Retrospective 04: Laafi Bala

One of the first things that Burkinabe will ask you about in the daily 10-minute greeting routine (this is well documented in many other blogs, I don't feel the need to cover it) is your health (laafi in Moore). The philosophy is simple: if you have your health, then what you perceive to be problems will eventually work themselves out (ça va aller or ça ira).

In Americaland, what would you pay to have total coverage, i.e. doctor on-call "24 on 24" (the French equivalent of 24 hours a day/7 days a week/365 days a year)? If you watch Royal Pains at all, apparently you would pay a lot for the services of your concierge doctor for each call. If you are a Peace Corps Volunteer, you pay nothing. That's right nothing. PCVs only get a monthly allowance that is adjusted based upon the standard of living, and after two years of service a readjustment allowance of less than USD$10000, but we get total health coverage. It was quite wonderful if you ask me.

Granted, our PCMOs (doctors) are not there to be abused. We are given basic survival health training, and encouraged to call during business hours for non-emergencies. Nonetheless, all of my medical tests (blood work, stool and urine samples), medication, dental and even vision were completely covered. In the event that I had to buy my own medication, I could apply for reimbursement. During my service, I had a couple of dental emergencies that were resolved within a week, regardless of where I found myself in the world.

PoopIn the beginning, almost all new PCT/Vs have to readjust their definition of emergency. The most constant problem for most of us are gastrointestinal issues. Many new PCT/Vs are disappointed that explosive diarrhea once is not just cause to freak out. When it's repeated and frequent, then there is a bigger issue at hand. Some people get parasites, bacteria, viruses or amoebas through the water, food, or poor personal hygiene of the food preparer/server/self. Others have issues just because of stress or change in diet. My frequent enemy was Giardia (aka Beaver Fever which can lead to Vitamin B deficiency and Anemia and lactose intolerance and destruction of the body's ability to absorb nutrients). Luckily, there are drugs that destroy it and also to help your body absorb nutrients.

Food
(the source of Poop)Many PCTs find that the food in Burkina is much more oily, salty and starchy than what they are used to in America. However, when one considers the lack of preservatives, fillers and other things that go into American engineered food. Food in Burkina is actually healthier... provided it is prepared correctly and that you make an effort to balance your diet. A lot of food in Burkina can be overcooked, and bouillon cubes (MSG + other things that make me want to pass out) and non-iodized salt are often used.

Balancing your diet can be tricky in Burkina, but that is mainly because most new PCVs don't learn Burkina's agricultural cycle during PST. Certain fruits and vegetables are only available at certain points of the year (with the exception of the major cities). This combined with local traditions in small villages (e.g. my village cancels the market day for a month every year) can lead to malnutrition problems such as anemia. My second and third years, I was prepared for this magical month of no fruits and vegetables (recognized by Americans), and avoided the drastic weight loss I suffered my first year. If you are open-minded, and try the local foods (like various tree leaves, and dried versions of fruits and vegetables), then you will be able to provide your body with all of the necessary vitamins and minerals.

Traditionally, female PCVs gain weight and male PCVs lose weight. However, I've found this is directly related to the activity level and the diet of each individual (as can be expected and appears to be an international conclusion). So, in theory, if I maintain my preference for a bland diet (since most engineered foods here make me feel miserable) and start exercising again now that I'm in Americaland (after a six month hiatus... riding a motorcycle is so much more fun than a non-existent (read: returned to Peace Corps) bicycle), I should be down to fashion model size in about a year.

Wild SpeculationSo, there is still hope for me to become America's Next Next Top Model (I might be watching too much terrible TV)... except I'm too old and blind. At least, being healthy will more than make up for it (maybe).

Of course, certain bridezillas may disagree and want me to be all plump for their October wedding.

Morals of the story: There is a 99% (made up statistic, but close enough) chance that a PCV in Burkina Faso will have debilitating gastrointestinal issues. A balanced diet is possible and exercise is good for you.