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?

Tuesday, March 4, 2008

the grocery store

When I was in Dakar last week for WAIST (West African Invitational Softball Tournament) I enjoyed all of the perks of a huge capital city swarming with other PCVs from all over the region. I ate delicious food, spoke English almost exclusively, spent hours by the pool, wore jeans (hooray!) and went out dancing at every opportunity. I guess I had underestimated how long I’ve been in country and how long it’s been since I’ve really been exposed to Americanesque decadence and choice. Aside from Rome, when I was in Italy I spent most of my vacation in our apartment, catching up on quality family friend time. I supposed I wasn’t as exposed to the same kind of abundance, or at least it didn’t freak me out as much for some reason. So I surprised myself in Dakar during a stop at the massive toubak grocery store, Casino.

I was supposed to go in and pick up a few things, toiletry items, and some lunch. I figured, “oooh, what a great chance to make something totally delicious with lots of vegetables!” But when I walked in to this grocery store (mind you it’s about half the size of the one my family shops at in America) I was totally overwhelmed. So overwhelmed in fact, that all I could do was wander around in circles and stare wide-eyed at all of the choices, and products, and delicious food, and the concise organization of it all. I walked up and down the aisles in a state of total disbelief. They even had a proper public bathroom! Thirty minutes later, after perusing every aisle at least twice, I walked out of the grocery store empty-handed. I couldn’t even buy anything! It was like total sensory overload! I couldn’t even get it together to choose a type of bread, or cheese, or decide if I wanted a sandwich, or cereal, or yogurt, or ice cream or or or…

Looking back now I’m kicking myself for not getting a grip and enjoying a delicious toubak meal while I had the chance, but it was way too much for one PCV to handle! I mean they had 3 kinds of smoked salmon for crying out loud! And the razors…I mean a razor is a razor right? It cuts hair. Is one really that much better than another? There were gender specific designs, triple blades, double blades, single blades, 5-packs, 10 packs, individuals, ones with aloe vera strips, double strips, super softening strips, disposable, or ones that took disposable blades, battery-operated vibrating razors, rubber grip, plastic grip, Bic brand, generic brand….

I never did go back in. I couldn’t. I needed someone to go and make the decisions for me.

I told my mom about it and she laughed and said I was just like our Romanian friends who came to visit America immediately following the fall of the Iron Curtain. I mean clearly they had had much less exposure to choice than I have in my life, but now I can at least appreciate why they were so shocked and why the women wept during their first visit to an American grocery store.

Because there just aren’t choices here. Everyone sells the exact same kind of powdered milk, instant coffee, vegetables, the same 3 kinds of soda, the ubiquitous Biskrem cookies, and the list goes on.

Because of this little episode, I’m anticipating the total basket case I will become during my first visit to our beloved Nugget Market when I’m home over the summer. If you’re lucky enough to see it, you might find me wandering the aisles muttering to myself, picking things up off the shelf only to put them back down again. That, or I’ll end up with a basket full of random combinations of food like cereal and brussel sprouts, or ketchup and ice cream, canned cheese and laundry detergent, food supplements and greeting cards, or just mountains of produce.

So next time you’re in a Safeway, or the Nugget, or Albertson’s, or Price Chopper, take a minute to look around at the condiment aisle, or the frozen food section (Ha! Imagine…having so much food you have to freeze it to keep it fresh! Amazing!) and picture what it would be like to have all of that taken away for a year and then step back into it unprepared, without a list, or a friend to keep you focused. I think you would’ve left Casino empty-handed too.

That, or maybe you’d still be wandering the aisles asking, “why are there so many kinds of soap?”
I definitely don’t have a good answer for that one.

7 rams later

People often ask me why I don’t go to our regional/transit house more often. I try to explain to them that it’s not just because I’m 200K away, that’s not the problem. From the next town over, if I can get a station wagon, and the car doesn’t break down, we don’t get stopped by the gendarmes, and barring all other major disasters, the trip usually only takes about 3 ½ hours door to door. Those are the good days, and they are rare.

Around Tabaski (muslim holiday in December) when I was leaving for Italy, I had the quintessential Senegalese public transport experience, which will help me illustrate why I try to stick around the Matam area as much as possible. If I need a night away, I prefer to just pay for a night at a hotel in air conditioning rather than make the trek to the regional house. This is why…

7:30 AM
I left the compound as soon as the sun was bright. I made the 20 minute walk to the garage with my bags and was pleasantly surprised to find that there was a station wagon available that morning (we call them “7 places”, meaning there should be 7 passengers including the driver. They are about the size of a Subaru Outback…but not nearly as luxurious, and they “hold” 8 full grown people, plus bags, no shocks, little ventilation, and various other discomforts). So I was thrilled because I could get this car directly to the regional house and not have to stop in the next big town over and change cars (which is usually the case).

6 passengers on board, one to go. #7 shows up. I think “Great! Let’s be on our way!” No way I’d be that lucky. Because what does this guy have as baggage??
Not 1, not 2, not even 5….No ladies and gentlemen, he brings with him 7 FULL SIZED LIVE RAMS!! Yep, you read that correctly, Rams, as in grown male sheep. Not puny little baby goats, full-sized rams that come up to my waist, with horns and all. I’m just standing there, my mouth open, staring and shaking my head “no way! There is no way they are going to fit 7 rams, 8 people and all our bags in this car. No way!”
I should know by now to have more faith in “max capacity transport situations.”

The men (of which there is always an abundance at the garage, sitting around idly looking for something to do, or watch, or anything really to stave off boredom) finally pack all of our bags in the back of the car. It is absolutely crammed full of our bags (which is why I unfortunately don’t have a picture of the whole thing).

Now they start to tackle the rams. Normally livestock are tied up and then stuffed into empty rice sacks to help cut down on the urine and feces that fall on us through the window (though if you’ve been following my blog since the beginning, you know that they are not very effective). But this time there were no rice sacks. I’m sure you clever people can imagine what’s going to happen later as a result.

Somehow, an hour later, we are on our way. This is the text message I sent out to a fellow PCV
“What do you get when you cross 7 full-grown Wolof men, 7 rams, and 1 astounded toubak? Answer: the contents of my 3.5 hour (inchallah) 7place ride.”

I have been shit on 2x during the 23K drive to the next town that I mistakenly thought we’d be able to bypass.

Reminder: It’s now been 4 hours since I left my hut and I’ve only traveled 23K. Tremendous.

We stop at the garage in the next big town. And what do we do? The men UNLOAD all 7 rams while the owner goes and buys 7 rice sacks. Then they reload them into the sacks, and back onto the roof. Meanwhile, I am in a state of total helplessness and disbelief at the fact that we have all paid the same amount of money to ride in this car and yet the rest of us have now wasted almost 2 hours for this guy’s posse of livestock!

Rams in sacks, people packed back inside. We take off…again.

We stop for gas. Except there isn’t any at this particular GAS station.

We stop at the next gas station and fill up.

Surprise! We stop again. Why? So one of the men can greet a friend and pick up his cell phone!? Are you kidding me? Last time I checked we weren’t in this car to run personal errands. But apparently I was mistaken.

Arrive at regional house.

For those of you keeping count that’s 7:30AM-3PM, 7 ½ hours it took me to travel 200K or 125 miles.

When I told this story to an ex-marine he said to me,
“Cait…in all seriousness, I’ve been tortured, and I can honestly say I’d choose it any day over that.”

That definitely made me feel a little better. At least after the fact.

In the words of my dad,
“Cait, I never thought I’d say this, but among my children, you are the one who will make it closest to any kind of military training.”

The best part about this story though is that I did not lose my cool. I remained calm, plugged into my Ipod, and buried in my book. Maybe if I was more culturally integrated I’d have been able to laugh and chat with the men as we waited, but I’m pretty proud of myself for not losing my mind, and exercising the Peace Corps mantra of Patience and Flexibility.

And if nothing else, now I know what the maximum capacity of a station wagon really is!