have.

Saturday, April 12, 2008

Links to Amanda's Photos

Here is the link to my most recent visitor's pictures from her trip. Amanda's photos are mostly the same as mine, but her captions are hilarious. (She is much wittier than I). Check them out and enjoy!

Senegalese Doula!

I finally got to be a doula in Senegal!

It was so wonderful to attend/help with a birth that wasn’t on the side of the road, and that was carried out under the supervision of skilled medical professionals. There was so much less pressure on me, and so much less anxiety.

One of the women from my mother’s group, Hawa, was very pregnant at our last meeting. She stuck around after the lesson was over and we talked about her upcoming birth and my sister brought up the fact that I had been a doula in America. Hawa’s eyes lit up and she asked me somewhat jokingly if I’d be willing to help her through her birth when the time came. I said of course and told her very seriously that she MUST call me, at any hour of day or night and I would come running and escort her to the health post and stay with her throughout the entire birth. I wasn’t sure if she would call, but I really hoped that she would.

6am on one of the 3 days that my visitor was in my town, I got the call.

The two of us threw on clothes and sprinted out the door to her house. We met her on the road to the health post. She told me she had been having labor pains for roughly three days but they were now getting much more intense and she knew the baby was coming soon. (This was her 4th). She and I and Amanda (my guest from home) and Hawa’s friend and fellow group member, Mairam, all walked the 10 minutes along the dirt path to the health post in total silence with her. I held her hand and offered my arm as support when the contractions came and she had to stop and breath or lean against a wall.

Now in Pulaar culture (not sure if this is true of all of Senegal) women are expected to give birth silently. Crying, or yelling is seen as a sign of weakness.

So the majority of the walk we spent in silence, Amanda and I flanking Hawa with Mairam walking alongside, silently mumbling her morning prayers. Not once did Hawa cry out, she just whimpered softly to herself. I mentally timed the frequency of her contractions by noticing her face and the few times when she paused to rest because the pain was too intense to walk through.

What struck me most was the power and the intensity of the intimacy I felt among these women. I was reminded of the book The Red Tent (see PC reading list) and the cherished moments, and secrets the women shared under the tent.

I thought about this shared bond, the work ahead of us, and the strength of this courageous woman who was about to bring her baby into the world. I felt reverence for Hawa, for all mothers, for women, for the gift of a womb, and for that private moment that the four of us shared-two young single American women, and two older, Senegalese, Pulaar mothers, walking silently, arm in arm down the quiet sandy streets in the early morning light, before the heat of the day. Them in their traditional Senegalese dress and head scarves, and us in our t-shirts and long skirts.

I don’t remember feeling anxious. I felt secure, confident, slightly hurried, but mostly honored. I was honored that she trusted me so openly to accompany her and attend to her through this difficult and frightening journey.

I was pleased to find that the midwife on duty was my friend. One of the ones I liked the most. She had helped my counterpart give birth and I knew we were in capable hands (as capable as can be for such a basic maternity ward).

My thoughts were going a mile a minute. I was trying to notice every detail but simultaneously give Hawa all of my attention. Here I was finally getting a glimpse into the “quality of care” that I had studied at LSE in my reproductive health course. I didn’t want to miss anything. Granted I’ve seen quite a lot just by hanging around the health post, but this was the first time I would have the chance to see the whole process up close.

I remember feeling relieved that it was so early and that it wasn’t a busy vaccination day. The health post was practically empty which would mean some privacy. The midwife, Nabou, told Hawa to get up on the exam table (in the first room where the registration desk is). She sat at the desk and filled out some paperwork while I helped Hawa lay down. Nabou examined her briefly, and felt her belly, which was visibly pulsating with every contration. To hear the baby’s heartbeat Nabou used a funnel pressed flush up against Hawa’s belly and her ear at the other end. She asked how long Hawa had been in labor and when Hawa said three days, Nabou scoffed and asked her why she hadn’t already stopped by for treatment. Hawa corrected her saying that she had and that they had given her a prescription (for what I’m not sure) and had told her to come back when the contractions were closer together. Then we moved her into the delivery room.

It’s a dirty, stifling hot room with a back door, a sink, and two very basic, very dusty padded, metal tables with stirrups. Mairam was sent to the pharmacy with a list of things that she had to buy for Hawa: gloves, tubing, a syringe, a bag of glucose for an IV drip, gauze pads, and various medicines that I did not recognize. I learned that you really have to have someone, often several people to accompany you and help you at the health post. I learned that if you don’t have the money for the necessary supplies, the health post will pay for the medicines and you just have to pay them back. I was actually pleasantly surprised by that.

To get the money Mairam first had to go back to Hawa’s house and then to the pharmacy. I practically had to bite my lips off to keep from offering to pay for everything. I knew that she could get the money, I just had to be patient. Also, that would start a terrible trend and I could envision the line of women coming to me for money when they had to go to the health post. I told myself that it was enough that I was there with her, and that if I hadn’t been no one else would be. I discovered later that typically they don’t allow anyone else in the delivery room and that they made an exception because, well….I’m a toubak, and they knew I had had some experience, and mostly because the midwife was a friend of mine. That and I’m sure they knew me well enough by now to know that if they had tried to kick me out, I would have pitched a fit and stayed anyway.

Mairam was gone for about thirty minutes during which time Nabou was getting terribly impatient and kept yelling at Hawa for Mairam’s slow pace. I went outside and told Hawa’s aunt and my sister (who had both showed up at that point) to bring cloths and fabric to wrap her and the baby up in afterwards, and sheets to lay on the post-partum bed. Meanwhile Nabou was getting things ready in the delivery room. Washing up, setting up the IV drip, etc. I was focused on Hawa and helping her through each contraction which were getting more and more severe and coming about every minute by that point. She vomited once, and luckily I was there because I got her the trashcan in time. (I’m sure she would have been yelled at had she vomited on the ground). I mostly just stood by her, holding her hands, giving her my body to hold onto, cooing to her that her body was strong, her baby would soon be in her arms, and that even though she was tired it would all soon be over and she would be able to rest. The only thing I could think to do to make her more comfortable was to wet a packet of tissues from my purse with the ice water Amanda and I brought with us and hold it on Hawa’s forehead. She kept telling me how tired she was. She never complained about the pain, only how tired her body was. She continued to let out long sighs and whimpers, calling quietly to “Nenam” meaning, “my mother.” It surprised me that she did not call out to Allah, but to some other grand feminine force. I remember thinking how beautiful that was and realizing that birth really does connect all women.

It was definitely a challenge to try and coach and soothe her in Pulaar, but I did my best and I remembered that it didn’t really matter what I said as long as it was soothing and repetitive. I settled on telling her that she was strong, she could do this, to breathe and that soon her baby would be in her arms.

(I also realized in that moment that this was now the fourth birth I had ever attended, and that none of them had been in my native language! The two in the states were in Spanish, and then these two in Pulaar. I sighed to myself and thought about what a relief it would finally be when I could be a doula in English!)

Nabou set up the IV and now there were roughly three other midwives bustling about, chatting amongst themselves and getting things ready. There was a lot of activity for such a tiny room and it was a struggle to keep Hawa focused and for myself to try and ignore the midwives and focus only on Hawa.

As the contractions came closer together and more severe, Hawa did start to cry out some. I didn’t even think anything of it, but one of the midwives came over and scolded her. Saying that she needed to stop crying because people outside could hear her! I was appalled. But I kept my mouth shut because I didn’t want to risk being asked to leave. The midwives explained to me that they gave Hawa Pitocin to increase the contractions, saying that the baby was tired and so was she and they needed to get the baby out right away. The baby was nearly crowning when one of the assistants starting violently shoving on Hawa’s stomach. Now I’ve heard of this before when the mother is tired, but it looked incredibly painful and they certainly weren’t timing the pushes with the contractions. They kept yelling at her to push even in between contractions, and Nabou was scolding her for not keeping her legs open enough. I felt so helpless and wanted to be in 3 places at once, to hold her legs, and simultaneously be at her head to hold her hands. Nabou kept yelling at her to push even between the contractions (which is pretty much counterproductive and a waste of energy). Hawa was definitely crying out at this point and so overwhelmed by all the different directions and things happening to her. Finally the baby was crowning and instead of having the head come out in one contraction and then waiting for the next one to ease the body out, Nabou pulled him out in one go, with one massive yell from Hawa.

The moment he was born and I saw him I burst into tears. I looked over at Amanda (who had come in to watch during the last few minutes, her first birth ever!) and we were both teary eyed, she was trying so hard not to cry because I had told her it was culturally unacceptable, but I definitely couldn’t help it. With tears streaming down my cheeks I told Hawa it was all over, she had a healthy baby boy, that she did it, praise be to God, may her son be in health etc etc. Nabou smiled at my tears. She wrapped him up in a cloth and laid him on the next table over! Hawa didn’t even get to look at him! She put the vitamin K drops in his eyes to avoid infection, and then just left him there, alone on the table wrapped in a dirty cloth, with the hot sandy air and flies coming in the door. I asked if I could give the baby to Hawa and Nabou said no, that she knew that in America we put the baby immediately on the stomach, but here they waited until the mother was in the other room and cleaned up and resting. I couldn’t help but be angry and confused, with how nicely Nabou was speaking to me throughout the birth, and how mean and impatient she was with Hawa. As she worked to get the afterbirth out, Nabou yelled at Hawa repeatedly to open her legs and scoffed “oh come on, how many births is this for you? Open your legs, so I can finish.”

Hawa lost a lot of blood and was pretty disoriented. Nabou had to kneed her uterus to get the excess blood out and to get it to contract back up. I pointed out that getting her to breastfeed right away would help with that, and again offered to bring the baby over, but she refused. After Nabou finished cleaning her up, the other midwives came in and wrapped her up in cloths, scolding her (yet again) for not bringing a pair of red underwear (or any at all) to act as a diaper to stuff the fabric into. They made do with the fabric she had brought and tied it in a diaper-like fashion around her, changed her clothes and we moved her into the next room to lay on the bed. Her aunt still hadn’t showed up with the sheets for the new bed, so she was yelled at again. At that point I had been over to pat the new baby boy and coo at him, and Amanda and I were the first ones he saw when he did finally open his eyes.

I helped lay Hawa down in the next room. And realizing that the baby was now ALONE in the delivery room and no one seemed to care, I yelled to the new midwife on duty (Nabou’s shift had ended by then, and she practically ran out of there) that I was bringing the baby to Hawa. She said fine and so I carried the little baby boy to her and laid him next to her to let her look at him for the first time, roughly 30 minutes after giving birth. She was so tired, and initially refused to, but I insisted that she breastfeed him and told the midwife to encourage her to also. I sat with her on the bed, watching and making sure he was latched on correctly, which he did almost instantly, with gusto! Amanda sat across from us on the next bed and we smiled at each other, both of us totally unable to process all that had just happened. Hawa’s aunt brought Hawa a steaming hot cup of coffee. I rolled my eyes and told her that she should also drink water if possible. (I know now that arguing over coffee is useless even though it’s crazy to me to want coffee over water after being so dehydrated, but that’s how it is here). At least she was breast feeding and was healthy. I sent Hawa’s aunt out to get her some ice water, to which she asked if it was okay that she drink cold water. I said of course, and then explained to her the importance of getting her hydrated (hence the IV drip) and why immediate breast-feeding was so crucial. She nodded her head and seemed enthusiastic about my help.

I asked Hawa what she was going to name him and she said she was disappointed it was not a girl because she would have named her Binta, but that she wanted to name him after my dad! Again I nearly cried and thought that perhaps Shel might be a difficult name for a Senegalese kid, so I settled on Barry. Senegalifrenchified it sounds like (MbaarY). She seemed happy with that so I’m expecting that will be the little guy’s second name. Children here are given several names so it will probably be used as a nickname mostly just by his mom. But now both my mom and dad have infant namesakes! Cool huh? I keep telling them that now they HAVE to come visit.

We sat with Hawa for another 20 minutes or so and at her urging left to go home and have our own breakfast. It was about 10am by that point and Amanda and I were both starting to feel pretty exhausted and dehydrated. So we made the windy, sandy, hot trek back to my house and sat down for coffee and muesli. My family was thrilled that we had both been there and gave us both all sorts of praise.

Around 11am I called my sister and asked if she had gone back to the health post. She said that no she hadn’t and that Hawa had been transported by ambulance to the next hospital and that there had been complications! I was so upset, and of course in Pulaar there aren’t sophisticated medical terms so all I knew was that she was “tired and missing blood.” I took that to mean that she hadn’t clotted properly and was still bleeding. Her whole family had raced to the next town to be with her so there was nothing Amanda and I could do but wait. We said we would call back in the afternoon and see how she was.

I fretted the entire time. We spent the day making doughnuts with my family for the little soirée we had planned that afternoon for Amanda’s last day, as a thank you for having her. But I was so distracted and anxiously awaited my sister’s phone call. Finally around 2pm I called and talked to Hawa’s husband who said that she was indeed better, but that she had to stay overnight and would be back tomorrow. I was relieved, but still anxious.

I told my Yaaye and she said something that almost made me cry. I told her how relieved and happy I was and how anxious I had been all day, and she just looked at me and said, “Binta I know. I could see it in your face all day. I knew you were scared and worried. I was watching you make doughnuts and you were so distracted and your face was pained. It’s because you are so good and you care so much about your family and your Senegalese family. I spoke to Binta earlier about how upset you were. We were all worried and now we can all be relieved together.” I almost hugged her. How wonderful that she knows me well enough to know what I’m feeling even better than I do!

So Hawa came home the next afternoon and is now healthy and happy. I am so disappointed though because I had to miss the baby’s baptism because I am sick with amoebas + some other horrible bacterial stomach infection + a head cold at the regional house. I could not even travel home and instead spent a week holed up at the house feverish, watching movies, eating soup, and running to the loo every 30 minutes. Yuck. I’m so bummed. I of course called to explain why I couldn’t be there, but it was really a big deal to me to be there, and if I possibly could have made the drive I would have, but it was out of the question to be away from a bathroom and on public transport for 4 hours. I plan on showering her with gifts when I do get back though.

But, my good friend Mairam, who is part of another family totally unrelated to me, and who are my dear dear friends, just called me to tell me that one of the women in her family gave birth to twin girls yesterday!! She was HUGE and I told her that she was having twins. Everyone thought I was crazy, but I insisted. Mairam told me that she is naming one of her girls after me! Hooray! My very first namesake. I’m so honored. But I’m irritated because I have to be down helping with the training for the new volunteers, and am AGAIN going to miss the baptism, but Mairam said that they would postpone it until I came back because they couldn’t imagine me missing it and they didn’t want to have it without me. What an honor. Especially, because it is so important in their culture to hold the Baptism on the seventh day.

These births (and my interaction with the breastfeeding mommy-see previous entry) have absolutely refueled me and helped me out of my mid-service slump. They’ve reminded me of the connections I’ve made in this community and that my work and my presence is valued and respected and needed.
And what an honor.
What an honor to be included and trusted in some of the most important moments of people’s lives.
I am so lucky.


I affected change!

I have concrete proof that something I did, something I taught, some piece of information I transferred actually produced results that improved someone’s health! It was one of the most inspiring, uplifting moments I’ve had in country.

About 2 months ago I was at my friend Mairam’s house and I met a woman with a brand new premature, very sickly looking baby. We talked about her baby being so skinny, and I asked if she was breast-feeding. She of course responded yes, and then she proudly mentioned that she was also feeding her cooking oil! (An unfortunately very common practice here). I told her very nicely that no, she did not need to give the baby oil, that the reason the baby was sick was because she was feeding her oil, and that all the baby needed was breastmilk. I explained to her what was in her breast milk and that it had all the sugar, and water, and vitamins and antibodies (‘the vitamins to kill germs’) that her baby needed. I didn’t think much of the interaction until I saw her again recently when Amanda and I went to greet that same family.

There she was with her baby. I asked to hold her and noticed that she looked a lot better! She had put on some weight, her eyes were tracking better, she seemed livelier and more alert. I told her mom that to which she responded, (to my extreme delight)…

“Well Binta, I stopped feeding her oil. I’m only giving her breastmilk now. Breastmilk ONLY. Just like you told me to!”

I almost burst into tears. I get goosebumps just thinking about it.

That I contributed to the health of her baby by giving her information, by taking five little minutes to just sit and speak with her nicely and give her a little advice, and not yell at her, and encourage her and tell her that she was a good mom….and to have her come back and to physically SEE the progress her baby has made and have her mom tell me that it was BECAUSE OF ME! I am over the moon about the whole thing.

There it is, everyone always says about development work that “if I can just help even 1 person than it’s all worth it.” Well you know what? Checkmark on that one.

And the thing about that interaction is that you can’t quantify it. I can’t write that on a resume, or even in my quarterly report to Peace Corps. It’s not a specific “project” or a health talk, or a class. I was just in the right place at the right time. And because I’m always looking for a chance to talk about health issues when sitting around, I finally made a difference! In some ways it seems like such a trivial victory, but it will make a difference in her life, and her baby’s life, and her future children’s lives and hopefully she’ll tell other people and so on and so forth.

That’s how change starts right? With one person. You just have to plant the seed. I finally have proof that I did.

Tuesday, March 25, 2008

Senegalese events

I don’t know why I still let myself get talked into attending big “formal” Senegalese events?

During my first couple of months I was dragged to a few and I almost lost my mind and ET’d after them. Most of the time I find a way out of them, but today against my better judgement I attended one because it was held under the premise of “health sensibilizing of the community.” I disagree.

A neighboring village, 3k away arranged this massive race. There were two parts, the cyclists and the race. It was championed as a day to promote cardiac health, sports, and youth. Now in my mind it already seems a little bit ridiculous to blow an entire day/budget/fuss on cardiac health and sports when almost every single person in attendance most likely doesn’t wash their hands before they eat or sleep under mosquito nets year round, they’re constantly active, barely sleep as it is, don’t hydrate, and well, quite honestly, it sounds horrible to say but usually don’t live long enough to suffer from cardiac problems.

But you know, that’s just me… I’ve only lived here for a year…
What could I possibly know about the health problems in my community?
(insert dripping sarcasm into that one J)

At least going into it I knew it would be overwhelming so I planned accordingly. I brought my ½ gallon container of ice water, a cliff bar, a book, plenty of cell phone credit, and I wore my most lightweight Senegalese outfit. The woman from the mayor’s office I attended with told me to meet her at 7am so we could get there on time (the race was supposed to start at 8 or 9am). I knew better than that and met her around 8:15 (and waited for her) at the garage. We headed towards the next village and of course arrived to a mostly empty event. People did trickle in soon afterwards though and I was actually amazed at how early the crowd appeared.

Now at these things everyone is dressed to the nines, in the hottest, stiffest, most uncomfortable fabric you can buy in country. And they wear yards and yards of it and pounds of makeup, and fake mesh wigs, and there must have been 50 different girls in various groups of “hautess” (bridesmaid…basically matching outfits). The whole thing was quite impressive to look at from afar.

It was set-up along the main road (of which there is one in all of Senegal, so traffic all day had to be diverted), there was a massive blowup finish line, a trophy table, 2 shade tents with chairs for the invited visitors, massive speakers, police officers, event organizers, reporters, cameramen, photographers, signs and placards, and a raised platform with huge couches and chairs for the ministers and officials to sit on.

The big deal was that apparently President Abdoulaye Wade’s right-hand man was scheduled to attend the day’s events. He did and so did about 20 other “official” so and so’s. I’d say 12 different SUVs arrived each carrying about 1 or 2 individuals. The ministers paraded in and took their seats on the raised platform at around 10am. 4 griots crowded around them, to sing their praises while a young Western-outfitted man gave a lengthy speech in Pulaar and French to introduce the ministers and thank the various attendees and organizations. It took him about 30 minutes to get through it all.

At one point he did briefly mention that this was supposed to be a day about youth, cardiac health, and sports promotion. He said something like, “Today we are encouraging young people to get exercise to avoid cardiac problems, but we don’t need to talk about them because we all know what cardiac illnesses are.” That was it. Then he continued on to talk about the ministers and how wonderful it was for them to attend etc. etc. etc.

By this time I feel as if I’m sinking into the “9th ring of…” if you know what I mean. The crowd is totally out of control. People are packing in chairs all around us, there are no walkways, everyone is pressed up against one another, chairs are passing overhead, gendarmes are trying to push people out of the view of the seated invitees (myself included), women are dancing, babies screaming, everyone’s talking, griots are singing, it’s 100 degrees, and all the while huge 1 story high speakers are blaring.

I remember looking around and thinking, “okay, don’t panic, you’re not a claustrophobic person, you can handle this. You have your book, your water, it’s not that hot, you’re in the shade, you can do this.”

The race finally started around 10:45. I watched long enough to see the first and shorter race and to see the first students cross the finish line, absolutely dieing and overheated. I stayed long enough to see the ambulance and the Senegalese Red Cross volunteers help carry people away who were too exhausted and suffering from heat stroke.

I could feel myself totally losing it… and getting so furiously angry about the events that were unfolding in the name of “health.”

This fear started to rise in my gut, and I was looking around feeling like I was slipping deeper and deeper into total chaos. Then the woman I came with told me to scoot over and share the chair with her to make room for a very large friend of hers. Basically acting on instinct I just got up, said “I’m leaving. This is way too much for me. There are too many people. It’s too hot.” And amidst her protests (she said she was mad at me) I just shoved my way through the people in front of me and wound my way behind the crowd to a compound where I could gather myself together, use the bathroom, and plan my next step.

I was feeling a bit better now that I had some open space around me and chatting with some girls who had also come to seek some refuge. She picked up my thermos and asked if it was my water. I said yes, and she put it back down. I let my mind wander for a bit feeling proud of myself for not totally freaking out yet, and trying to strategize how I would spend the rest of the day until lunch, and then get through that, make my appearance with the important people, and then escape as soon as the heat of the day broke.

When I focused back in I heard one of them ask me about water, I turn around and there are 5 teenagers guzzling down my water. It’s gone! Then they ask me if it’s mine. I basically am just so exasperated, say yes, grab my thermos from them and bail. Not noticing in time that they’ve replaced my lid with the lid from their thermos which is filthy and broken. (Not a big deal, just an annoying side note since I just bought the thing last week). At that point I’m out the door and walking down the road towards my town, 3k away, holding my headscarf like a tent under the sweltering noontimes sun and I am marching straight home. Do not pass go, do not collect 200 dollars.

And I did, I made it home, wasn’t too badly dehydrated, and was ultimately pleased with my decision to bail every step of the way.

As I was walking back many of the racers passed me, panting, sweating, stopping with side cramps, asking passing cars for water, picking up huge rocks and holding them up against their ribs to “cure” their sidecramps. Hhmmm. Clearly these kids have had NO training, NO information, NO water, NO NOTHING! And this is supposed to be a HEALTH awareness day! Ugh. I again watched the ambulance pass back and forth, sirens blazing, picking up various students who couldn’t make it back.

It was absolutely the most frustrating, most ridiculous display I’ve seen yet to date.

Part of me is furious at myself for not being able to “hack” it. I’m angry that I didn’t make it through the whole day and perhaps try to make some good of it. After all, the original purpose for me going was to meet the members of this very active association in the next town over who might want to collaborate on future projects. But it just didn’t seem worth it.
And for what? Had I stayed through the races, and then the speeches and the trophy giving I’m sure I would have learned absolutely nothing, been dehydrated beyond repair, and just gotten more angry. The cameramen got that coveted shot of a toubak at a Senegalese gathering (I’m always a target when cameras are around), I made enough of an appearance so that Peace Corps was represented, and then I bailed. And I’m glad, because at the end of the day, it’s better to freak out (or at least be annoyed) in the privacy of my own hut then to lose it in front of several hundred Senegalese people and ministers, teachers, officials, and health workers.

I wish there were some way I could get my hands on the budget for this thing. I made a mental list of all the money that went into this day:

Several hundred T-shirts
50 hautess outfits
Chair rental
Gas for 20 SUVs
Inflatable finish line,
Lunch for several hundred,
Donations to the griots for singing the minister’s praises
Water/Electricity bills
Payment of gendarmes to keep the crowds under control and re-direct traffic
Etc etc etc.

And yea sure, huge events happen like this in America to raise awareness about various diseases, but last time I checked…they health concern of choice is actually relevant, and information about the problem of disease is distributed, and speakers actually talk about the problem at hand and strategize about how to solve it, and usually it’s all done to raise money so the participants are sponsored, and the events are not held in the desert during mid-day in the hot season.

And I’m not trying to sit here and put down these efforts, I mean, I guess in a way that’s what this entry has done, but that’s not my intention, and I think it’s important for other people to understand the kinds of things that do get accomplished here, but also how far they have to come. Not that they have to be carried out “my way” or in a more “Western” way. That’s not my point. But they are so lacking in every respect and in content mainly, and yet I would never be able to get that kind of attendance, or support at any kind of event I would hold.
So where is the middle ground? Is it my job to figure that out?

It’s endlessly frustrating.

Now here I am, I’ve retreated into my room for a few hours of alone time, sucking down ice cold crystal light (thanks Phyllis!) and listening to music. In these moments I usually seek out my family for some comfort and company, but I just went to lunch and it made it so much worse. Basically in the middle of lunch my sister asked me, “So wait, Binta, what is your work? What do you do? People are always asking me what you do here and I just tell them I don’t know?”

I wanted to simultaneously vomit and cry.

I’ve been here a year, busting my ass, away from my home, my family, my friends, my career, my culture, my native language, making no money, trying to help this community, fending off illnesses, watching my body deteriorate, and my very own host sister doesn’t even know what I do? What’s the point? What AM I doing here? If my own SISTER doesn’t have a grasp on it I must be the biggest most ridiculous failure.

But because I HAVE been here a year I realized that she is the one at fault, and I called her on it.

A year ago I probably would have just been devastated (which I still was) and explained to her again what I do for the zillionth time, but this time I called her out on it, I told her “Binta, I’m mad at you. I’ve been here almost a year, I teach YOUR women’s group about your health concerns, you listen to my HEALTH radio shows, you listen to me talk about the HEALTH classes I teach at the schools, and the HEALTH talks I hold all over town, and you still don’t know what I do?” To my family’s credit they all rallied behind me and they were all laughing at her and me (because somehow I managed to keep a smile on my face…I guess it’s ingrained in me that anger and sadness don’t work and that the only way to get through IS laughter) and backed me up and made her feel silly for asking the question. And maybe once and for all, they will all speak up for me and tell others what I do here. One can only hope.

Then my mom started talking to me about how I need to make my room look nice and I need to spray for scorpions before I have guests coming and I told her that I will but not until the end of the month because I don’t have the money to buy the chemicals. She said I didn’t understand and started repeating herself and I insisted that I DID understand what she said but that I can’t until I have money. Again the rest of my family backed me up and I felt good that at least I was being clear even if she didn’t understand me in that moment.

I was definitely not hungry after that and I abruptly left for my room where I burst into tears and called another volunteer. Which always makes me feel better because even though I could imagine people from home having good advice, and lending a sympathetic ear, until you’ve experienced these same kinds/levels of frustration, there is only so much you can share and understand, and only fellow volunteers seem to be able to console me in the way I need at that moment.

I guess they must have known that I was frustrated because about an hour later, sitting in my hut, drying my tears and on the phone, my little sister comes to my door holding an ice cold frozen juice bag from Binta. It might not seem like much, but that gesture put a big smile on my face all over again.

And I’m wiped out. Today is done. No more emotional roller coasters today please. I am finishing this blog and then going to hang out all evening in my compound with my family, and go to bed early and drink ice cold water, and tomorrow I will face my neighbor’s baptism (which I never go to, but this one is a must because they are my friends).

And I am vowing to never again attend another big event…



Though I pride myself on giving you all a pretty realistic glimpse into my PC life, I do not publish all of my writings. I do try and save some for myself. But I think it’s important that you all understand how much time there is to think, and over think the entire PC experience. And you all seem to appreciate me sharing my experiences so honestly and have commented positively on my ability to self-reflect (is that proper English?) so I thought I would include this little blurb that I recently wrote to a friend in an email:

I’m in such a slump right now. I know it’s normal to have a 1 year bummer, everyone in PC goes through it and we usually lose a couple people at mid-service, but I just can’t help but feel like I’ve accomplished absolutely jackshit here, and I’m starting to panic that I wont end up doing anything substantial with my two years. And it makes it so much worse when people from home are like, “ You’re so inspiring, I’m so proud of you, you’re changing the world!” and I just shake my head and think, “you are so unclear on the concept. I’m not doing anything you couldn’t do.”

And of course I know (better than most probably) that change is SLOW, and frustrating, and development workers make mistakes, and there are setbacks, and inefficiencies, and that you just have to have faith that what you’re doing makes a difference even if its not tangible and you can’t see the fruits of your labor until years down the line…blah blah blah, and usually I do…(you know me, I’m eternally optimistic, sometimes annoyingly so), but there are so many flaws with this program, especially the Health program, and it’s endlessly frustrating because PC has so much potential, and really its still pretty incredible (or else I wouldn’t be here) but my expectations for what I would accomplish were low coming in here, but I secretly hoped that maybe they wouldn’t need to be.

And I think that the real problem is just having WAY too much thinking time! You know? Like always being by yourself, but never alone? It’s something that I don’t think anyone can fully understand until you’re thrown into another place and made into a television show, but still totally isolated from all things familiar. It’s just bizarre.

And my god how I love it most of the time!
I really do, and some days I sit back and think, “wow. I’m awesome. Look at what I’m doing. Not just anyone could do this.” But maybe my own standards are too high also?

I just miss feeling like myself. And being on malaria meds, and constantly hot, and sleep deprived, and never feeling quite right, and lacking good food, and not having the control over exercise or a routine…or control over anything can just make you feel so helpless and confused.

But at the same time I absolutely adore my little life, and have gotten used to the slow pace of things, and feel comfortable just doing nothing some days, and being busy and needed other days, but then the guilt gets to you. That’s the worst part, the guilt that I’m not absolutely maxing myself out every single day and busting my ass to help my community, like I was at home, or at least in academia I was.

You know that it’s in my nature to operate on full force at all times, and so here because I can’t operate like that I feel like a failure. And logically I know that that attitude and attack just doesn’t work in this kind of a program (I tried at the beginning and it almost killed me and sent me home), but some days it just eats away at you, especially knowing so much about development work and its good and bad sides. And I’m thankful that I do know so much about it, because I feel like I’m so much better able to understand the complexities of the challenges this country and the people in my community face, but man, I’m so tired of thinking all the time. I do wish I could just be mindless sometimes. It’s enough to make a person crazy.

I just miss feeling like super-healthy, on top of her shit, bubbly and energetic, confident, do-gooding Caitlin. That’s all. And I’m not entirely sure how to get her back? Or if I’ve even lost her in the first place?

And like I said, don’t worry too much about this rant. I have it with myself probably 3x a week and I ultimately end up convincing myself that I am happy and everything’s fine, but it feels nice to share it with you, because I know you’ll read this and be thoughtful and honest about it. I may post it on my blog at some point just so that people understand what goes on in my brain…


Monday, March 17, 2008


1 YEAR!!

I have officially been in Senegal for one year! Woo hoo! I made it! I can’t believe it. The time has absolutely flown by. And I know everyone always says that, but I really do feel like Ramadan was just yesterday. All outgoing PCVs always say that the first year is the most difficult and after you get over the 1 year slump, everything just falls into place, and your work, language, friends, and contacts just take off.

I’ve used this landmark as an opportunity to go back and read up on my blog entries from my first months at site. How far I’ve come! I’ve learned so much. I think the thing that’s especially surprising to me is how much better I can tolerate everything! That and how much more articulate I used to be. My English writing truly has suffered.

While most of the stuff I complained about before still exists, it just doesn’t affect me anymore. I highly recommend that you all go back and read some too. They might entertain you. One thing that worries me a bit though is how sort of sarcastic and jaded I feel I sound sometimes. The idealism and enthusiasm practically pours out of my entries from my Community Entry Period. Though I’m still able to maintain some of that, I definitely notice a prevalence of sarcasm and underlying bitterness in some of my entries. The mood swings have certainly lessoned though (see June 2007 entry “Living in a World of Mood Swings”) which is something I hadn’t realized until now. I also laugh a lot more when I used to just get angry.

I hope that this week I’ll get a chance to write a “reflection” entry about my experience during the past year, but for now, here is my 1-year index for your entertainment:

# of days in Senegal: 365
# of days since I’ve seen my parents: 368 (because of the 3 day orientation in DC)
# of months at site: 10
# of current different ongoing work projects: 5
# of packages received: ~25 (amazing…keep ‘em coming! I feel so loved.)
# of known packages currently in the mail: 2
max # of weeks its ever taken for a package to arrive: 8
# of visitors: 1 (with another one on her way in less than 2 weeks! I can’t wait to see you Amandita!)
# of PCVs from my group who have ETd (Early Terminated): Still 6 (though 1 more soon. Good luck at Johns Hopkins Jamie!!)
# of PCVs still left in our group: 37
# of COSing PCVs from my region: 9 (I am going to miss them all desperately)
# of new PCVs coming to our region: 7 (We can’t wait to meet all of you!)
# of times per day I think about what I’m going to do post PC: ~3
# of degrees in my room right now: 107 F (and I’m barely even sweating)
# of scorpions found and destroyed in my hut: 12
# of rotting lizard corpses stuck to the rafters of my hut: 1
# of times I’ve refilled my tiny gas stove: 1
# of times I’ve had to burn my trash: 5
# of buckets of water I use per day (if it’s not hair-washing day): 1
# of times I’ve had to change my light bulb: 0
àMy carbon footprint is like zero!!
# of babies delivered: 1
# of PCV medical emergencies attended: 1
maximum # of rams seen tied to the roof of a station wagon: 7
# of pairs of flip-flops I’ve worn through: 3
Highest # of degrees I’ve seen on my thermometer: 137 F (I swear. This year I’m taking a picture as proof cuz no one believes me)
Lowest # of degrees I’ve seen on my thermometer: 63 F (early morning during the cool season)
# of holes in my mosquito net: 1 (it’s held up amazingly well)
maximum number of mosquito bites on my body at 1 time: 123 (I counted)
# of baptisms attended not including my own: 1 (never again. Totally overwhelming.)
# of sisters married and dropped out of school at age 17: 1 (my favorite one)
Average # of marriage proposals per week: ~3 (they’ve FINALLY slowed down).
# of family members I pretty much don’t speak to ever: 1 (my older brother. More on that soon).
# of times people have stolen cell phone credit from my phone: 2
# of schools I’m currently teaching at: 3 (primary, secondary, and preschool)
# of women’s groups: 2
# of pounds lost: ~15
# of PCVs from my region who have had malaria: 1
# of PCVs from my region who have been exposed to Tuberculosis:1
# of PCVs I know of who have married Senegalese during their service: 2
# PCV friends (that I know of) whose families have come to visit them in country: 14
# of times I’ve left the country: 1
# of months until I come home to AMERICA for a vacation: 4
# of times per week I wash my hair: 2
# of times I’ve henna’d my hands and feet: 1
# of times I’ve let my sisters braid my hair: 0
# of times per week I see other PCVs/speak English: ~1
# of times per week I get to the internet: ~1
# of text messages sent: 4,071 (so that’s where all my spending money goes…)
# of text messages received: 2579 (that ratio is kind of sad).
# of times I’ve been sick with stomach issues and fever: 4 (all pretty mild)
# of times I’ve made myself sick at the regional house from eating “American” food: Almost every time I’m there.
# of books read in country: 14 (I really thought I’d be reading a lot more. I’m glad I’m too busy to be).
# of solo hut dance parties I throw for myself per week: ~2
# of tubes of anti-fungal foot cream I’ve gone through: 1
# of Senegalese outfits I currently own: 5
# of times per month I have to scrub massive calluses off my feet: 2
# of hours I spend awake at night per week: 4-7
# of goats currently staring at me from outside my screen door: 1
# of times I’ve accidentally cleaned out my water filter with too much soap and made the water taste like rotten eggs for months afterwards: 1
# of times I’ve seriously thought about ETing: 5 (though barring all medical and family emergencies I know I won’t)
# of times I’ve nearly wretched at the thought of eating another bite of oily rice: ~20
# of other PCV’s sites visited: 6
# of friends from home who have gotten married or engaged or pregnant: 6 (Just in the past year!!)
average # of flies I have flying around my room at any given time: 6
Litters of kittens my family’s cat has had: 2
Litters of kittens my family’s cat has EATEN: 1
# of times per day I’m called toubak if I’m just walking around my town: ~2
# of cockroaches I’ve seen in my douche or hut: 0 (amazing!)
# of blog entries written: 103 (including this one).
maximum # of children I’ve ever had studying in my room at once: 5
# of liters of water per day I drank during the cold season: 3
# of GALLONS of water I’m drinking now that it’s the hot season again: 2 (yes, gallons, I’ve retired my liter Nalgene bottle and have taken to carrying around a ½ gallon thermos that keeps water ice cold)
# of times per day I buy a block of ice from my family: 1
# of times per day I’m asked for things by my family: 0-1 (much improved from my first months at site)
# of times per day I’m asked for things by people in town: 2-3 (usually Talibe kids asking for money)
# of hours per day my family’s TV is on: ~8 (barring all power outages)
# of babies in my family that scream and cry every time they see me because I’m white: 1 (luckily she doesn’t live in my house)
That is all for now. I hope you enjoyed my index. 1 YEAR!

Night Swimming

On Friday night myself and 6 other PCVs went to visit a fellow PCV (my closest neighbor) in his village 7K away. His two years are up (though he’s extending for a year in Dakar) and wanted to have a little get together/barbecue for his family so that we could meet them all and see his village.

His village is along the river and so of course, as the sun was going down, we all got it in our heads to go for a swim! (We girls had to wear long skirts/pants of course). Some of you may know that these rivers are not exactly the most sanitary. Schistosomiasis anyone? Animals and people definitely use them as toilets, as well as wash their clothes and dishes in them. But when its still 100 degrees at 8pm adds to the enthusiasm of 6 other PCVs we all jumped in and swam across the river to Mauritania! It was such a cool thing to do, to stand up there on the banks of Mauritania and look back and see Senegal. Perhaps it was not the safest, or most sanitary thing to do, swim in an unknown and fairly deep river with a current in Africa at night, but we all made it safe and sound and showered off all the remnants afterwards.

No harm done? Not totally sure…

During the swim I couldn’t help but sit back for a moment and think about how cool I felt doing that. I was envisioning the conversation a few years down the road… “this one night, in Africa when I swam across the Senegal River to Mauritania under the stars with 6 of my friends…” It just made me reflect on all the adventures I’m having here whose “coolness factor” probably won’t hit me until I’m home in America sharing them with others.

That night we ate a ton of meat and I spent a long time dancing with some kids in his family to Akon, Sean Paul, Shakira, playing on his Ipod speakers. It was so fun to be there under the stars, after a swim and a meal, with friends and little kids. For a few hours I felt “Peace Corps normal.”

The next day was my stage’s one-year anniversary in country! Woo hoo! Which happened to coincide with my jr. highs big annual celebration. Two days of sports games, club performances, lots of music, dancing, and a final soirée. So the morning after being in my friend’s village I woke up at sunrise and caught a car (lucky me…not a charet!) to my town. I dressed up in my brand new Senegalese outfit complete with gigantic headwrap and attended all the day’s events. As I am an invited guest at these kinds of functions I’m always given a chair among the mayor, official ministers, and teachers in the shade with cold drinks. I was even asked to get up and speak! So there I was in front of probably 500 people (mostly kids) thanking and praising them for their celebration and telling them how much it meant to me to celebrate my one year in country with them etc etc. It made me feel very loved to see all those faces and to realize how many people in my community know me. Afterwards I had a bunch of them come up to me and tell me how much they loved my speech (all of 1 minute long. And yes mom, I have pictures).

I came back just after dusk totally exhausted with some of my siblings, only to spend the rest of the night in my douche with Giardia, or some such disgusting virus. The jury is still out on whether or not it is Giardia, amoebas, or some other lovely parasite, or all of the above. I’ll find out next week some time after my very dear friend gets to haul down a my stool sample to the PC med office in Dakar. What a guy huh? But thank god for the PC med kit and Oral Rehydration Salts is all I can say. That, and cell phones and cell phone reception because I was able to call the PCMedical Officer for counsel and seek sympathy from my mom and family at home.

I’m assuming it was something in my friend’s village that has made me ill, so perhaps our fabulous night swimming adventure was not without consequence? (Absentmindedly ingested some river water maybe? I shudder at the thought).

What a classic way to celebrate my one-year anniversary in country right? Sick as a dog with some hideous GI bug. Ah well, I’m feeling a bit better today and at least I got to have a great adventure and participate in almost all of the jr. high’s activities (For obvious reasons I could NOT go to the soirée, though the music blared all night long and I would have loved to have gone and danced with my teacher friends all night).

As soon as I find out what is wrong with me, and assuming it’s not just a passing 1 time only virus, I’m sure I’ll be started on a whole slew of fabulous medicines with all kinds of side effects, but for now I’m functional and well-hydrated and I’ll still be able to make our radio show on Tuesday no problem.

I hope this entry doesn’t scare off any visitors who think that I’ll be a reckless hostess. It’s just that after a year you start to let your guard down a little bit. But this has been a perfect reminder that that’s stupid and makes you miserable. Time to be a bit more careful maybe? Though a day off to lay around, nap, hydrate like mad, and read and drink ice cold crystal light is not all that bad.

Though as I type this, it is 112 F in my room.


Thus far this month the elementary school has been in session for 2 days because of strikes, religious holidays, and random government scheduled holidays. If there are no more strikes they will only have been in school for 6 days this entire month.
When I realized this I started talking to people in my town about it. Everyone agrees and knows that it’s totally unreasonable, but what’s to be done about it? They are flabbergasted when I explain to them that we have a minimum number of days we must be in school (180 right?) and that if there are unplanned cancellations (for strikes, blizzards etc) that we must make them up at the end of the school year. I also explain that we only have a 2 1/2 month long summer vacation, not 4, and that teachers cannot just cancel class to hold meetings.
These poor kids don’t even stand a chance. No wonder so many of them have to repeat grades, and drop out early, and can barely read at age 9. They’re NEVER in school!
And it’s frustrating for the teachers too (the ones who care that is) because there’s no time to teach anything!
I didn’t have a real purpose for writing this entry, I just needed to vent my frustration at my total lack of ability to teach this entire month. I’ve taught 1 class, on AIDS, in English, which went really but that’s absurd. Thankfully I’ve been occupying myself with translating our years worth of health radio skits into French so that we (and our replacement volunteers) can use them in the schools. Tedious and time consuming, but necessary and keeps me focused and gives me a task.

I know I’ve said this before but what this country needs is a total overhaul of its education system…PRONTO!

Thursday, March 6, 2008

Senegalese medical "care"

Other people’s medical emergencies seem to follow me wherever I go.

Maybe it’s a sign that I should finally take the plunge and go into the medical field (something I’ve been on the fence about for a long time). For better or for worse, my experience yesterday navigating the Senegalese medical system (if you can call it that) certainly re-motivated me to look into public health and nursing programs post-PC.

(I’m hesitant to even share this story because I know it’s going to make my mother cringe, but it has a happy ending and looking back on it there was never any serious danger, just a lot of confusion and delay.)

Around 11:40AM yesterday, I was in my town, at the post office picking up a package. I was sweating profusely in my brand new Senegalese outfit, (having dressed up to teach that morning, only to find out that the teachers were on strike of course) when my phone rang. It was our PC security officer (PCSO) (who is absolutely wonderful by the way). He explained that a fellow PCV nearby had fallen off of her bike and cut herself badly and asked me to get to her ASAP. So of course I accepted and told him I could be there in about an hour. Luckily I arrived at the garage to an almost full bus so we took off right away. En route the PCSO called and told me that she had been transported from where she fell, by charet, back to her village and now her village had called a car to take her to the Senegalese hospital in the big town between us. He also told me NOT to let the Dr. give her stitches, but to stabilize and clean the cut and that a PC car was on the way and would be there in several hours (little did they realize how far away we really are, because a trip they thought would take 5 hours, took them about 9). I called another volunteer in the area and told her to meet us there as well.

Here’s where it gets ridiculous…

I arrived just as they did, in the “Urgent Care” office. I walked in and there she was, sitting in a wheelchair with a borrowed bloodied headwrap wrapped around her knee. But instead of being treated, the duty Dr. is arguing with her about speaking in Pulaar. Classic. At this point, she is exhausted, dehydrated, and finished talking, so I take over and try to explain to him about the stitches. The majority of the day was spent speaking in French so it wasn’t nearly as challenging as it could have been had I had to use Pulaar.

The Dr. was really aggressive and angry and he has basically been yelling at her because we insisted on coming in the room with her and now he starts in on me saying that it’s ridiculous for us to refuse treatment, we can’t tell him what to do or how to treat, that if a Senegalese person came to America they wouldn’t question the Dr.’s authority etc etc.

I have to be really calm with him and I explain very clearly that it is unfair to yell at us, and especially not her because it is not up to us, and would he please speak to our PC Dr. who we have on the phone. He refuses of course and gets more pissed off. Meanwhile the assistant starts pulling at the PCVs pant leg so that he can get a look at the gash. Now I’m sorry, but any First Aid certified stooge knows that YOU DON’T PULL!! So I have to tell him “hey, stop it. Get scissors and CUT the pant leg OFF!”
(Insert various inappropriate curses in English said to myself).

Finally the Dr. talks to our PCDr. and has meanwhile called in another Dr./surgeon. We’re still sitting in the office, all of us are on various cell phones, the poor girl is still holding her own leg, so I pull over a chair for her to prop it up on so she can relax it. And the assistant just grabs a bottle of Betadine and is about to dump it all over her! I mean, we’re in the waiting room and still being yelled at for crying out loud!

So just so you have the scene in mind. I’m standing next to her in the wheelchair; she’s in tremendous pain (being super brave about it and keeps saying she can’t cry cuz Senegalese people don’t cry. Hilarious.), the other volunteer is on the phone with her counterpart who has meanwhile also gotten a car and is running around trying to find us and help in any way possible. The assistant finally stops messing with her pant leg, and the Dr. and I are passing the PCDr. Back and forth on the cell phone. Finally she gets the phone back and while we wait for the other Dr./surgeon to show up the Dr. starts asking me if I have a husband! “ARE YOU KIDDING ME?” I roared. “NOW?! You’re asking me NOW! While she’s sitting in urgent care with fat and tissue hanging out of her kneecap, waiting to be treated…SERIOUSLY??”

In walks Dr #2 and the first words out of his mouth are, “What’s all this I hear about you not accepting our treatment? This is ridiculous. What are you doing here? I refuse to talk to any other Dr. There are other patients waiting. If you don’t want our treatment get out.” So two doctors have now yelled at this poor PCV and I made the executive decision to get us out of there and I tell our PCDr. That this is no place for her to receive medical care and we wheel her out.

Part of me understands that we (toubabs) come in with this air of distrust and fear at the prospect of being treated in a Senegalese hospital cuz well, it’s just not good care! I mean I was the one telling the guy to CUT her pants, and I stabilized her leg. Worrisome. Now they told us that of course they would use local anesthetic and then do stitches, but at that point we were all so angry at each other that I told the PCDr. that I would clean and dress the wound and we’d get her to a hotel and stabilize her and wait for PC to arrive.

Now all PCVs are equipped with extensive medical kits, but in the rush to get to her I didn’t bring mine because at that point she was still in her village and had her own. So I go to the pharmacy AT THE HOSPITAL and ask if they sell gauze or antiseptic or codeine.

None of the above.

It’s a hospital pharmacy and all they sell is paracetemol. Awesome. Too bad she doesn’t have a headache, she’s had a major trauma to her kneecap!!

So the other PCV who lives close by races home and brings back her med kit while myself and the people from her village and the other girls’ counterpart all get her to a hotel room. Oh yeah, and the first hotel we went to was full so we had to go to a different one.

It’s now been about 2 ½ hours since the initial fall. She’s been put on a charet, in a car, taken to a hospital, left the hospital untreated, and now we settle her in at a hotel in some AC. The counterpart is amazing and he goes out and buys her codeine, water, food, and juice because she’s feeling faint from the heat and the shock and all the excitment.

The other PCV arrives and I clean it out with hydrogen peroxide, loosely dress the gash, give her food, codeine, juice, and water, and get some ice on the knee to reduce swelling. Meanwhile our PCSO tells us that there is a Senegalese military nurse on his way to us at the hotel. (One of our PC drivers’ brothers works at the base nearby. Gotta love family connections right?)

The military driver, the nurse, and a random Pulaar woman (a nurse assistant I think) all arrive and come up to the room. They check out the wound and basically insist that she needs stitches and that PC really won’t be able to get here in time. Which is true. You need to do stitches with 8 hours because you need live tissue.

He gets on the phone with our PC nurse who is en route (still about 6 hours away) and we all agree that he can do the stitches. He brings a local anesthetic and injects it right by the cut. Which is incredibly painful as you can imagine. Here is where she is SO brave. Later she nicknamed me her “stitches doula” which I thought was awesome. And it was really amazing how similar the “coaching” really was. There was so much commotion and chaos and pain that I had to get right up in her face, and hold her hand, and have her concentrate on me, and her breathing, and help cover her eyes and give her a play-by-play of what was going on so she didn’t have to look.

Now in Senegalese/Pulaar culture women barely even make noise when they give birth. They have this crazy relationship with pain that I cannot understand. So poor injured PCV is trying her best not to cry, (and crying out in Pulaar mind you, which I thought was pretty badass). But the needle with the local anesthesia is very intimidating and painful, especially for someone who already has a fear of needles.

Basically this guy had no bedside manner. I don’t doubt that he wasn’t trained, and the job got done, but certainly not in any way we’re accustomed to. Now typically with local anesthesia, you have to wait several minutes for it to take affect. So what does he do? He starts the first stitch immediately even though we’re pleading with him to STOP and WAIT! This poor girl, is in so much pain, and being so brave, but terrified because he isn’t taking her pain seriously.

We get our nurse on the phone and convince him to wait a few minutes, now that he’s already done the first stitch to see if the anesthetic will kick in. Ultimately, for whatever reason, the local anesthetic doesn’t take. He keeps pushing on her knee and asking her what she feels to which of course she responds “OW that HURTS!” But he doesn’t believe her. They keep saying it’s all in her head!

We tell him we need a timeout. She and I weighed her options: they can give her another anesthetic, but there are only two stitches left and they have other patients waiting for them (supposedly, though he was napping before the driver had brought him over so I think they were just annoyed with us and wanted to go to lunch).

She decided to just bear through the next two stitches, as long as I promised to cover her eyes, help her breathe, and give her a play by play with a break in between sutures. I have to hand it to her…she spoke Pulaar throughout the whole thing and barely even shed a tear. Very impressive.

Once he finished, they started asking if we had anti-biotics, and anti-imflammatories, and offered to give her a tetanus shot. Basically they were going to give her every drug known to man. Kind, but unnecessary, and not good care. This is a huge problem in Senegal-over prescribing. People come home with bags of medicine for a headache and are given huge long prescriptions that they can’t read and don’t know which one is the most important because they usually can’t afford to buy all of them.

We refused all of the above noting our PCnurse told us not to and that she already had codeine, and local anesthetic coursing through her system. He wraps up the knee (MUCH to tight mind you, so I cut it off after they left).

We thank them, they leave and as I’m walking them out they mention again to me that it was all in her head and that she wasn’t really in pain. That the local anesthetic worked but she was just scared. Yeah, um…doubtful.

The upshot of the rest of the day was that the three of us hung out in AC, we gave her more codeine so she was feeling pretty great, we all finally ate lunch and hydrated (it was about 4pm by then), and watched DVDs on a portable DVD player while we waited for PC to arrive.

At 8:45pm the PCnurse, our PCSO and the driver arrived. They had already stopped by the military base and thanked them for their help and given them the appropriate “cadeaux” for their services. Our nurse told us that while the cut had looked really deep and severe, that the stitches looked well done and that there really had been no alternative, and that she had to have them done ASAP and PC wouldn’t have made it in time. She got her started on anti-biotics and anti-inflammatories, now that she didn’t have quite so many painkillers in her system.

That night the other PCV got a stomach bug, and had a fever so the two of them camped out in bed and got a full night’s sleep. I had a lovely dinner with the PC staff and then got my own hotel room, and watched Family Guy in the AC until I unwound from the adrenaline rush and fell asleep.

Looking back on the whole experience, initially I was upset with Peace Corps for being so unclear and indecisive and moving her around so much, but I realize now that it is really difficult to pronounce on the severity of an injury over the phone and they did everything in their power to help. Apparently it’s unheard of for them to drive all the way for a “minor” trauma. Of course in a more serious or life-threatening emergency we would be med-evacked to a more appropriate location. But in the end it was a good relationship to establish because the head of the military base told our PCSO that he should be our first emergency contact, at any time, for any reason because he is well-connected and they have lots of people all over the region that can get to us in no time flat and he is happy to help.

So while there was no bedside manner to speak of, and the quality of care was zero, the job was done and she is fine and on her way to Dakar today in the comfort of a PC car.

I can’t help but wonder if we had just accepted the treatment in the first place at the hospital would it have been that bad once the “proper” Dr. arrived? But the fact that they used Betadyne only was worrisome. Hydrogen peroxide is a much more effective tool (whereas Betadyne is typically used topically and takes several minutes to sanitize) and the military nurse in fact did not even know what hydrogen peroxide was! The collaborative effort of all involved though was comforting- from PC staff, to other volunteers, to village families, counterparts, and hotel staff. Bottom line is she is going to be just fine.

And as a result, I’m going to spend my morning looking up Public Health and Nurse practitioner programs in America. Because if there is anything this experience has taught me, it’s the importance of GOOD MEDICAL CARE EVERYWHERE, and it really highlighted the total lack thereof.

My reproductive health course at LSE included an entire section on the importance and dearth of Quality of Care, but now I really understand firsthand the difference it makes in a medical setting and why people in my town hesitate to see the Dr. and wait until the very last moment, which sometimes comes too late.

Hopefully that will be my last impromptu medical emergency, but now at least I have a better understanding of how to handle them here in Senegal.

And if nothing else, all of these experiences make great stories right?