Sunday, November 28, 2010

Health update

A word about my health and other health topics

I was doing fine health-wise until a couple of weeks ago when I picked up a water born parasite called giardia that gives one nasty cramps and other intestinal distress. I was going to Ouaga for a check of some skin spots anyway, but went a day early when I found I was hot, not just because it was 90 degrees or so but because I was running a fever. They kept me there for 10 days, which was a good thing because I lost more weight and was feeling tired all the time. The Peace Corps takes very good care of our medical problems. The dermatologist assured me that the places on my skin I thought might be a problem were not, and I regained my appetite so now I am back at my site and feeling fine. That is also the reason I was fortunate enough to be in Ouaga for Tabaski. Now on to health issues for the locals.

Malnutrition
I have been going to the local maternal health center twice a week to “help” (mostly to get in the way and scare the babies) with the baby weighing. All of the babies born in the town are supposed to come once a month to be weighed and to be vaccinated at the appropriate times. Vaccinations of various kinds are free to the people who bring in their babies, but not all babies come in on the proper schedule. The mothers have a little booklet in which the midwife made notes about the pregnancy. After the baby is born his or her name is added to the book and a record is made of the baby’s weight each month. We have a book that stays in the center that lists each baby born in the town. When the mother brings the baby in, the official worker, who can speak Moore, checks the mother's book to see the baby is there on the right day, has the mother put the baby on the scale, and records in the mother’s book both the weight and whether the baby’s weight is > 100%, > 90%, > 80%, >70% of the expected weight for a child that age. If the baby is 70% or less of the expected weight, the baby gets an examination by the “sage femme” that is, wise woman, or midwife, and the mother gets a consultation about the baby’s problems. The mother is then supposed to bring the child back weekly to keep track of progress and for the midwife to talk further with the mother about better nutrition. Some of these kids are easy to spot at the health service. Often they have reddish hair and a very swollen belly, along with very thin arms and legs.

Up the road a bit is a medical center connected to the Catholic Church where I went for the wedding of my community homalogue's daughter. I met one of the nuns at the wedding, who happens to be American, and she gave me a tour of the facility. They treat severely malnourished babies there, but their main mission is to teach mothers how to make a nourishing baby cereal by combining ingredients they can easily obtain in their villages. For example, cereal that combines a grain, such as corn or millet, with either beans or peanuts, will provide a complete protein for the baby.

This Sister goes out on her moto to visit remote villages that are too far away for most people to be able to bring the children in. She has trained someone in each village to take a simple tape measure and measure the upper arm of each child under 5 in the village. The area of the tape that measures the smallest circumference is red, the next yellow and the rest green. If the arm measurement falls in the red or yellow area, chances are the child is malnourished. She visits the villages every three months for a year, weighs the children, and talks with the group of mothers whose children have been identified as being malnourished. For people who live closer, she tries to get mothers to come to the center to learn how to prepare more nutritious food. There is a big room at the center, with lots of openings to the outside air, in which there are wood burning “stoves” where the mothers cook as they would at home. They also make bags of the cereal with they give or sell, I am not sure which, to the mothers. This seems like a very fine program.

Government Health Care
I have mentioned the maternity and baby part of the government supported health service, but I should say there is another building where people with health problems can come for consultations and prescriptions, and there is a dispensary for giving out drugs. I am pretty sure there is a charge for this service because people have tried to get me to give them medicine for some kind of problem. We were warned this might happen and given strict orders never to share our medications with others so I have to tell them, “No, I am not a doctor or nurse and I have been forbidden to give out any drugs.”

Polio
There is a real problem with polio in Africa and there is a big push to get all children immunized. In November there was a big country wide campaign to get all the children under 5 immunized, regardless of whether they had already been immunized or not. The idea is that, if all children are immunized it will be possible to end this epidemic.

In the town near me, and in other towns I believe, there are centers for handicapped people. Many of these folks have problems with their legs and they get around on big tricycles. The peddles have been placed up by the handle bars and they “peddle” with their hands. Some of them can move pretty quickly. There are also folks who have to use a crutch, like the guy in my favorite little store. They create original arts and crafts or work as tailors, or at other jobs that do not require a lot of moving around or strength. I believe most of these folks are polio survivers, but there are probably other reason for the handicaps.

More on the neem tree
I had the name wrong for that tooth brushing tree. The tree is the neem tree, known in its native India as the tree of 40 because it is said to cure 40 diseases, according to Wikipedia. It is apparently good for more than just cleaning teeth. Check out the article if you are interested in all the things it is supposed to be good for that have not been substantiated. They claim it is drought resistant and evergreen. We shall see about that in the spring when it is really hot and dry.

Friday, November 19, 2010

Tabaski

For those of you who do not know, Tabaski is an annual festival in the Muslim faith that is the beginning of the new year. It commemorates the day when Abraham showed his obedience to God by being ready to sacrifice his only son, and the fact that God then sent a ram to be sacrificed instead, so the son did not die. In the Judeo-Christian tradition the son was Isaac, of course, but in the Muslim tradition that son was Ishmael, through whom they trace their heritage back to Abraham. In any case, it is a big religious festival and a legal holiday here. Every family that can afford it buys a sheep, kills it, and has a feast.

I was fortunate enough to be in the capital for another reason at that time, and to have just met an acquaintance of my son in law here, who very kindly invited me to join him and his family for the fete. I did not get in on the sheep sacrifice part of the day, nor did I go to the mosque. My escort, who works in the government here, picked me up (in his car, no less) about 1 in the afternoon and our first stop was at the home of his secretary. He gave her one of the ubiquitous black plastic bags everything is put in here when you buy anything. I think it had some of the meat from his sheep, but I am not sure. The women in the family were in the court yard, preparing the mutton and other food. We were escorted into the house and served pineapple juice. Then the secretary brought a plate of French fries and fried plantains, and another plate with several pieces of grilled chicken. I ate only a little because he had warned me that on this day you are expected to visit many people and eat everywhere you visit.

Next he took me to his house where there were quite a few people gathered. Some were seated on the front terrace and others in the living room. I was invited to sit in the living room where there were overstuffed chairs and couches to seat about 9 people. I sat there and tried a drink made from the sap of the palm tree. It was not bad, but had a bit of a bite to it. I still wonder if it was not a bit alcoholic. I assumed it would not be because Muslims do not drink alcohol. Later those of us in the living room started the line to the food. First there was of a big plate of crudité, that is, all sorts of raw vegetables, cucumbers, onions, tomatoes (green) canned corn, grated carrots and I don’t know what else, with a yummy dressing. Then there were the French fries served with an onion and tomato sauce in place of ketchup, fried plantains, baked fish, couscous, very well cooked lamb, and grilled chicken. Having eaten my fill, it was time to visit another house.

He drove me to the fancy part of town, called Ouaga Deux Mille, that is, Ouaga 2000. It is the new area near the presidential palace where there are a number of government offices, embassies, and very upscale houses for the high up government officials, I think mostly at the level of cabinet ministers. There were a lot of people there, all dressed in their holiday clothes, and here I was, this ancient American woman wearing my traveling clothes. I was glad that my blouse was the one made of the material celebrating the 8th of March, International Women’s Day, so I was not a total western interloper.

At the gate there were guardians, like for all big important houses, but these were dressed in camouflage fatigues so I think they may have been military. Happily, no guns in sight, however. As at my host’s house, there were several seating areas. First there were those seated outside. Then there about 20 men seated on one side of the six sided entry hall. In the center of this hall was a gravel pit, about 10 X10 feet, with a banana tree or some other tropical tree, growing up toward the sky light a couple of stories above. On another side there was what was clearly to be the buffet line, and another set of doors opened into the air conditioned “great room.” There were a couple of seating areas for 10-15 people. We greeted folks at the first one and ended up seated in the second one. At first I was seated in one of those plastic lawn chairs that serve the function of folding chairs here, but very quickly I was asked to stand for a second so they could replace it with a padded chair from a rather elegant dining room set. And THAT is a sign of respect, folks. You get the really good chair if you are an honored guest. My host introduced me as a Peace Corps volunteer and the mother in law of a colleague in American and that was about all the conversation about me.

In any case, after a few minutes it was time to start the buffet line and our room was invited to go first. The choices were rather similar to those at my host’s house, but there were a few differences. In addition to the things he served, there was to and sauce, although the sauce had big chunks of chicken in it, which is not your usual to sauce! The mutton was being sliced by a carver, as you might see at a fancy buffet in the states, and was pretty tender.

After all of the people in our seating area had eaten a server brought over a bottle of Champaign and one of red wine. Only about half the folks accepted and I found out later that, in fact, Muslims will serve alcohol to guests because they know others expect to have wine with meals. The only rule is, they will not serve too much, so as not to cause problems for their guests. It is also possible that the minister and his family are not Muslim, becasue everybody celebrates all the holidays here, regardless of their religion. I had been introduced to the minister on the way to the buffet line and had a chance to thank him on the way out. We were escorted to the front gate by his wife, again a real honor.

We returned to my host’s house were the people who work under him were paying their duty calls to give good wishes for the fete and the new year. Some of them had met my son in law and I knew they really did know him from the little French I could understand, “the big guy with the beard who talks fast and negotiates hard.” That’s him, all right.

By 5:00 it was time for the neighbors to start calling and for my host to go visit neighbors so I asked to be taken back to my living place, having seen the general idea of the fete, having eaten way too much, and being rather tired. What an adventure!

Friday, November 12, 2010

Health

There is, of course, a lot of illness and disease here in Burkina Faso. The thing you hear about the most is malaria. Just a few weeks ago the government health service in this part of the country gave out free mosquito nets to people in the villages who had signed up to receive them. I, of course, have been sleeping under my Peace Corps issued mosquito net or in my Tropic Screen Tent ever since I arrived and taking my anti malaria drugs faithfully.

In spite of putting on insect repellant every day, I still get mosquito bites. Malaria is carried by the mosquitoes that are out in the evening, hence the value of sleeping under a mosquito net. My Peace Corps friends in the health service say that people tend to say they have an attack of malaria (the palu) whether it is malaria or a cold. There is, however, an anti-parasite drug that people get treated with when they have malaria. Several people I know, or their children, have been in the hospital and were treated with this drug, so I am sure many of those who say they have malaria actually do. I hope the new mosquito nets help. The data suggest that using them significantly reduces the chances of getting the disease.

Teeth

One of the most obvious signs of poor health is the condition of people’s teeth. So many adults have missing teeth that it is surprising to see someone with all of them. Often you see a smile with big gaps in it, or only one or two teeth visible. Sometimes you see decayed stumps in the mouth. Pretty sad. There are tooth brushes and tooth paste available at the local stores, but the most common way to clean teeth is to grab a twig off a tree and rub your teeth with it. It turns out this is not just any old tree, but the mim tree. One of my friends stripped a twig of it for me to try and it is pretty bitter. It must have some particular chemicals under the bark. Some people who use them a lot seem to have pretty good teeth, so maybe it is one of those reasons to preserve biodiversity. It may be the next new ingredient in your tooth paste. Who knows? Another friend told me that it works best if combined with sodium, which you can buy at a boutique or the marché. He said that, if you don’t have money for sodium, you can crush salt and use that powder. He has great teeth, so he is a pretty good testament to the effectiveness of this method.

Truffela Trees

If you are a Dr. Suess fan you know about truffela trees, that were all cut down to make sneedes. (Dr. Suess aids the environment.) Someone pointed out that in some of my pictures there are trees that remind one of truffula trees. They are the mim trees, mentioned above, and here is a picture of one. Compare it to the book, if you have one at your house.




Eyes

I have been struck by the number of people with a lazy eye, that is, one that does not focus with the other. You see this in children and adults. You also see people who are clearly blind in one eye. I am sure many people who need glasses do not have them because the only people with glasses are the functionaries, that is, the people who receive a salary

Umbilical Hernias

It amazes me how many of the children have huge umbilical hernias. They may protrude several inches. Most of the young kids run around naked, or nearly so, so it is something you can easily see. Because clothes tend to be quite loose, and often rather ragged, you can see that these hernias are not a new thing. Adults have them, too. I don’t think it matters whether the baby was born at the maternity or at home, but I will keep an eye on the babies I see at the baby weighing

Saturday, November 6, 2010

Harvest Time

Here we are at the beginning of November. The rain has ended and it is harvest time here in Burkina Faso. When the millet has ripened, people go out and cut the grain bearing part off of each stalk. You see donkey carts or big bowls balanced on people’s head going from the fields to the courtyards, where the grain is dried in the sun, removed from the stalk, and stored to be used later in the year. The peanut plants are pulled up and carried home in the same way. As I mentioned before, there were beans growing up the millet stalks, which were harvested a while ago. In some fields you now see the gourds, used to make the calabashes for eating and drinking that have also been growing among the millet.

After the grain is removed, the stalks of the millet plants are cut down and left to dry. They can be used as animal fodder during the dry season, when nothing grows, or woven into mats to be used to create shade, like the hangar I showed you in the demystification entry. To build a hangar you need poles. Because it is against the law to cut down trees here I wondered where they were coming from. Then I heard chopping from semowhere down one of the paths by my house. I looked out to see a neighbor up in a tree, cutting off a couple of branches. It is really just pruning the tree, and it will grow two where one was removed, I guess. Below is an example of this kind of pruning. I did not get the top of the tree in the first picture because I had no idea they were going to prune it. I was get taking general picture of the countryside. I am standing in front of this tree in the picture in the pagna blog, so you can check it out there, too. The top used to be much higher than the part that is left. Maybe you can get an idea from these pictures of how much was “pruned” to get wood for the fire and for a new hangar.






Another thing that happens is that the animals, which have been carefully tethered to stakes pounded into the ground, away from the crops, during the growing season are now set free to roam and graze at will. One day I was surprised to hear cattle lowing and a loud rustling sound. I looked out my window and saw a herd of 50 or more cattle wandering through the millet field behind my house. I had not seen many cattle here, but there were a lot that day! I did not see any cows, only “beef” as they say here. They sure do make a lot of noise!

I asked a neighbor about whether people were upset to have the animals grazing in their fields, and he told me there is a person who tells the village when it is OK to let the animals graze freely. I guess if you are slow getting your crops in, it is just too bad for you. Now there are pigs and piglets of various sizes, goats and sheep with lots of baby goats and sheep, chickens and guinea fowl with their chicks, as well as the cattle and donkeys, roaming everywhere.

Bats are gone

It appears that the poison gas attack was successful in getting rid of my bats, that is to say, killing them all off. They removed the dropped wooden ceiling in one of my rooms and the smell from the attic is terrible. Now I am waiting for the carpenter to go to the nearest big town to make the lath that will hold up the bigger pieces of light plywood that form the ceiling. Interesting to have to make lath! I have to keep the door to that room shut and hold my breath when I walk past it. Hopefully it will have a ceiling and the smell will be confined to the attic soon.

Now that the bats are gone, I thought I could sleep at night without being awakened by critters, but the other night I was awakened by the rustling of paper. Yikes! What was that? I knew it could not be a person because my house is very secure. I told myself to go back to sleep, but that wasn’t happening! I got my flashlight and checked out the room. I found a toad (I love the French name for toads, crapaud, pronounced crap-oh) sitting on my package of toilet paper that was on the floor. I think it perceived the plastic wrapping as water and was trying to go for a swim. In any case, I threw a pair of slacks over it, captured it and put it outside, only to be awaked in another hour by the same sound. This time the toad (the same one or its friend, I don’t know) trying to swim on the wrapping of a small pack of tissues that was on the floor. Another toad trapped and put out and I made sure there were no more attractive places for the toads to try to swim in my room.

I told a neighbor about the toads and she said, yes, the toads come into the house this time of year and hide in the corners. Now that there are no puddles for them to swim in, they try to find cool places to go to ground. I think that they burry themselves for the dry season and re-emerge when the rains return in June or July. I don’t think I have told you about the racket they make. During the rainy season they were very noisy, singing to each other all night long. I got used to hearing the sound, and had not noticed that they are no longer singing until my recent toad encounter. As every perceptual psychologist knows, it is easier to detect the presence of something than the absence of something, unless the change is abrupt and here is a good example of that. (Sorry, I can’t quit being a dispenser of information.)