Kaolack Girls Empowerment and Leadership Camp 2014

A couple of weeks ago I was fortunate to be a part of the amazing Kaolack Girls Empowerment and Leadership Camp. Thirty-six girls and four exceptional female counselors from the Kaolack, Fatick and Kaffrine regions came together for a week of personal growth, learning and fun. The talented Caitlin Healy created a video that captures the essence of the camp better than I could in words, so please check it out: http://peacecorpssenegal.org/2014/08/21/kaolack-girls-empowerment-camp-2014-36-girl-leaders-take-on-the-future/. 

Once again, I want to say a huge THANK YOU to those of you who donated to this wonderful camp! This week meant the world to the girls who participated and confirmed for us volunteers that the future of Senegal is bright. The hope, tenacity and desire to create a better Senegal that the girls and the local speakers displayed is truly inspiring. 

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Souadou, one of the girls I brought from my town

Souadou, one of the girls I brought from my town

Salla, one of the girls I brought from my town

Salla, one of the girls I brought from my town

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Boot Camp! Waterfalls! Bed nets! Fajitas! Or, a life update.

When you first get to country, older PCVs tell you that the first year will drag on forever and you won’t know what to do with yourself. Then the second year everything suddenly clicks and you are comfortable in your community and suddenly the work starts piling up and before you know it your service is over. When they told me this I mentally rolled my eyes and thought, “Yeah, right. I’m never going to have a clue and two years is such a long time how am I going to make it???” Lo and behold, they were right. The last couple of months have been crazy busy  and they have flown by. I already have the next two months completely planned out and then it will be October. Where is this year going?? I used to desperately try to find things to do to keep myself occupied but now, with only a little over 8 months (!) left of my service, I realize that I need to prioritize what I want to do and accept that I will not be able to accomplish everything I thought I would in the beginning. In my last few months I am going to focus on the quality of my projects instead of the quantity. Here’s a list of what I’ve been up to recently and what I have in store over the next couple of months. It’s kind of long, so bear with me :)

May/June

  • At the end of May I participated in a malaria project spearheaded by my friend Adel. There’s a great write-up of the project here. As part of the project I spent two afternoons with a group of about 30 high school students training them on malaria prevention and treatment through the Grassroot Soccer Skillz Malaria program. The curriculum uses soccer metaphors and games to teach youth about malaria in a fun and engaging way. We had a great time and I was so inspired to see how motivated and interested these kids are in helping their communities fight malaria.
Students demonstrating how to properly tuck in a net

Students demonstrating how to properly tuck in a net

  • In May I finished conducting focus groups and interviews with men and women in my community about their knowledge and practices surrounding prenatal care. As part of my Master in Public Health final project, I am conducting this research to understand why women aren’t going to their prenatal care visits as early and often as they should, and how to make it easier for them to attend.
  • Malaria Boot Camp: I spent two weeks in June at the Stomping Out Malaria in Africa Boot Camp, held here in Senegal. PCVs from 14 countries around sub-Saharan Africa were invited to attend this intensive training on malaria prevention and treatment strategies and how to be leaders in malaria activities in our respective posts. This was an amazing experience. Our sessions were led by experts in their fields, either in person or via Skype, and I loved getting to know volunteers from other countries and learning about the similarities and differences in our experiences.
The Stomping Out Malaria Boot Camp X Crew!

The Stomping Out Malaria Boot Camp X Crew!

July

  • I spent another 4th of July down south in the beautiful region of Kedougou. Every year the volunteers in this region host a huge party with a fire-pit roasted pig and loads of American spirit. Kedougou looks like a completely different country from where I live, with green, rolling hills, gorgeous waterfalls and cute, miniature cows. It’s a great chance to see friends from all over the country and remember that there is topography in the world besides flat, dry and brown.

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  • As part of the malaria project that I started in May with the high school students, I held a couple of bed net care and repair events in different neighborhoods of my town. Pretty much everyone here is aware that they should be sleeping under insecticide treated nets (ITN)s every night, and some do. But a lot of the time they fall into disrepair, with lots of holes and dirt, and people stop using them. These events were held as a way to encourage people to wash and sew their nets so that they’ll last longer and better protect them against mosquitos. Unfortunately we were in the middle of Ramadan (the Muslim holy month where they fast all day) and hot season, so some of the women were not as enthusiastic as I would have liked. Nevertheless, we managed to sew and wash quite a few nets and I plan to hold similar events in the remaining five neighborhoods of my community in August.

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  • After Malaria Boot Camp in June, I really wanted to start a national malaria committee made up of volunteers to better support and organize the malaria work that we do here in Senegal. Many other PC countries in Africa have similar committees and I thought something like this could really help motivate more volunteers to participate and feel empowered to do malaria activities. A couple of weeks ago a few Boot Camp alumni, PC staff, and I met in Dakar to discuss creating this committee. I was voted to be the first National Coordinator and we’ll be putting out an open call for applications in the next few weeks for the rest of the PC Senegal community. I am so excited for this new venture and I’ll keep you updated over the next few months!
  • The development I am perhaps most excited about came about serendipitously and I will have to devote a whole other blog post to it soon. Basically, I am helping out with a pilot mobile health project in Senegal that is seeking to help community health workers (CHWs) to better manage their work and get women to go to prenatal care earlier and more often. It fits perfectly with the work that I am doing for my MPH project and I am so happy that they are letting me participate. Over the next few weeks I will be shadowing CHWs in my area while they do home visits and health talks on prenatal care using a mobile home care assessment application on my phone. The information that I gather will help the mobile app development company and the NGO tailor their app to Senegal.
  • I celebrated my 28th (yikes) birthday in Dakar with good friends and good food. Beef fajitas in Senegal?? Yes, please!

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August

  • The first week of August I will be presenting on malaria treatment and malaria in pregnancy at the newest health stage’s in-service training. It’s a bit surreal since it feels like just yesterday I was getting ready to go to this training, but somehow a year has gone by and apparently I am supposed to be the knowledgeable one now (eek!)
  • Right after I present at IST, I will pick up two girls from my town and we will head to the Fatick region for the Kaolack Regional Girls Empowerment Camp for six days! Planning for this camp has been underway for months and I cannot believe it is almost here! Many thanks to those of you who donated and made holding this camp possible! If you donated you will receive a special thank you card in a few weeks :)
  • Finally, at the end of the month I will be leaving Senegal for the first time since I got here 16 months ago!!!!! It is vacation time and I am so ready. I will be meeting my Dad and Linda in Spain and France for what I know will be an amazing time and I seriously cannot wait. I’ve warned them that I plan on stuffing my face with all the food I can find. It will be glorious.

Saving lives in rural Senegal

After a year in site, I realized I haven’t shared much with you about the health system and the people that I work with to improve our community’s health. Senegal’s national health care system can be broken down into several layers: regional hospitals, district health centers, health posts, health huts and community health workers.

My town is home to the District Sanitaire, or district health center. It is responsible for providing medicines, supplies and training for health workers at the seventeen health posts in our department and the numerous health huts in the more distant areas. The health center is managed by the Medecin Chef, a doctor who spends most of his time on administrative, financial and program planning duties rather than treatment. He is in charge of organizing all of the health campaigns in the department, such as house-to-house polio vaccinations and vitamin A supplementation and HIV testing. The health center is also home to several nurses, nurse assistants, midwives, traditional birth attendants, community health agents, a lab tech and a pharmacist. There is a lab that can take care of pretty much all blood and urine work and the doctor can take sonograms, as long as the electricity is working. For major traumas like broken bones, pregnancy complications and severe injuries, people are referred to the regional hospital in Kaffrine. Luckily for us, we have two full-time chaffeurs on staff that can transport people in a well-maintained ambulance.

On a typical day, the nurses take turns consulting with patients and writing prescriptions. The community health agents do a lot of the basic treatment: treating wounds, giving shots. Every morning the midwives and birth attendants provide prenatal and postnatal consultations, family planning and births. Sometimes they will give short talks to the women waiting on topics like preventing tuberculosis or the importance of attending all of your prenatal visits. Our health center is one of the pilot centers for a USAID Severe Acute Malnutrition (SAM) Program. A nurse who specializes in treating malnutrition consults with women and their children. If the child is diagnosed with SAM they are admitted to the health center and provided with medicine and Plump’y Nut (a peanut based food developed specifically to treat severe malnutrition), usually for a minimum of two weeks. Once the child has improved, they are sent home and monitored over several weeks to ensure that they continue to progress.

Khathya, a nurse assistant, measuring a child as part of the malnutrition screening program

Khathya, a nurse assistant, measuring a child as part of the malnutrition screening program

My host mom Fatou, a traditional midwife, giving a woman a birth control shot

My host mom Fatou, a traditional midwife, giving a woman a birth control shot

The activity that I have been most involved with at the health center is child vaccinations. Every Friday morning we weigh and vaccinate babies, usually under twelve months old, for tuberculosis, polio, measles, mumps, rubella, diphtheria-pertussis-tetanus (DTP), hepatitis B, Haemophilus influenzae type B, pneumococcal infections, and yellow fever. I don’t do the actual vaccinations-that part is for the trained health workers-but I help weigh the babies and enter all of their information into the various records that have to be kept. Every woman who attends the vaccinations is given a yellow WHO card that includes information for their child’s weight and all of their vaccinations-in an ideal world, that is. Unfortunately we’ve been out of these cards for a couple of months now so if a woman doesn’t already have one, we have to enter the data into their prenatal consultation cards, which also include space for vaccinations. This can get confusing when women have both cards but may forget to bring one or the other to the visits. That’s what we have the other books for, where we record the information that stays at the health center. It’s not a perfect system but considering the circumstances it works fairly well.

The head nurse, Maimouna, weighing a baby before the vaccinations

The head nurse, Maimouna, weighing a baby before the vaccinations

Maimouna giving the oral polio vaccine to an infant

Maimouna giving the oral polio vaccine to an infant

These mornings can get pretty chaotic, not to mention loud, with all the screaming infants, but it is something I look forward to every week. I know there is a lot of controversy at the moment in the US and UK over childhood vaccinations, but I am grateful that the women here in Senegal happily comply with the recommendations and show up month after month to get their kids vaccinated. The likelihood of contracting diseases like tuberculosis, pneumonia, yellow fever and measles here are very high and life-threatening to children under five and the vaccines save millions of lives every year.

The health facilities here are understaffed and undersupplied, and I don’t always agree with how they treat patients, but I have so much respect for the health workers. They work incredibly long hours in difficult conditions for very little pay, and yet they still show up to work everyday and do their best to keep their community healthy.

GO, GROW, GLOW

Last weekend my friend Hana, who is a sustainable agriculture volunteer in a village about 30K from me, held an open field day for the students at her local school. Hana’s village has a Master Farm-a field where a Peace Corps sponsored local farmer works with a volunteer to develop a demo space to teach improved and advanced gardening techniques. She invited Kaffrine volunteers from all sectors (health, sustainable ag, agroforestry) to come help out. There were stations on composting, transplanting vegetables and creating tree nurseries. My friend and fellow health volunteer Jordan and I were in charge of teaching the kids about nutrition and hand washing.

In the field of nutrition the GO, GROW, GLOW model is often used to teach kids about a balanced diet in an easy to understand way. GO foods are the ones that you need to have energy (carbohydrates), GROW foods are the ones that help you grow big and strong (proteins) and GLOW foods help your skin, hair, nails and eyes (vitamins and minerals). Peace Corps Senegal has a fun and culturally relevant way to teach kids and adults about nutrition-the ‘complet’ model. In rural Senegal, most women wear a ‘complet’ every day, which consists of a wrap skirt, matching top and a matching head wrap. In the ‘complet’ model, the GO foods go in the skirt, where your legs are to show that you can walk and be fast; the GROW foods go in the shirt, where you have strength; and the GLOW foods go in the head wrap, where you have beautiful hair, skin and eyes.

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The complet model. Beautifully drawn by Hana :)

Once we explained the model to the kids a few times and made sure they understood, we had them practice building a balanced meal. In the corner of the room we set up a “market” of laminated veggies, carbs and proteins. We split them into two groups, gave each a bowl and told them to go shopping for lunch. They had to have all three food groups in their bowl to succeed and have a healthy lunch.

The "market"

The “market”

Then, we asked them to explain what they had chosen and put the card in the right place on the complet. Overall this was a good activity, although at first the kids just grabbed everything they could and ended up with powdered milk and bananas as part of their rice and fish lunch (yum?). After some extra explanations everything went well though!

Shopping!

Shopping!

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We ended the lesson with a song about what they’d learned, which unfortunately was not as well received as we had hoped. Maybe next time we need to have a better beat. After the nutrition portion, we all gathered in the shade to do a brief hand washing lesson. The teacher surprised us at the end by having all of the kids sing (more successfully) a great song that I wish I’d had when I was first teaching hand washing at the schools in my town. I have a video clip but I can’t figure out how to get it uploaded on here without paying, sigh. Anyway, it was a great day for all of us and I am looking forward to replicating this lesson at my schools very soon.

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(Mis) education

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Students learning about diarrhea and how to treat it with oral rehydration salts.

Since arriving in my town almost a year ago (!), most of the work that I have done has been with the schools. There are five elementary schools, a middle school and a high school in Malem Hodar. The school directors and teachers that I work with are wonderful. They are incredibly hardworking and motivated, which is pretty incredible considering the obstacles that people face to receive and provide education here. Why, you may ask? Senegal has an education problem.

Let me paint you a picture: Imagine that you are an elementary student in the US. You grew up speaking English at home, but when you start elementary school at age 6 or 7, you are expected to learn everything in German. You have never studied German before. You know some of the numbers and how to say ‘hello,’ but that is it. Now try learning science, math, history, etc., all in German. You’re probably not going to comprehend very much, right? That’s how it is for most of the kids here, especially those in rural areas.  In my family all of the kids grow up speaking Wolof, the most common national language. The only adult in my compound that speaks any French is my uncle, and he taught himself. My host brothers and cousins can’t ask anyone in the family for help with their homework because almost all of the adults are illiterate and speak only Wolof.

On top of the language barrier, the teaching methods used in most schools lack creativity and critical thinking. This is not the fault of the teachers, rather it extends far back to French colonial times and the use of traditional French teaching methods like rote memorization. I’ve watched as the kids in my compound memorize passages about science and history word by word, but if you ask them what the passages actually mean, they can’t tell you. My brother recently had a homework assignment where he had to write a conjugated sentence 100 times in his notebook, but if you ask him to conjugate the verb without looking at the page he can’t do it.

The students are trained to memorize what is on the board and respond to a specific set of questions. If you deviate at all from what they’ve learned they struggle to answer. This has made working with the schools particularly frustrating. In the fall and winter I taught a series of lessons on germs, hand washing, diarrhea and how to make oral rehydration salts. Granted, my  Wolof language skills are not great, but it would take multiple times of going over very simple information for anything to stick. I tried to do a pretest at the beginning of the lessons to gauge their initial knowledge level, but the concept of a simple question/answer quiz was difficult for them to grasp. I’ve always had a deep respect for teachers. It is an incredibly difficult job and I think it is a profession that is often undervalued. After seeing all that they have to deal with, I am even more in awe of what they try to accomplish despite all the barriers.

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Part of the blame can also be attributed to the school calendar. In my area of Senegal, the rainy season begins in late June/early July, when school usually lets out. Between then and the middle of October the kids are in the fields helping their families plant and harvest corn, millet, sorghum and other crops. That is five months out of the year the kids are already out of school. Once they start school in early November (because school never starts on time), they have about six weeks of class before the Christmas holiday, which is two weeks long. What is particularly odd about this is that Senegal has a 95% Muslim population. The entire school system shuts down for a holiday that less than 5% of the population celebrates-oh, and they also have a two week Spring break that they take around Easter. So that’s another month that they aren’t in school. Add onto this the teachers’ strikes that occur fairly regularly and the kids are not in school very often (the teachers strike because they often aren’t paid for months at a time by the government).

The schools here also work with very few means. There are usually three or four kids to a desk that should fit two. Teachers regularly run out of basic supplies like chalk, pens and notebooks. School lunches are provided irregularly-depending on whether the government has provided any rice or if they have a canteen funded by the World Food Program. While the kids have school every day Monday through Friday, they are in class far fewer hours than American children. M,W,F they are in class from 8am-1pm, T, TH from 8am-1pm and 4pm-6pm.

I realize that I’ve painted a pretty bleak picture of the education system and it has a lot of problems that need to be solved if Senegal wants to have a chance at becoming a more developed country. But it has made significant progress over the last twenty years: in 1994 only 55% of primary school age children were enrolled in school; by 2012 the number of children enrolled increased to 84%. This is still under the average of 94% for other sub-Saharan countries, but it is significant nonetheless. Check out the World Bank Data site for more interesting country facts: http://data.worldbank.org/country/senegal.

Despite all of the issues that I have noticed living here, I love working with the schools. They are enthusiastic and accommodating work partners who are genuinely interested in working together to improve the lives of the community’s children. Even with all of the obstacles that these children face, they are bright and eager to learn.

A handwashing mural that I painted at one of my schools after doing a lesson on germs and hand washing.

A handwashing mural that I painted at one of my schools after doing a lesson on germs and hand washing.

Garden Update

Since the gardening training, work has been moving along steadily! I am so happy with the progress that the gardens are making and the motivation that all of the participants have shown. In the few short weeks since the training, all of the schools that attended have applied at least one of the techniques they learned to their gardens. They’ve been hard a work double-digging beds, spreading peanut shells as mulch, making organic pesticides out of neem leaves and hot pepper, and using compost to amend the beds. Here are some photos of the progress:

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Coumba indial goura, man may la Coumba

Marriage in Senegal is a big deal. Not in the US, “Say Yes to the Dress” reality show, bridal magazine, Pinterest crazed way; rather it is deeply engrained into the culture and is taken very seriously. Not a day goes by where I don’t receive multiple marriage proposals or questions about my husband (or lack thereof). It doesn’t help that my name here is Coumba. The title of this post are lyrics from a popular Senegalese song that translate to: “Coumba bring the cola nuts, we’ll give you Coumba as a wife.” People here love to sing this song to me whenever I walk by them. Men and women are baffled when they find out how old I am and that I still don’t have a husband. I tell them that I am waiting until I find the right person and that right now I am focusing on my career, and they just laugh and shake their heads before offering me their son, brother or cousin as a promising candidate.

Here, it is largely assumed that a young girl will be married by her late teens or early twenties. Sometimes she chooses her husband out of love, but often it is a contract of convenience between families. In many cases, particularly when the bride is still in her teen years, she is forced to leave school once she is married. Instead of learning and interacting with girls her own age, she will spend her days pounding millet, pulling water, cooking, and cleaning. Then, usually sooner rather than later, she will become pregnant with what will likely be the first of many children. Contraceptive use is extremely low in Senegal, especially in my region of Kaffrine, where fewer than 5% of women use some form of contraception. I will go more in depth about pregnancy and family planning in another post, but I bring this up here because there were a couple of high profile articles this week that highlighted the dangerously high birth rate and lack of birth spacing in Senegal. If you want a glimpse into these complex issues, I recommend giving them a read.

Now, back to marriage. In my compound I have two very different examples of traditional versus more modern marriages. Within the first week of my arrival in Malem Hodar in May, there was a wedding ceremony and a baptism in my compound. The bride at the time was no more than 16 or 17 years old. Her husband was 19 and unemployed. This was a marriage of convenience. The bride, Aminata, comes from another village and did not know many people before arriving. The ceremony that was held is called a chet, which celebrates when the bride moves into her husband’s compound. The women cooked in massive iron pots from early morning until afternoon for at least 100 people, while the men sat around talking in groups and drinking tea. After eating a special meal (it had meat!), the real fun began with lots of vibrant music and dancing. Fast forward 10 months and Aminata is in what looks to be her third trimester of pregnancy. She still does the same chores every day and will likely continue to do so right up to and then right after she gives birth. She is fulfilling the traditional role that most women here play, that of homemaker, wife and mother.

On the other side of the coin there is my host sister, Ndeye Yande. She is 25 years old and lives with a friend in an apartment in Dakar. She is studying marketing and communications and wants to be a human resources director. A couple of days ago she got engaged to a doctor in Dakar, whom she loves. She will not quit school when she gets married and she will likely not have children until she is done with school and has a job. In the next week or so, she and her husband will visit Malem Hodar so that we can host the sey, a marriage ceremony similar to the other, except that she will continue living in Dakar. Before they can arrive for the ceremony, the husband has to send what I guess could be considered a dowry for his wife. Traditionally, as part of the dowry a member of the husband’s family is supposed to bring goura (cola nuts, which taste awful, but the Senegalese seem to love) to the bride’s family to ask for her hand in marriage. In my sister’s case, the dowry also included a color TV for my host mom, 500,000 CFA (about $1000) to throw the party, a gigantic bag of candy, and a Samsung Galaxy tablet for my sister. As we say here in Senegal, her husband is patron! After the items are brought, all of the bride’s family’s female relatives, friends, and neighbors gather to check out the goods. Because it is a Senegalese gathering, it also involves lots of singing and dancing. I am really looking forward to Ndeye Yande’s sey, not only because she is one of my favorite people here, but also because she is an independent, well-educated woman in her mid-20s and she is marrying someone for love.  It’s relationships like hers that give me hope for the future of Senegal. She grew up in a relatively rural area, but her parents were supportive of her education and did not force her to marry at a young age, giving her the opportunity to pursue learning and a career.

Senegal will not be able to develop unless more girls follow this path. The earlier they get married, the more likely they are to have more children. The number of children they have and the timing in which they have them can have dire effects on the health of the mother and child. It also increases financial difficulties and strains an already overburdened education and health system. Although many religious leaders here protest family planning, saying is tantamount to population control, it is a fact that nations with high birth rates develop much slower than those with a lower birth rate. I know that Senegal has potential, but until early marriage is stopped and more people use family planning, it will be nearly impossible to reach its full potential.