Retrospective 06: Health & Education Working Together

Burkina News:
A lot of Burkina is still in a lot of outrage over death of student in police custody due to police-claims of meningitis and the subsequent loss of life in initial riots following his death. Major cities still have striking and rioting, including burning down police buildings and allowing prisoners to escape. Some pro-CDP areas (supporters of the President) have had little public reaction and students have started going back to schools.

I'd rather not get into opinions about politics because it just ends up making me angry. So, let's talk about what sparked this whole problem: the alleged meningitis.

Some people join the Peace Corps because they believe they can save lives. I was more realistic upon arrival (I hope). I believed that I could maybe change some people's lives. I would love to claim that I saved lives in Peace Corps, but as a Secondary Education Volunteer, I don't think I saved any lives because my students learned some math. I might have saved some lives in the long term because my students learned to think a little bit more critically and creatively and also the importance and proper use of using condoms.

Upon reflection, though, I might have saved some lives from meningitis and other diseases by just being there... emphasis on might. The advantage to being the Nasara is that people want to see you and want to be taught by you. The disadvantage is of course you are basically a celebrity. Some people want to use and abuse you. Also, when you're not actually white but considered white it can lead to an identity crisis... more about that later I promise (as I have for the last couple of posts, I know).

Why is the Nasara effect important in the classroom? It brings people in to events (including school) and people pay attention to you. Once they get over the initial glamor of being near you (imagine yourself in the presence of your all-time favorite celebrity in the known universe), they still hang on to every word you say and hold it close to their hearts to be repeated over and over again. Even the troublemakers who normally don't show up to other classes, will come just to be in your presence. If they cause trouble, as they are often bound to do, and are kicked out of class they do everything possible to stay in the classroom and be in the presence of the Nasara. As a good educator though, you must look beyond the promises of "I won't do it again" and be stern in the beginning. With time, the Nasara effect will fade, but if you have used it to your advantage, it will be replaced with awe-tinged respect (especially if you can kick any of the other teacher's behinds in logic).

You can use your powers as a Nasara to discuss health issues (including sex!), something that the majority of teachers are unwilling to do. (I was lucky and had multiple teachers that were unashamed of talking sex, discrimination and other sensitive subjects at my school. Some were actually bashful in the beginning but transformed as they realized the only way to solve a problem is to talk about the problem and possible solutions. I would love to claim credit for their awesome, but the reality is that they are just awesome open-minded individuals.)

Back to meningitis and neglected diseases... if you play your cards right you can twist the arms of these adoring children into coming to class on Vaccination Day. Sure all students love to hear talk about sex, but who really enjoys being stabbed by a needle? (Masochists and drug users aside.) These vaccines and also chemotherapy (read: medication) against neglected diseases save the lives of people every day. This is important because few people use the health clinics, especially in rural areas. The tendency towards self-treatment and suspicion of "modern" medicine (I really hate this term) is still prevalent with the majority of births happening at home. However, as the enrollment rates increase, the ability for organizations like the World Health Organization (Organisation Mondiale pour la Santé) to turn schools into key disease prevention sites has also increased. Campaigns going door-to-door are also effective (especially for Polio which is nearing eradication, but that's the hardest part), but time-consuming and difficult if there is not enough humanpower. The key role of the educator at this point is not to do the actual vaccinating or the medicating, but to help the students understand why they are being vaccinated, and why it's important. And also, to make sure that each and every student is vaccinated and swallows their medication.

The exciting thing about meningitis is that it used to be an extremely expensive vaccine, but now it isn't and was distributed for free in December! Schools were used as vaccination sites, with priority to students and personnel first, but then people in the general community also lined up to be vaccinated. You can read more about it here.

Now, if we could only get a malaria vaccine, people would expect to live beyond the age of 60. The median age of Burkinabè would be over the age of 17. People would have less kids and at a later age because they wouldn't fear the early deaths of themselves or their children.

In the mean time though, any incoming PCT should know that you will find yourself in the face of death, especially those who will be working in Health. Sometimes, the life of someone very close to you will be taken unexpectedly. There is nothing that can really prepare you for the death of anyone in your life, but you should know that it is very unlikely for a PCV to leave the country without knowing someone who died.

May they all rest in peace and continue to be our inspiration to live and to serve.

Morals of the story:
• Always use a condom.
• Get vaccinated.
• I saved lives by glaring.
• You can't save everyone.
• Create a malaria vaccine and you will be a hero.

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.

Culture Shock 02: Reintroduction into Consumer America

Dear America,

I officially (and quite literally) took my first steps outside into the cold hard world of consumerism. I tried very hard to buy things at Costco and also on the internet, but largely failed.

My biggest purchases at Costco may have been contact solution and brie. Aside from my delicious cheese (you can never go wrong with cheese that comes in a wheel), I found that Costco was too full of preservatives, sugars and engineered food oils. Once upon a time all of these things seemed so delicious, and of course candy still is. However, the baked goods were lackluster. So I bought the ingredients instead to make my own. I felt like I walked through the entire warehouse at least three times, but still gained weight from all the free samples (most of which I avoided). However, I will save ranting about food for a later post, but here is a preview:

America you have grown too fat and lazy!

The reason why Americans are overweight and malnourished (not undernourished) is a combination of food engineering and heating/air conditioning...

My other two forays involve the internet. I, having spent the last three or so years in Africa, seldom access the majority of my accounts for this or that site on the internet. Now upon my return, I lock myself out of one of said accounts out of incompetency (typing on the US keyboard is hard!) and too many passwords in my head. Two hours of head banging later in an attempt to reach a human being on the automated customer service phone lines, I was finally able to reset the password to my account. The issue was not the confusing menus, but the fact that each time I was "being transferred" to a customer service representative after pressing the correct buttons the call dropped! I tried multiple customer service lines available for the company and same result. After much frustration and resorting to button mashing, I was finally transfered to a representative when the call dropped. So, after a final round of frustration and button mashing, I finally communicated with a human being and got my account issues resolved.

I don't understand why it is so difficult to communicate with an actual human being in this country! We expect excellent customer service from others, but don't provide it ourselves (actually, it seemed like the machines were programmed to frustrate clients, but this is true on a broader level). In addition, I remember now how much I disliked being an "overrepresented" minority in this great country. It seems as if no matter where I end up in the world, I will have to deal with being different from the rest of the majority. Even in Asia, I physically stand out. Ack, more on being a minority in America and in Peace Corps in a later retrospective post. But a small excerpt of my thoughts:

When will the world become color blind and finally see people for their actual intentions, skills, and character?

Anyway, my final foray into consumerism was eBay. I attempted to buy things. I realize that purchasing Sims 3 may will ruin my productivity and impede my job hunt. Luckily, outbid. I realize that I don't need another pair of beautiful cute shoes... but I do really want them. Luckily, also outbid. What I don't understand is why there are no flat ankle boots with a pointed-toe out on the market. I had a pair in high school that I thought was fabulous. (More on high school later) Unfortunately, they disappeared sometime between high school and now. Heeled ankle boots are aesthetically pleasing for so many reasons, but oh so impractical, especially right now with ice and snow everywhere.

So, in conclusion. I am too overwhelmed to buy anything because the majority of products are full of fillers I don't need, or particularly want. The products I do want are extremely difficult to find (and not in fashion, which means they will be in next year, everyone be forewarned). So instead of exhausting myself by trying to be a consumer and interview for various opportunities (I've hardly slept these past few days, though it may be partially because of an extremely rich diet providing me with oodles of energy), I believe I will, focus myself on my future and not my present. (This goes back to my argument of Now vs. kNow).

Hmm... maybe I'll actually sleep tonight.

Busua Beach, Ghana, August 2010. They have trash cans there!
This may have been the first time I ever took a vacation just to relax and sit on the beach for multiple days where all I did was eat, drink and love...everything!

Sebraogo Kiendrebéogo, aka Seb

Seb was my APCD on paper for three years, but in reality he was so much more. He was a mentor, a friend, a brother. I made the mistake thinking that there would be more time with him. So, I put off seeing him. I had already seen him during parts of his illness and it was just too hard to see him when he was unwell.... So, I went and visited other parts of the country because I thought there would always be more time. More time to laugh, more time for him to be at important events in my life, more time to make memories. I was wrong. I didn't want it to hurt, but either way it would hurt just as much.

So if you are looking to some cause to donate to, please donate to his family. He leaves behind his wife and two young children, but also all of his extended family as well.

Beaver Fever

I am in town for the day to drop off paperwork, pick up paperwork, enjoy internet and air-conditioning and just escape the complete emptiness of village.

One of the great things about being a PCV is being terribly ill from a gastrointestinal infection.

I took a short trip up to Dori a few weeks ago, just to check it out and say goodbye to PCVs who are COSing and going back stateside. It was pretty fun, we crossed two flooded barrages in a bus (think tour bus-sized). Got to eat some really darned good pork (shout out to JL). Did not really see much of the city.

The day after I got back to my village, I ended up being terribly sick with giardia (aka, beaver fever, and not the good kind like those good old college days... go beavers!). Unfortunately, I did not know I had giardia and was rather miserable for the first few days trying to do the standard treatment for diarrhea (which didn't work), stabbing stomach pains, and mild fever (101-102ish). Needless to say, one MIF kit later, it was confirmed that I had giardia.

Now, I have not had problems with sending things TO Ouaga via my transport, but getting things from my transport has been a miracle recently. The last few times I spent days biking up and down my road stopping every car in Yaba and finally found out that my medication was sent back to Ouaga from Toma and then when it was re-sent it ended up in Toma again and a friend had to pick it up. Clearly, not a viable option for someone who practically lived in a latrine for ten days (since biking takes me somewhere between 30 to 60 minutes and all of my friends were gone from village when the prescription came through, also not buyable in village). So, I decided the best thing to do would be to commission someone in a large city who was on their way back to my village to pay for my meds and give them to me. Luckily, it worked out much better than the transport method (i.e. I got my meds as expected, took them and now actually have an appetite!).

Two weeks ago, I was at a solid 68 kg (just shy of 150 lbs), now I don't even dare weigh myself. I am at pinky to thumb ratio of skinniness on my wrist. And as we all know, I have rather small hands for my size, and a very short pinky.

Yes, I know this should be a much more exciting update of how I have been vacationing/cultivating/volunteering now that the school year is out, but realistically I have just been downright miserably sick in village and everyone is out farming the fields. I've got some projects in mind, and will be doing a training on HIV/AIDS and Life Skills in a few weeks. So, now that I am back up to healthy (sort of). I am going to head back to village and get more appropriate forms signed and hopefully the ball rolling in a good direction as opposed to in a circle.

Here is a fun little song I composed while being sick and in the rain (it hasn't rained all that much at all at my village, literally the clouds stop raining at my village and continue afterwards)...

Rain, Rain come today
Come again for many days
Burkinabe want to eat
Rain, Rain come today

Dental Woe / Quickie Post

I don't have much time because I will be running to my gare in a few minutes to catch my bus back to village (if there is such a bus this morning).

Monday afternoon after lunch while flossing out the wonderful bits of food stuck in my teeth, the floss broke. So, I tried again, second time around, one of my fillings popped out. No, Doctor Stender, it was not one of your fillings, it was one of my old, should-have-really-gotten-it-replaced-before-I-left-California fillings. In all cool-headedness, I popped it back in and sent a message to the PCMOs to ask them what to do.

Normally, I have Thursday mornings off, with English club in the afternoon. So, English club got cancelled and I planned to leave Wednesday night for a Thursday morning village and then back to village on Thursday afternoon... Yeah, so things did not pan out. I spent all afternoon watching as cars went away from the capital and not towards (except one camion, which passed really early but I truly believed the bus was coming that afternoon). Come 5 PM, after my friends across the street at the primary schools had watched me wait all afternoon, one of them calls the gare to find out what's up. They say they are not running at all this afternoon. If I had known that at 2 pm when I saw the camion, I would have jumped on and gotten off at the closest city with decent transport 70 km away. Fortunately, people in the Faso understand transport doesn't always work out. Got my dental appointment rescheduled and left yesterday morning (after being rejected by a couple of cars which were full of people who wanted to leave yesterday afternoon like me).

CLO helped me find the dentist; got some new shiny silver in my mouth; ate a good dinner on one side of my mouth (like I have been all week); saw Liz and caught up on life in general (who I have not seen in FOREVER).

So, how's village? It's going. The school year is almost over. In fact, I am rushing back to village to surveille the BEPC blanc. The BEPC is the middle/junior high school exit test. We are giving the examen blanc, a pre-test (think PSAT:SAT) over the next four school days (Sunday is excluded).

I might be online again soon (as I have not checked to see rumors have panned out). Internet may or may not be coming back near me at least for the next week, but hopefully permanently.

I have been extremely bad these past two trimesters about keeping in touch and I apologize. Things have been kind of hectic as the school year winds up. Don't worry, I will write lots of letters in June.

Much love from the Faso.

PS, I put a couple new photos up in the usual places (FB/Picasa). Sorry, not more specific, gotta run.

And So It Begins...

Model school started last week; and officially, I began teaching this week (though I taught division of fractions last week in a full one hour lesson). Apparently, my years of customer service have made me very patient with children. Though today, I did kick a student out of class because he refused to come to the board.

Yesterday, I considered a success even though my students were not given bonne motivation because I did not vomit in class despite strong desires to do so. So far, these past few days have been up and down health wise. Making me feel like a yo-yo who also has to figure out how the heck to make quadrilaterals and their properties interesting. I am hoping to hit parallelograms and areas and perimeters tomorrow, and trapezoids on Thursday. And then something fun and not rote on Friday. Though, I haven't figured out a fun activity for reviewing it all as of yet.

A lot of people have asked me for photos. Unfortunately, these are hit or miss since I haven't been very camera happy and some days the internet does not like the idea of me checking my email, let alone uploading photographs.

Healthwise, I am doing well after a sleepless Sunday night. I wanted to say hello to all the parents and friends of current stagiaires out there because I have been informed that my life sounds cushy as of yet (friend of C---). Don't worry though. In a month, I will be shopping for furniture (a disaster awaiting to happen) for my new house, including necessities like a stovetop, a ridiculous number of marmites and tamarinds, and necessary furniture like a bed, a wardrobe, and a cupboard for dishes and food. How do I plan to protect all this from pests? I have been informed that large cans filled partially with kerosene deter pests well and then putting the furniture legs into said cans. So; I think thats my plan of attack contre my friends the creepy crawlies. BTW, I have seen and killed already the "scorpion carrying spider" in the first few weeks, I just didn't realize what it is until recently. I don't think it looks like a spider, but that's what the call it. I have not seen a scorpion yet, but I promise to have at least one amusing story about that and poisonous snakes by the end of service.

A little bit about my site and my experience with transport: I am off the paved road by about 100 km. I hear I have to travel 40 km to get to the nearest unreliable source of internet (and also no daily transport there, so you figure out how I travelled there afterwards to visit a current PCV). Though, there is a slim possibility that I will have internet within 12 km of me (I am not holding my breath though). In theory, I am three hours from capital. In practice, I woke up at 4 am for a 6-7 am bus. I didn't get to my site until well after dark at around 8 pm. In total, I think I saw my site in about six hours of daylight. It is pretty, with lots of trees. It is fairly large, but not as densely packed as the volunteer who I visited later on in the week. I met my proviseur, and some people around village, but for the most part, people were out cultivating. I have met some people who come from that village and general region. And because of the many different tribes, I am considered a sister of theirs now. However, this means I have a "joking relationship" with one of the larger groups in BF, the Mossi people. It makes for a lot of fun joking around during breaks since a lot of the staff are Mossi. "They" say my people aren't very nice, but we all know I'm not very nice. So, I think I'm fitting in well culturally. ;p

All right, I got two minutes to go. Hope this provided life is being good to you all.

Another Short

I don't really have that much to say right now, but I felt obligated to blog since I'm splurging this week and hanging out at the internet cafe twice (so far).

Model school started officially, and either tomorrow or Friday, I will be doing my first co-teach. On Monday, I get up and do my first full hour lesson by myself. I am worried of course, and probably will spend most of this weekend preparing my lessons (since I signed up to teach both 6e and 3e math).

The summary of the past few weeks: sick combined with travelling on public transport. Not exactly easy out here. I think I hit reality a lot more than some of the other PCTs though.