Thursday, September 16, 2010

Islamic Festivities and Getting down to business

It's finally come time to do some active health work in my village and surrounding areas. The past week has brought the opportunity to help facilitate health talks at several women’s groups in my community. My intention is to help guide sessions and ensure that all important points are covered. The local “health relais,” or volunteer health workers whose role is to sensitize their community on health, should be leading the sessions. This guarantees that when Peace Corps is no longer a part of Medina, health knowledge and trusted relais remain.

I've started organizing a “Women's Care Group,” and I am really excited about the possibilities. How it will (hopefully) work is that there will be 10 women in Medina dar Salam who volunteer to share health knowledge with their neighbors. My counterpart and I will meet with these 10 women (6 who have already been chosen!) bi-weekly to discuss a chosen health issue and do skits, songs, visuals to bring the subject to life. Then, each of those 10 women are responsible for sharing that health knowledge with 10 other women/households (that are predetermined ad remain the same through the duration of the program). They will go house to house over the two weeks in between meetings and individually greet, teach and build relationships founded on health, with their neighbors. This is all very idealistic considering how things will probably work, but I have high hopes that it could be a successful program that could be replicated in other villages.

My worry is that people will “talk the talk but not walk the walk.” This ugly phrase has come to mind often since I've been in Senegal. You see people who know that washing their hands with soap before eating with their hands will decrease diarrhea and other illnesses or that making and using natural mosquito repellent will likely prevent mosquito bites that cause malaria, but do not oblige by these simple health standards. Even my own counterparts and health relais talk about how important hand washing and other hygiene practices are, but if you go into their compounds you do not see most of it in practice. It's a tough road because people argue that soap is expensive or that they are already too busy to add yet another step in the schedule of their daily lives. It's true that people don't have money so my goal is to convince them to use the little money they do have to prevent illnesses, rather than doling out a large sum of money for malaria treatment. I am determined to slowly convince these 10 village volunteers to follow the health advice that they are sharing with their neighbors. In the long run BEHAVIOR CHANGE is my goal, whether it is pure peer pressure induced from other community members or truly a personal decision to follow the road to better health. Thoughts and prayers that these women (especially the volunteers) surpass all previous expectations and pave the road to better overall health in my village is much appreciated!

While getting to know my village, one of the biggest health issues that were identified are poor maternal and child health care. Every woman I talked to about child birth would mention that they have had one or several infants/young children die and I've heard of several women dying in childbirth or shortly after due to complications. Babies are not named for a week because infant mortality is so common. Based on the women I have talked to so far, I would say that the majority of women in my community are giving birth alone in their huts, conditions that I consider too unsanitary for my own health, let alone a newborn or a woman who has just given birth.

The nearest health post, a step up from the health hut in my community, with a matrone (who has training, but not equivalent to a midwife) is 7 k away. It has a structure meant for to be a maternity ward, but has been damaged due to poor construction and storms since its construction and has sadly never been used. Currently, women who make it to the health post give birth in a small room with two beds (only one meant for labor) with no comforts.

Spence (my closest neighbor who lives 1k away from the health post) and I are in the process of trying to ensure the training of a midwife who will serve the women that go to the health post. We plan to find funding (God willing, as they say here), to repair the maternity ward, provide better care to women and infants and lighten the 'doctor's' work load.

I want to also bring a trained matrone to assist in childbirth to my own community. Again, the health post is 7k away and while it is definitely better to give birth there, many times circumstances will not allow it. I think that having a woman educated in child birthing hygiene, problems, etc. could greatly reduce the maternal and infant mortality rates in my community.

On a lighter and more fun note RAMADAN HAS ENDED!!! Not that I was fasting at the end of it, but it was still a fun community celebration. Korite is the second most important or celebrated holiday for Muslims in Senegal after Tabaski. The men shave their heads and dress in their finest apparel and the women braid their hair, henna their feet and hands and adorn themselves in jewelry and their prettiest complets.

The day before Korite was spent getting ready. My sisters hennaed all of the women in my compounds feet, including mine. The drums went off at the mosque around 7:30pm signifying that the moon had been spotted and sure enough Korite would take place the next day. People were giddy with excitement.

On Korite morning my sister braided my hair and my brother ironed all of our clothes. We all went to mosque and there was surprisingly something very familiar about the repetion and praying in unison that was comforting. I had been to mosque a few times before during Ramadan in the evening, but this morning time prayer felt nearest to home. At the end of prayer everyone went around saying, “Did you pray in peace?” Just like the Christian sign of peace. People asked for days afterward if you prayed in peace. I gave my brother, Mamadian, my camera and was rewarded with a billion and two photos. Here are a few:



The rest of the day people spent eating (Yes Sam...even corn on the cob now!). I went around the entire village meeting and greeting people who were celebrating. It was a special time to be in people's homes, break their month long fast with them, joke around, play with their children, etc. Mamadian again had my camera and here are a few shots for you to enjoy.

At the end of the day there was a soccer match that was all the rage in Medina and the surrounding villages. It was like the stereotypical high-school football game crowd. All of the girls dressed up even more than they did for mosque that morning and all of the guys huddled in groups making fools of themselves. Again feelings of home popped up as I watched the game with my siblings. Overall Korite was a special day shared with meaningful people.

Oh yeah...I've lived in Senegal for 6 months now! Thanks for the love, support, and prayers of everyone who has kept me going and sane. I love you and am grateful that everyone of you is in my life!