The Bamako airport is full of travelers and eager Malians swarming them with luggage carts and little trinkets for sale, trying to make a buck. I have decided to come all the way here to bid farewell to my uncle Steve, cousin Matt and sister Katie. I just wasn’t ready to say goodbye at the hotel. So I hugged them goodbye before they weaved through the crowd to catch the night flight to London, promising that the months before my Christmas visit would go by fast. It was a good week, and a great experience for all of us.
Of course, I was overjoyed to see my Boston relatives. The fact that they came all the way here to spend some time with me in the middle of nowhere, well that’s about as cool of relatives as you can ask for. But when I saw my sister, I gave her the biggest hug ever. My mom later asked on the phone, “Did you cry when you saw each other.”
“No mom,” I said, “I was just so happy.” I looked at Katie, expecting her to comment on how mothers are overly-emotional. But instead Katie said with her little honest smile, “I cried a little!” It took about 5 minutes after we were reunited for me to say, “Katie, I feel like I just saw you yesterday.” It had really been 13 months, but we were so comfortable with each other, having fun already. Man, I have the best sister in the world. She really is my other half, and all week, I felt like whatever might have been missing in my day to day life out here had been filled.
A big red bag, like Santa’s sack, came with the crew. All filled with goodies. Birthday presents like new clothes and mountains of granola bars from friends and family, magazines, homemade jam and applesauce… (Thanks everyone!) Uncle Steve even came with a solar powered flashlight and a new tent that he would leave with me after they left. It was incredible! We stayed the first two nights at the fancy Radisson hotel, the next night in a little motel in the city of Segu, then we moved to a business hotel in Bamako (mainly for its incredible pool), spent a night in village, and then another night in Bamako.
I’ll let them tell you about the adventures through their own eyes. (Katie, Steve, Matt, you’re welcome to write something for me to post as well). They braved the Grand Marche the very first day, they spent hours in little Malian cars so we could see the port of Segu and make our own Bogolon fabric. They took the broken old bush road to Dombila where they danced with the xylophones, tried Malian food, and mingled with the locals. Uncle Steve even went for a peaceful morning run with me and Shaka! Matt was the star of the dance party, showing off his disco moves, and Katie impressed the kids with her back-handspring and also sported the traditional Malian garb along with henna painted on her foot. (Only ONE foot though, to the great confusion of the Malians).
Katie and Matt also had some great skills at the rock climbing/ rappelling hike in Siby. They are fearless! They even got on Malian transport to return to Bamako. That was after we gave up waiting for hours for our driver to come back with something to mend a flat tire. Uncle Steve got a bit worried when we showed up 4 hours late, but all was good.
Aside from the adventures, we had significant R&R time. The pool at the hotel was paradise, we ate some really nice meals out, and I even got to work out a couple of times in the hotel gym! I feel like I was treated like a princess. Nice showers, clean all the time, air conditioning, a great bed, great company, great food. It was more of a vacation for me I think! At first, I was really uncomfortable being in these fancy hotels spending a lot of money, but then I started to get used to the high-life. It’s strange, you know. And now I feel like an American again, needing my daily dose of the internet and drinking bottled water. I’m going back to village right now, with that site guilt on my shoulders. I’m living between two worlds, and I’ll never fully be a part of either of them for the next year. I was feeling Malian, now I’m feeling like an American. But whatever doubts and worries I have, about status, about rich and poor, white and black, though they may always be in the background isn’t the essence of my identification, my relationships. Katie, Steve, and Matt reminded me of my roots, my home, and the beauty of it. But now I take a deep breath, push aside my doubts and know that no matter what my roots, today, I have another real home, in Dombila. So as much as I was tempted to hop on that plane in the Bamako airport last night and reunite even more fully with my roots and with the “comfortable life”, that time has not come. I’m heading back, and trying to figure out what the heck I can do for this poor little village.
PS- Matt has an incredible camera and great photography skills. He will send me his flicker site to post so that you can see some more pictures of Mali.
Wednesday, August 12, 2009
Wednesday, August 5, 2009
Mother of the bride
"My daughter is getting married on Thursday in Kati. I am the mother of the bride. It is a big deal. You are coming."
I looked at Irene with a blank stare. Who? Not Awa, though she is a new mother, I know she's not getting married.
"What's her name?"
"Batuma." I had never heard of this daughter before. But sometimes Malians extend their immidiate family like that. When I told them that my uncle was coming to visit, they asked if it was an older or younger brother of my mom's. "It's my dad's older brother," I explained to them. "Ohhh," said my host mom, "that's not your uncle, that's your other father."
In that same logic, Batuma was really a neice, her mother alive and well. But aparently Irene was the mother of the bride and I was obliged to go.
I met up with them after I spend a couple of sick days in Bamako (all better now), and found Irene primping herself with tons of scary eye-makeup and her hair all did. She had a very large sparkly headress and a moumu. (She would proceed to change her outfit a total of four times during the day). She actually looked cool though, like an African queen. She had one of her little neices put henna on my feet and hands. Henna is black dye that Malians draw flowers and little designs on their hands and feet for special occasions. Its kind of like temporary tatoos that last for a week or so. It dried painfully over the many blisters I aquired from wearing my Caroline's running shoes the day before.
The wedding was different than any I had attended in Dombila. Namely, this was the bride's side. And also, these were richer people. I felt pretty underdressed in my old pink complee. No sparkly headress here. I didn't even have any jewlery with me. We sat in fold-out chairs under a colorful tent with dozens of women. Yes, only women the whole day. This was not a man's party. They danced in a circle surrounding the xylophones, and Irene literally forced me out of my seat a number of times to join the dance. I wish I could write about this experience from the point-of-view of a visiting anthropologist. A beautiful traditional ceremony filled with colorful culture. Yet as much as I tried to enjoy the experience, I essentially was Irene's dog on a leash all day, and abided to follow her everywhere when she called me. What else was I going to do?
We spent the late afternoon in the bride's room. You see, the Malian bride does not come out of the house on her wedding day. She stays inside, greeting people who stop in, as she waits for nightfall. That's when they will bring her to her husband's house where she will stay FOR-EV-ER. I told you how distraught I was when I saw Mody's new wife crying upon being left in her new husband's compound, but I think I understand now. It's just like going off to college, for good. A girl lives with her father until her wedding day, and then packs up all of her stuff and leaves. It's a tearjerker for the whole family.
Batuma was inside with her closest girl-friends, Irene, and I (feeling quite awkward and out of place). Her things were packed and she was waiting on her bed, looking beautiful in dark bazan, henna, and fine jewlery. The room was dark and stuffy, and I was sitting on the bride's right side while people came in to greet, give blessings and cry.
At one point we went outside to do the first round of gifts. A griot (traditional singer of blessings) would sing to Batuma, who was getting her face and feet washed by an old woman. You could throw money toward the griot and she would announce, in song, how much money you gave to the bride and then sing your special message. Irene gave a small bill and I heard her whisper to the griot that she has know Batuma for 18 years and how special she was to her. The griot began singing, "Oh Batummaaaa, she's known you for 10 years..." And everytime she said "10 years" Irene scoffed in the background, shaking her haid. "It's much more than 10." When it was over, they shooed Batuma away, and called, "Next!" and a whole other group of people came to the spot. I was confused.
As we waited in the bedroom, Batuma had a dark shawl and veil covering her. Another girl came in with the same exact outfit, followed by the future sister-in-law who looked at them closely. "This one's Batuma. You're coming with me!" Was this some kind of traditional guessing game? With look alike brides that you have to pick the real one? I had no idea.
They passed a long time putting off the big leave, nighttime fell and we went without dinner. Soon the party had ended and Irene was taking Batuma around the street, greeting the elders and getting ready for the departure. This was Irene's show now. And when she called a car over, she and Batuma entered, and so did I, on that leash.
We drove and drove through the night on the streets of Kati toward Bamako. After a while, the rickety old car descended off the road into a dirt path in a small valley. We twisted and turned- as far as I could see we were going into the middle of nowhere with only our two headlights to light the way. I prayed for our saftely.
We arrived in a large compound in a small village. The husband's house. The family was welcoming, and among 3 albino young women, I felt somewhat at home. We sat in the dark as Irene went through a series of negotiations with the new family. "You must buy her a white gown," Irene demanded.
They agreed, as long as they would agree to abide by the tradition that a new bride must stay inside the house for a whole 7 days after the wedding. "Our neighbors new bride only spent 3 days inside for the honeymoon. And that marriage turned out terrible!"
We headed back to Kati late, Irene semi-emotional, but also complaining of a tea-deprived headache. She was good to have around for the new bride, I thought, people listen to this woman. But why did she do this job?
"The real mother of the bride never drops the bride off. You always get a relative and name her 'the mother of the bride'. They go and do all the negotiations and drop the daughter off."
Ohhhhh. I get it now. But why was there another girl dressed as a bride? Were there two marriages today?
"There were four." I guess its normal for a family to get all of their weddings done in one shot. In one day, this family married off three of their daughters, and brought in a woman for their son. No wonder it was a big party.
I looked at Irene with a blank stare. Who? Not Awa, though she is a new mother, I know she's not getting married.
"What's her name?"
"Batuma." I had never heard of this daughter before. But sometimes Malians extend their immidiate family like that. When I told them that my uncle was coming to visit, they asked if it was an older or younger brother of my mom's. "It's my dad's older brother," I explained to them. "Ohhh," said my host mom, "that's not your uncle, that's your other father."
In that same logic, Batuma was really a neice, her mother alive and well. But aparently Irene was the mother of the bride and I was obliged to go.
I met up with them after I spend a couple of sick days in Bamako (all better now), and found Irene primping herself with tons of scary eye-makeup and her hair all did. She had a very large sparkly headress and a moumu. (She would proceed to change her outfit a total of four times during the day). She actually looked cool though, like an African queen. She had one of her little neices put henna on my feet and hands. Henna is black dye that Malians draw flowers and little designs on their hands and feet for special occasions. Its kind of like temporary tatoos that last for a week or so. It dried painfully over the many blisters I aquired from wearing my Caroline's running shoes the day before.
The wedding was different than any I had attended in Dombila. Namely, this was the bride's side. And also, these were richer people. I felt pretty underdressed in my old pink complee. No sparkly headress here. I didn't even have any jewlery with me. We sat in fold-out chairs under a colorful tent with dozens of women. Yes, only women the whole day. This was not a man's party. They danced in a circle surrounding the xylophones, and Irene literally forced me out of my seat a number of times to join the dance. I wish I could write about this experience from the point-of-view of a visiting anthropologist. A beautiful traditional ceremony filled with colorful culture. Yet as much as I tried to enjoy the experience, I essentially was Irene's dog on a leash all day, and abided to follow her everywhere when she called me. What else was I going to do?
We spent the late afternoon in the bride's room. You see, the Malian bride does not come out of the house on her wedding day. She stays inside, greeting people who stop in, as she waits for nightfall. That's when they will bring her to her husband's house where she will stay FOR-EV-ER. I told you how distraught I was when I saw Mody's new wife crying upon being left in her new husband's compound, but I think I understand now. It's just like going off to college, for good. A girl lives with her father until her wedding day, and then packs up all of her stuff and leaves. It's a tearjerker for the whole family.
Batuma was inside with her closest girl-friends, Irene, and I (feeling quite awkward and out of place). Her things were packed and she was waiting on her bed, looking beautiful in dark bazan, henna, and fine jewlery. The room was dark and stuffy, and I was sitting on the bride's right side while people came in to greet, give blessings and cry.
At one point we went outside to do the first round of gifts. A griot (traditional singer of blessings) would sing to Batuma, who was getting her face and feet washed by an old woman. You could throw money toward the griot and she would announce, in song, how much money you gave to the bride and then sing your special message. Irene gave a small bill and I heard her whisper to the griot that she has know Batuma for 18 years and how special she was to her. The griot began singing, "Oh Batummaaaa, she's known you for 10 years..." And everytime she said "10 years" Irene scoffed in the background, shaking her haid. "It's much more than 10." When it was over, they shooed Batuma away, and called, "Next!" and a whole other group of people came to the spot. I was confused.
As we waited in the bedroom, Batuma had a dark shawl and veil covering her. Another girl came in with the same exact outfit, followed by the future sister-in-law who looked at them closely. "This one's Batuma. You're coming with me!" Was this some kind of traditional guessing game? With look alike brides that you have to pick the real one? I had no idea.
They passed a long time putting off the big leave, nighttime fell and we went without dinner. Soon the party had ended and Irene was taking Batuma around the street, greeting the elders and getting ready for the departure. This was Irene's show now. And when she called a car over, she and Batuma entered, and so did I, on that leash.
We drove and drove through the night on the streets of Kati toward Bamako. After a while, the rickety old car descended off the road into a dirt path in a small valley. We twisted and turned- as far as I could see we were going into the middle of nowhere with only our two headlights to light the way. I prayed for our saftely.
We arrived in a large compound in a small village. The husband's house. The family was welcoming, and among 3 albino young women, I felt somewhat at home. We sat in the dark as Irene went through a series of negotiations with the new family. "You must buy her a white gown," Irene demanded.
They agreed, as long as they would agree to abide by the tradition that a new bride must stay inside the house for a whole 7 days after the wedding. "Our neighbors new bride only spent 3 days inside for the honeymoon. And that marriage turned out terrible!"
We headed back to Kati late, Irene semi-emotional, but also complaining of a tea-deprived headache. She was good to have around for the new bride, I thought, people listen to this woman. But why did she do this job?
"The real mother of the bride never drops the bride off. You always get a relative and name her 'the mother of the bride'. They go and do all the negotiations and drop the daughter off."
Ohhhhh. I get it now. But why was there another girl dressed as a bride? Were there two marriages today?
"There were four." I guess its normal for a family to get all of their weddings done in one shot. In one day, this family married off three of their daughters, and brought in a woman for their son. No wonder it was a big party.
The Miracle Tree
The kids and I planted a couple of dozen Moringa trees, which have grown quite nicely. Lately, I've been taking them around the village and giving them to mothers of malnourished kids and close friends.
So what is Moringa? They call it the miracle tree. It's leaves are amazingly high in an abundance of nutrients. Moringa has 7 times the vitamin C of an orange, 3 times the iron of spinich, 2 times the protien of milk, 4 times the calcium of milk, 3 times the potassium of bananas, and 4 times the vitamin A in carrots. The leaves can be dried and turned into a natural nutritional suppliment, which we can add to a baby's porriage. The seeds can be grinded into a powder that purifies water. The flowers can be made into a tea that aleviates headaches.
There are a couple naturally growing moringa trees in Dombila, but the kids and I have planted some more, which grow very quickly, even in unfertilized soil. I also planted 6 at the CSCOM with the help of Laji, a tree-worker who cut his leg down to the bone on the job and has been hanging out at the CSCOM for the past two months while it heals and he tries to figure out how to get money to keep up his medications. He took some pride in this occupational therapy. Unfortunately, most of the nutritional benifits of our baby trees at the CSCOM have been enjoyed by the goats.
I've written about moringa before, about how I put the leaves in my spagetti. It's hard to explain to Malians just how much of a miracle it is when they have limited understanding of vitamins, minerals, and macronutrients. I've found the most comprehensive nutrition education that makes sense to them so far is "This food has lots of vitamins. This food doesn't." So when I explain moringa, I say, "This has lots of lots of lots of vitamins!"
Little by litte, people are understanding. I have women tell me that their breast milk increased after putting moringa in their sauce, I caught Shaka's family cooking it for dinner, and almost weekly I find Irene giving a talk about it to pregnant women and mothers in the CSCOM.
For more information on moringa, here is a pretty good video.
So what is Moringa? They call it the miracle tree. It's leaves are amazingly high in an abundance of nutrients. Moringa has 7 times the vitamin C of an orange, 3 times the iron of spinich, 2 times the protien of milk, 4 times the calcium of milk, 3 times the potassium of bananas, and 4 times the vitamin A in carrots. The leaves can be dried and turned into a natural nutritional suppliment, which we can add to a baby's porriage. The seeds can be grinded into a powder that purifies water. The flowers can be made into a tea that aleviates headaches.
There are a couple naturally growing moringa trees in Dombila, but the kids and I have planted some more, which grow very quickly, even in unfertilized soil. I also planted 6 at the CSCOM with the help of Laji, a tree-worker who cut his leg down to the bone on the job and has been hanging out at the CSCOM for the past two months while it heals and he tries to figure out how to get money to keep up his medications. He took some pride in this occupational therapy. Unfortunately, most of the nutritional benifits of our baby trees at the CSCOM have been enjoyed by the goats.
I've written about moringa before, about how I put the leaves in my spagetti. It's hard to explain to Malians just how much of a miracle it is when they have limited understanding of vitamins, minerals, and macronutrients. I've found the most comprehensive nutrition education that makes sense to them so far is "This food has lots of vitamins. This food doesn't." So when I explain moringa, I say, "This has lots of lots of lots of vitamins!"
Little by litte, people are understanding. I have women tell me that their breast milk increased after putting moringa in their sauce, I caught Shaka's family cooking it for dinner, and almost weekly I find Irene giving a talk about it to pregnant women and mothers in the CSCOM.
For more information on moringa, here is a pretty good video.
Tuesday, August 4, 2009
Korotoun
Rainy season is bitter-sweet in Mali. It's a time of rejoycing in the planting of the new harvest. The hungry season has come to an end, the heat lets up after a refreshing rain-storm several times a week. In fact, the rain is so sacred to the Malians that I once got in trouble for joking about it. A strong wind came and everyone said that it was going to down pour. I said,"Nah, it's not going to rain". And it didn't. This happened a second time when I joked that I told the dark clouds to go away so that we could go on a vaccination expedition. The clouds let up and vaccinations were back on. Yet the farmers were angry- "Where's our rainstorm Aminata? You chased it away!" I continued the joke and out of the blue said, "Don't worry, we'll get a big storm Saturday night." What a coincidence it was, I was 3 for 3 and we got a steady, soaking rain on Saturday night. I stopped my weather forcasting after the rumor spread around village that perhaps I had some strange powers that could control the rain. "You gotta stop telling people you're stopping the rain!" Shaka says in all seriousness, "If the crop is bad this year, they'll all curse you!"
But now that we're well into the rainy season, not even I can stop it. Yet as much as the rains are giving life here, nourishing millet fields with puddles, these storms also bring the winds of death. Rain means mosquitoes. Mosquitoes mean malaria. Rain means everything is dirty. Uncleanliness brings intestinal disease, diahreah or worms, which also take the lives of kids in sub-saharan Africa. We've seen a lot of hardship at the CSCOM lately. One example, women and girls get up before dawn to go harvest the nuts of the shea trea far out in the brusse. I begged my host mom to let me go with her everyday. She refused- "It's too dark and dangerous out there!" When a young girl returned from a shea nut expidition and died from a snake bite two days later in our CSCOM, I stopped asking.
And the most frusterating is just when we feel like we're starting to get through to the women about malnutrtion, it skyrockets. It's amazing how the kids who have been in our program for a long time have recovered. I love taking out their sheet and putting them in pile of successes. But for every kid we let go, lately, there are 3 or 4 new ones that are referred to us. Some are fighting or recovering malaria or diareah, some are referred by our relais who are really stepping up their work in the community, and others are just simply not fed. They are strapped on their mother's backs all day to work in the fields. No time to specially make ameliorated porriage for the baby. Drink until the breast goes dry.
I registered 4 severely malnourished children (defined as less than 70% of the median weight for its height) in two days. But none was quite as bad as Korotoun. At 20 months, Korotun was barely 5 kg (about 11 pounds). In my 10 months in Dombila, I've only seen 3 other kids as bad as Korotoun. Each one we recommended in-patient treatment. Each one, the family refused. Can we really drop our lives and scrounge up the money to support ourselves to live in the dusty old sick-ward in the CSCOM for an indefinate period of time? Each one died.
But Korotoun's case was exciting because the family accepted in-patient treatment. We explained to the parents that they were to stay with Korotoun here as our staff carefully measured and prepared vitamin-enriched milk to be given her. She would also be given a coctail of medications and vitamins so that her body would eventually stop throwing up everything given to her, and that she would keep well hydrated and protected against vulnerable infections like malaria or rougeole. The father left in tears to walk back to his village, Dio, to collect their things. Of course, I felt so much pity for the child and the family. But I was more hopeful and excited as I had ever been. A father, sitting with his sick child, being so moved... that doesn't happen every day. A child is a woman's buisness. And if she can't feed him right, it's her fault, never mind the father. To see their courage and trust in us. Even the child's grandmother came, and the three of them set up camp in the sick room next to Laji, the guy who's had a gash on his foot for months.
I went straight to the book and planned out Korotoun's diet regimine for the first few days of her treatment. "We have to feed her every hour," Irene says. "Well, not necissarily," I said, "It might be better if we split it up every hour and a half so that she can get her calories gradually throughout the day." Of course, Irene is not refering to the handbook but only to the training she went to last year. "Believe me, I know, I went to the training." Well ok then. We'll feed her every hour.
Korotoun's case came at a time when I was looking for something to keep me busy. And honestly, I could have sat with that little girl every hour, feeding her the warm milk. But I was scared to. I was scared to take on all the responsibility that should be on the permanent CSCOM staff. But mostly, I was scared of getting to attached. Korotoun was so fragile. The day I met her, she couldn't even hold her head up by herself. He eyse too, kept rolling into the back of her head. Her cry was a pained, suppressed whimper, that was lost in the thickness of stuggles she must have been feeling. Yet she drank the milk. She drank it every hour. I left in hopeful confidence at about 2:00pm, Irene assuring me that she would administer the remaining 4 meals of the day.
I came in the next morning to find that Irene only had time to give one of the four meals of the afternoon. "We had a woman in labor! We were in there for a long time. We didn't have time to give the other meals. Besides, the kid was full anyway!" Are you kidding me? It's not about the kid being "full"! It's about carefully calculated calories, protiens and medications portioned out by scientists for her exact weight and height that should be enough to help stabilize her but not too much to overwhelm her system. You can't just wing it.
Cool it, Em, I thought. At least she's here. She got a lot more nutritents yesterday than she did in a long time. She's being helped and besides, she looks a lot better today. Her family was also optomistic. Her eyes were steady, and though too large for her sunken face, were stable and alert. She only lost a little of her food from yesterday, and had a good night's sleep. I began talking to Boary about switching her over to the transition phase, a post-stabilizing regime that initiates the weight-gain process. He said we would start that in another day. Even after I weighed Korotoun to find out her 5.1 kg had dropped to 5.0 kg since yesterday, I wasn't too worried. Today is the day she's really gonna start eating.
The CSCOM staff all signed up for slots to feed Korotoun so that she wouldn't miss a meal. I took the last two, number 7 and 8, so that I could go to market with Caroline during the day. I came back late afternoon to find that Irene had already given her her 7th meal. Her appetite had slowed down a little just before afternoon, but she had eatedn well during the day. I hung around until meal number 8, when I came in with the warm milk that I had made with UNICEF'S packaged powder. He mother spoon=fed her ever so carefully. It was 9pm and Korotoun was tired. She would give these little pain whimpers in between drinks. And I found myself wanting to sit with her forever. I concentrated so hard, on each sip she took. When she would turn away, I would look into her eyes. Very deeply, connecting with the life hidden inside her broken body. "Drink it," I whispered, "Drink it." And without taking her puddle eyes off me, she would calm her crying and drink. It took a while to get the whole meal down. "Drink it, drink it," I said, trust it.
I happily announced to Boure, our chef de poste, that Korotoun had had all 8 of her meals today. "Great!" He said. "Tomorrow we'll start her on the transition phase." Shaka, who had come to watch TV at Boure's, and I walked home about 9:30pm. "You were right Aminata. That baby's really skinny!" He said. "Yeah, but she's doing better today."
The next morning, I stopped by the CSCOM before work on my morning run to see how she was doing. I met Irene at the gate. "How's our baby? How's the family?"
"They left. She died last night. 10pm."
But now that we're well into the rainy season, not even I can stop it. Yet as much as the rains are giving life here, nourishing millet fields with puddles, these storms also bring the winds of death. Rain means mosquitoes. Mosquitoes mean malaria. Rain means everything is dirty. Uncleanliness brings intestinal disease, diahreah or worms, which also take the lives of kids in sub-saharan Africa. We've seen a lot of hardship at the CSCOM lately. One example, women and girls get up before dawn to go harvest the nuts of the shea trea far out in the brusse. I begged my host mom to let me go with her everyday. She refused- "It's too dark and dangerous out there!" When a young girl returned from a shea nut expidition and died from a snake bite two days later in our CSCOM, I stopped asking.
And the most frusterating is just when we feel like we're starting to get through to the women about malnutrtion, it skyrockets. It's amazing how the kids who have been in our program for a long time have recovered. I love taking out their sheet and putting them in pile of successes. But for every kid we let go, lately, there are 3 or 4 new ones that are referred to us. Some are fighting or recovering malaria or diareah, some are referred by our relais who are really stepping up their work in the community, and others are just simply not fed. They are strapped on their mother's backs all day to work in the fields. No time to specially make ameliorated porriage for the baby. Drink until the breast goes dry.
I registered 4 severely malnourished children (defined as less than 70% of the median weight for its height) in two days. But none was quite as bad as Korotoun. At 20 months, Korotun was barely 5 kg (about 11 pounds). In my 10 months in Dombila, I've only seen 3 other kids as bad as Korotoun. Each one we recommended in-patient treatment. Each one, the family refused. Can we really drop our lives and scrounge up the money to support ourselves to live in the dusty old sick-ward in the CSCOM for an indefinate period of time? Each one died.
But Korotoun's case was exciting because the family accepted in-patient treatment. We explained to the parents that they were to stay with Korotoun here as our staff carefully measured and prepared vitamin-enriched milk to be given her. She would also be given a coctail of medications and vitamins so that her body would eventually stop throwing up everything given to her, and that she would keep well hydrated and protected against vulnerable infections like malaria or rougeole. The father left in tears to walk back to his village, Dio, to collect their things. Of course, I felt so much pity for the child and the family. But I was more hopeful and excited as I had ever been. A father, sitting with his sick child, being so moved... that doesn't happen every day. A child is a woman's buisness. And if she can't feed him right, it's her fault, never mind the father. To see their courage and trust in us. Even the child's grandmother came, and the three of them set up camp in the sick room next to Laji, the guy who's had a gash on his foot for months.
I went straight to the book and planned out Korotoun's diet regimine for the first few days of her treatment. "We have to feed her every hour," Irene says. "Well, not necissarily," I said, "It might be better if we split it up every hour and a half so that she can get her calories gradually throughout the day." Of course, Irene is not refering to the handbook but only to the training she went to last year. "Believe me, I know, I went to the training." Well ok then. We'll feed her every hour.
Korotoun's case came at a time when I was looking for something to keep me busy. And honestly, I could have sat with that little girl every hour, feeding her the warm milk. But I was scared to. I was scared to take on all the responsibility that should be on the permanent CSCOM staff. But mostly, I was scared of getting to attached. Korotoun was so fragile. The day I met her, she couldn't even hold her head up by herself. He eyse too, kept rolling into the back of her head. Her cry was a pained, suppressed whimper, that was lost in the thickness of stuggles she must have been feeling. Yet she drank the milk. She drank it every hour. I left in hopeful confidence at about 2:00pm, Irene assuring me that she would administer the remaining 4 meals of the day.
I came in the next morning to find that Irene only had time to give one of the four meals of the afternoon. "We had a woman in labor! We were in there for a long time. We didn't have time to give the other meals. Besides, the kid was full anyway!" Are you kidding me? It's not about the kid being "full"! It's about carefully calculated calories, protiens and medications portioned out by scientists for her exact weight and height that should be enough to help stabilize her but not too much to overwhelm her system. You can't just wing it.
Cool it, Em, I thought. At least she's here. She got a lot more nutritents yesterday than she did in a long time. She's being helped and besides, she looks a lot better today. Her family was also optomistic. Her eyes were steady, and though too large for her sunken face, were stable and alert. She only lost a little of her food from yesterday, and had a good night's sleep. I began talking to Boary about switching her over to the transition phase, a post-stabilizing regime that initiates the weight-gain process. He said we would start that in another day. Even after I weighed Korotoun to find out her 5.1 kg had dropped to 5.0 kg since yesterday, I wasn't too worried. Today is the day she's really gonna start eating.
The CSCOM staff all signed up for slots to feed Korotoun so that she wouldn't miss a meal. I took the last two, number 7 and 8, so that I could go to market with Caroline during the day. I came back late afternoon to find that Irene had already given her her 7th meal. Her appetite had slowed down a little just before afternoon, but she had eatedn well during the day. I hung around until meal number 8, when I came in with the warm milk that I had made with UNICEF'S packaged powder. He mother spoon=fed her ever so carefully. It was 9pm and Korotoun was tired. She would give these little pain whimpers in between drinks. And I found myself wanting to sit with her forever. I concentrated so hard, on each sip she took. When she would turn away, I would look into her eyes. Very deeply, connecting with the life hidden inside her broken body. "Drink it," I whispered, "Drink it." And without taking her puddle eyes off me, she would calm her crying and drink. It took a while to get the whole meal down. "Drink it, drink it," I said, trust it.
I happily announced to Boure, our chef de poste, that Korotoun had had all 8 of her meals today. "Great!" He said. "Tomorrow we'll start her on the transition phase." Shaka, who had come to watch TV at Boure's, and I walked home about 9:30pm. "You were right Aminata. That baby's really skinny!" He said. "Yeah, but she's doing better today."
The next morning, I stopped by the CSCOM before work on my morning run to see how she was doing. I met Irene at the gate. "How's our baby? How's the family?"
"They left. She died last night. 10pm."
Friday, July 10, 2009
Is Irene in jail?
No, she’s not. And she’s not going to be. But there was a question that she may be up for it. Is she going to be fired? Possibly. If she isn’t, she is going to quit and leave her job as a midwife, and leave the town of Dombila for good. At least that’s what she says now.
Irene was involved with what us as Americans would understand as a medical mal-practice civil case. Not quite as technical in Mali, but still gave her a bunch of problems. I’ve tried to act dumb and stay out of it but I’ve caught the drift and it’s not good.
It was revealed after a medical examination at the CESREF of Kati that Irene pushed on the stomach of a woman in labor so hard that she broke the umbilical cord. Irene didn’t call the ambulance for three days. When the women went to Kati and had 2 operations, her and her husband blamed the death of their child on Irene. “And-” as it’s always emphasized when a Malian is telling this story, “the baby was a BOY!” Oh no! Not a boy! If it was a girl, well, maybe we’d forgive her.
The father has demanded that Irene be fired from her job as a midwife. She took off to Kati for a week while ASACO had a series of meetings about it. Because there is no hard proof that she was responsible for the death of the child, she is probably not going to be fired. But according to Irene, the father said that even if she is not fired, he is going to kill her.
After all this I came to visit Irene in Kati on my way to Bamako. I was surprised to find her in good spirits. She said if it wasn’t for me, she’d call her daughter and have her bring her things and never come back. “The people of Dombila don’t trust me. The doctors in Kati say hat I’m mean and lazy and that I do not do my job well. If this is resolved, something else will come up soon. I’m done with midwife work.”
My shocked face also didn’t surprise her. “I’m not leaving you now. Once your service is up, I’ll quit. But we work together and I made a promise to Peace Corps that I would work with you and look after you. So don’t you worry. I’m not going anywhere. But when you go to America, I’m also leaving the village.”
I’ll be the last to stop her. I enjoy working with her, but her passion for the job has waned as she gradually looses her connection with the community. She is always speaking of how the Dombila women are lazy and stupid and impossible to work with. And apparently, they think the same about her. I love Irene, don’t get me wrong. She’s taken me in as her own daughter and has been enthusiastic about my projects and aspirations for Dombila. But I want to work with someone who isn’t going to walk out at the same time I do. Talk about sustainable development. If I work with one person closely for two years on improving the village, who is just going to leave the village, well, where does that leave our work?
So pray for her, and for the family of the dead child. It seems optimistic now that this situation will blow over. But the lasting effects it will have on the relationship between Irene and the community are yet to be told.
Irene was involved with what us as Americans would understand as a medical mal-practice civil case. Not quite as technical in Mali, but still gave her a bunch of problems. I’ve tried to act dumb and stay out of it but I’ve caught the drift and it’s not good.
It was revealed after a medical examination at the CESREF of Kati that Irene pushed on the stomach of a woman in labor so hard that she broke the umbilical cord. Irene didn’t call the ambulance for three days. When the women went to Kati and had 2 operations, her and her husband blamed the death of their child on Irene. “And-” as it’s always emphasized when a Malian is telling this story, “the baby was a BOY!” Oh no! Not a boy! If it was a girl, well, maybe we’d forgive her.
The father has demanded that Irene be fired from her job as a midwife. She took off to Kati for a week while ASACO had a series of meetings about it. Because there is no hard proof that she was responsible for the death of the child, she is probably not going to be fired. But according to Irene, the father said that even if she is not fired, he is going to kill her.
After all this I came to visit Irene in Kati on my way to Bamako. I was surprised to find her in good spirits. She said if it wasn’t for me, she’d call her daughter and have her bring her things and never come back. “The people of Dombila don’t trust me. The doctors in Kati say hat I’m mean and lazy and that I do not do my job well. If this is resolved, something else will come up soon. I’m done with midwife work.”
My shocked face also didn’t surprise her. “I’m not leaving you now. Once your service is up, I’ll quit. But we work together and I made a promise to Peace Corps that I would work with you and look after you. So don’t you worry. I’m not going anywhere. But when you go to America, I’m also leaving the village.”
I’ll be the last to stop her. I enjoy working with her, but her passion for the job has waned as she gradually looses her connection with the community. She is always speaking of how the Dombila women are lazy and stupid and impossible to work with. And apparently, they think the same about her. I love Irene, don’t get me wrong. She’s taken me in as her own daughter and has been enthusiastic about my projects and aspirations for Dombila. But I want to work with someone who isn’t going to walk out at the same time I do. Talk about sustainable development. If I work with one person closely for two years on improving the village, who is just going to leave the village, well, where does that leave our work?
So pray for her, and for the family of the dead child. It seems optimistic now that this situation will blow over. But the lasting effects it will have on the relationship between Irene and the community are yet to be told.
Planting Season
We’re well into the rainy season here which means the mangos are gone, the mosquitoes are out, and everyone is hard at work in the fields. The new trainnees land in country the night of the 10th, and as I think about myself a year ago, its amazing how much I really feel at home here. These foreign, strange people have become my close friends, I speak their language well enough to have real meaningful conversations, and I even find myself wanting to be more like them. My millet pounding has greatly improved (I don’t knock over the hollowed out tree stump much any more subsequently spilling a family’s dinner on the mud…), and while everyone is farming, I wanted to jump on the bandwagon.
“Well, what would you plant? Millet? Corn?” Shaka asked me on one of our runs.
“Nah, when those things are ripe theres so much of them around. I want to plant something that there isn’t much of.”
“Like what?”
“Cucumbers.”
So my host family agreed to give me a section of their garden so I could plant my cucmbers. But, I didn’t really want to be crowding them. “Is there like a field or something I could throw down my cucumber seeds?” Ever since my mom saw Dafine’s garden on her trip here, she begged her to help me start a little gardening. One day, Dafine had Shaka take me out behind her garden to show me the place I could plant my cucumbers. Turns out, it was an entire abandoned garden! Somebody just left it there, and gave Dalfine the permission to let me have it! It’s so perfect. It’s got a good amount of space, a stick fence and gate around it so the animals don’t get in, two dug out wells, and it’s right near Shaka’s family’s garden. When the 4 boys took me to see it, I jumped up and down and picked them all up and spun them around. I couldn’t believe this was my garden!
Shaka and the younger boys agreed to help me out, and they’re also gonna grow some stuff in it themselves to sell at the market. Me and Shaka are going seed shopping on Saturday- not just cucumbers my friends, but green peppers, maybe carrots, and a few other vegetables that you wouldn’t know and I don’t know the English words for them anyways.
Before our run we went out there with little garden hoes. It’s tough work. There’s no rotar-tiller here, or hose. To water it, I’m gonna have to buy a watering can and tie it to a string and draw water from the deep well. I couldn’t believe how those boys can work it. It’s their life though. Once school gets out- it’s to the fields. I see my boys less and less these days because they’re always working. Their daily afternoon “Let’s go bug Aminata” sessions, which previously drove me crazy, have thinned out and I miss them. But to have them come and work with me in my garden was the funnest thing ever. They didn’t even beg me for candy either (but I gave them some anyways, I’m such a sucker.)
“Well, what would you plant? Millet? Corn?” Shaka asked me on one of our runs.
“Nah, when those things are ripe theres so much of them around. I want to plant something that there isn’t much of.”
“Like what?”
“Cucumbers.”
So my host family agreed to give me a section of their garden so I could plant my cucmbers. But, I didn’t really want to be crowding them. “Is there like a field or something I could throw down my cucumber seeds?” Ever since my mom saw Dafine’s garden on her trip here, she begged her to help me start a little gardening. One day, Dafine had Shaka take me out behind her garden to show me the place I could plant my cucumbers. Turns out, it was an entire abandoned garden! Somebody just left it there, and gave Dalfine the permission to let me have it! It’s so perfect. It’s got a good amount of space, a stick fence and gate around it so the animals don’t get in, two dug out wells, and it’s right near Shaka’s family’s garden. When the 4 boys took me to see it, I jumped up and down and picked them all up and spun them around. I couldn’t believe this was my garden!
Shaka and the younger boys agreed to help me out, and they’re also gonna grow some stuff in it themselves to sell at the market. Me and Shaka are going seed shopping on Saturday- not just cucumbers my friends, but green peppers, maybe carrots, and a few other vegetables that you wouldn’t know and I don’t know the English words for them anyways.
Before our run we went out there with little garden hoes. It’s tough work. There’s no rotar-tiller here, or hose. To water it, I’m gonna have to buy a watering can and tie it to a string and draw water from the deep well. I couldn’t believe how those boys can work it. It’s their life though. Once school gets out- it’s to the fields. I see my boys less and less these days because they’re always working. Their daily afternoon “Let’s go bug Aminata” sessions, which previously drove me crazy, have thinned out and I miss them. But to have them come and work with me in my garden was the funnest thing ever. They didn’t even beg me for candy either (but I gave them some anyways, I’m such a sucker.)
Progress
So to follow up on work in Dombila, there are some new projects on the horizon. I’ve partnered with a NGO that has worked with Peace Corps to help start up a small women’s gardening project in the village of Sidian-Coro. The boss of the NGO, a quiet, content guy in his 40s, is from the commune of Dombila, and was very eagar to work with me when I came to his office in Bamako. He also wants to be my best friend- and gave me a ride in his car all the way to Dio. It was nice, but maybe I shouldn’t have taken it. He followed up by offering to take me anywhere I wanted anytime. When he came to my site, he left shaking hands and giving me a 10,000 cfa bill (about $20) and refused to take it back. It’s so weird to have people offering me stuff when I’m used to people trying to get stuff from me. But, maybe luckily, after visiting the project site, the gardening project is not going to be as big of an ordeal as I thought, so I won’t have to deal with this weirdness too much.
Our chef de post, Bouary is still plugging away on his computer work. He seems to understand quite a bit now. While we work, we talk about projects and such. As for getting the HIV rapid test in Dombila, he thinks its extremely important and knows the CSCOM staff is capable of HIV counseling. “I know there’s AIDS here,” he says, and continues to talk about the mother-to-child prevention drug that can save infant from contracting HIV if it is detected in their mother. So I was sent on a wild goose chase, and talked to some officials in Kati. Man the situation here is terrible. There are no materials. Kati trained 17 CSCOMs in the rapid test, but the Malian government does not have their act together and these places can not be equipped with the necessary materials to continue this group. “We can’t add Dombila to this list unless we can guarantee testing materials.” It seems unbelievable to me that three decades into the AIDS epidemic, poor countries still cannot have HIV tests available to people of high risk. It seems like a deeply rooted problem, in politics and organization, deeper that I can understand right now. But I’m gonna try to dig in the dirt, get as much information as I can, and even if Dombila’s HIV rapid test does not come during my service, Peace Corps should be active in this work- find out what’s going on up there with those people in charge, and see if we can’t voice our opinions.
My biggest prospective project now is a week long school with our 30 community health workers. I’m putting together educational materials, seeking out guest speakers and trying to develop an evaluation system along side the health workers for better quality work. The training school should happen in January 2010, so there’s time, but a lot of work.
I think I’m finally getting into the swing of things with the radio show. My Bambara is comfortable enough that I can be interviewed on-air and not have to stop and ask him to repeat the question 3 times (very embarrassing). We had a great show about water sanitation in which I interviewed some people working on the project. We joked around on-air, and at that moment, I really felt like I knew this language, like I knew what I was doing, and that I was where I was supposed to be.
Handwashing stations: rest in peace. Funny story, I had a little sit down meeting with the new mayor the other day. Actually, he’s a pretty motivated and smart old thin, white haired guy. I explained to him what my job is and has been so far. I asked him for suggestions on small projects. “You know, maybe you could do something with the school.” He is not from central Dombila, mind you, but the tiny outskirt village of Koyan. “Like fix up the latrines or give them a place to wash their hands.” Sounds like a good idea doesn’t it? It’s like trying to fix a square peg in a round hole. Admit defeat?
Binot says he can make new hand washing stations with left over material from the new school. But trouble is, he also says he can do a project with me building some solar fruit mango driers to get ready for next mango season. And to top it off, the whole village is counting on him to fix these damn wells. Of the 19 that were in the project. 16 were done quickly, efficiently, and with good quality. He was a motivated worker. And then he convinced the project committee to give him all of his salary and since then, he’s been a lazy bum! I can’t get him off his feet to finish these darn 3 wells. To his defense, his two sidekicks have since abandoned him to go work in their fields, but come on! There’s only 3 left! Let’s get to it so we can moooove on! I crept up on him one morning with a branch (supposedly to whip him) only to find him listening to Malian Christian xylophone tunes on his cassette player. Darn it, he’s being all religious. I dropped the whip, said a few bean jokes, and tried to believe him when he said he’ll get to work right away.
Our chef de post, Bouary is still plugging away on his computer work. He seems to understand quite a bit now. While we work, we talk about projects and such. As for getting the HIV rapid test in Dombila, he thinks its extremely important and knows the CSCOM staff is capable of HIV counseling. “I know there’s AIDS here,” he says, and continues to talk about the mother-to-child prevention drug that can save infant from contracting HIV if it is detected in their mother. So I was sent on a wild goose chase, and talked to some officials in Kati. Man the situation here is terrible. There are no materials. Kati trained 17 CSCOMs in the rapid test, but the Malian government does not have their act together and these places can not be equipped with the necessary materials to continue this group. “We can’t add Dombila to this list unless we can guarantee testing materials.” It seems unbelievable to me that three decades into the AIDS epidemic, poor countries still cannot have HIV tests available to people of high risk. It seems like a deeply rooted problem, in politics and organization, deeper that I can understand right now. But I’m gonna try to dig in the dirt, get as much information as I can, and even if Dombila’s HIV rapid test does not come during my service, Peace Corps should be active in this work- find out what’s going on up there with those people in charge, and see if we can’t voice our opinions.
My biggest prospective project now is a week long school with our 30 community health workers. I’m putting together educational materials, seeking out guest speakers and trying to develop an evaluation system along side the health workers for better quality work. The training school should happen in January 2010, so there’s time, but a lot of work.
I think I’m finally getting into the swing of things with the radio show. My Bambara is comfortable enough that I can be interviewed on-air and not have to stop and ask him to repeat the question 3 times (very embarrassing). We had a great show about water sanitation in which I interviewed some people working on the project. We joked around on-air, and at that moment, I really felt like I knew this language, like I knew what I was doing, and that I was where I was supposed to be.
Handwashing stations: rest in peace. Funny story, I had a little sit down meeting with the new mayor the other day. Actually, he’s a pretty motivated and smart old thin, white haired guy. I explained to him what my job is and has been so far. I asked him for suggestions on small projects. “You know, maybe you could do something with the school.” He is not from central Dombila, mind you, but the tiny outskirt village of Koyan. “Like fix up the latrines or give them a place to wash their hands.” Sounds like a good idea doesn’t it? It’s like trying to fix a square peg in a round hole. Admit defeat?
Binot says he can make new hand washing stations with left over material from the new school. But trouble is, he also says he can do a project with me building some solar fruit mango driers to get ready for next mango season. And to top it off, the whole village is counting on him to fix these damn wells. Of the 19 that were in the project. 16 were done quickly, efficiently, and with good quality. He was a motivated worker. And then he convinced the project committee to give him all of his salary and since then, he’s been a lazy bum! I can’t get him off his feet to finish these darn 3 wells. To his defense, his two sidekicks have since abandoned him to go work in their fields, but come on! There’s only 3 left! Let’s get to it so we can moooove on! I crept up on him one morning with a branch (supposedly to whip him) only to find him listening to Malian Christian xylophone tunes on his cassette player. Darn it, he’s being all religious. I dropped the whip, said a few bean jokes, and tried to believe him when he said he’ll get to work right away.
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