Reflections and Travel Adventures

June 15, 2012

The things I am looking forward to the most about coming home (besides family and friends) are washing machines and organized trash disposal.  When I first arrived in country, I immediately noticed the black plastic bags everything, seemingly decorating the landscape as polka dots. I swore I would never come to littering. And I tried so hard at first, but it’s hopeless. People laugh at you if you try to save trash until you find a garbage can (likely not until you get home). Everything here is put into plastic bags to sell –you drink water from saches, market snacks are sold in saches or wrapped in paper. And there are no trash cans anywhere. But even more than organized trash disposal, I miss washing machines. I can’t wait to have all of my clothes except for the clothes I’m wearing be clean. Actually, I just can’t wait to have clothes that are actually clean. Before leaving for Peace Corps, someone told me they had read or heard a PCV say that her clothes had never been so clean and white because she had to scrub them herself and she could just see the dirt coming out.  I find this entirely false.  Yes, you scrub yourself and yes, you can see the dirt coming out, but you have to scrub really hard!  I can’t get my whites white again (in fact, I just don’t wear white anymore) and it’s exhausting!  I only kind of get my clothes clean. And even if they are clean, they get dusty and sweaty within 10 minutes of wearing them again, if they haven’t already gotten dusty sitting in my dresser. 

As I’m getting ready to leave, things are already becoming bittersweet.  Even as I was washing my laundry yesterday, I had a moment of “Oh this isn’t that bad,” (that thought didn’t last more than 2 minutes though).  I can’t believe how fast it’s gone by – I will be leaving my village in just over a month!  At this point, I’ve started to reflect; was it what I expected, was is what I wanted it to be.  No.  I came in with very few expectations, but they were still somehow completely turned upside down.  Language was much harder than I expected.  From what I read, I must have thought people magically learn languages.  Nope.  It was harder to get stuff done than I expected.  You make a mental list of what you want to accomplish and within one month at site, you throw it out.  You make another one, and two months later, you throw it out again.  You learn to always expect lots of unexpected delays and roadbumps (this rule applies to transport here as well). The projects you do are a mix of what you want to do, what your community wants you to do, and what your community wants to do themselves.  You think you will integrate easily into your community, yet even after almost two years, people make jokes and I still just don’t get how they’re funny (and it’s not the language thing).  Don’t get me wrong, despite all of this, I still feel like I am a successful, well-integrated volunteer.  Your terms just change slightly.  I am so thankful for the family I live with – they are fantastic and I feel very much part of their family.  Despite the total lack of privacy, having brothers who will get the bats out of my house makes it worth it.  I love the feeling of going to the market, greeting everyone on the way in Bissa, and everyone knowing my name. I feel like I’ve been successful in my work.  There’s always those moments of doubt where you think you could leave tomorrow and no one would be able to tell you were there, but writing my final report of my service, I’ve realized I’ve accomplished more than sometimes think (not saying there are still things I wish I had done or had done differently).  But the most important are the one-on-one things.  It’s not what I do, but what I can get someone else to do.  The mom you motivate to change her child’s diet so he’s not malnourished, someone who starts thinking more about HIV prevention because of something you say.  We try to look for organizational or institutional growth, but more often as a Peace Corps volunteer, it’s the effect you have on individuals that causes something to change.  Certainly there are things I wish I could have done, should have done, but overall, I am very happy with my service.  I feel like I’ve been exactly where I was supposed to be the last two years. 

Projects in village the last few months have been going well.  In March, I finished my second malnutrition rehabilitation program working with the mothers of moderately malnourished children.  My counterpart and I changed the format this time.  Instead of 12 days in a row, we worked with the mothers over one month, meeting twice a week to make enriched porridge and teach a small health class.  I did home visits during the program and talked with the fathers of every child so he can support the mother’s behavior change. 

In addition, I started working with the theatre group to put together a proposal for a hygiene performance.  They are asking the mayor’s office for financial support.  They wrote a budget, which has usually been our point of contention.  They consistently want more money for the performances, I think it’s too much.  As they wrote the budget and looked at the total, the president said “Gee, that adds up to a lot,” and lowered their price. We also started writing interior rules and a constitution so they can become an officially recognized group (which means instead of proposing projects, the health district or the mayor’s office can hire them).  It was cool because it was one of those moments where I actually felt like I was involved in the capacity building of an entire group.  I was there as support, but they took the initiative on the work. 

I’ve also continued health education at the high school. I worked with the PE teacher and we did health classes on HIV/AIDS. It’s cool to see the students open up and ask lots of questions. I am constantly amazed by their desire for more information and I wish I had more time with them because they certainly could use more time on health education. I also started doing informal English classes focusing on oral expression. We’ve discussed interesting topics like gender roles, girls education, and forced marriage. For the session on forced marriage, they performed skits. They really enjoyed that. Forced marriage is something that doesn’t happen as frequently here as it used to, but it’s still important to promote the idea that women can and should be involved in their life decisions. We also had a great discussion on girl’s education.

I’ve also worked on more latrine buildings, which I’ll admit hasn’t been one of my favorite projects. It’s logistically very difficult and also difficult to mobilize community members. The latrines were funded by a Small Project Assistance grant that US AID gives Burkina Peace Corps to administer. We’ve built the latrines in public places, like mosques and churches. This also works better than markets for example because there is a specific community it is for and then the pastor or imam can mobilize those communities.

Finally, I attended the Men as Partners conference in May with two community counterparts, Andre and Oussoudoma.  They’re community health agents and already tend to be more progressive, so I wanted to bring them because I felt like they’d be great role models for women’s empowerment.  The conference focused on how to implicate men in women’s development.  We talked about definitions and stereotypes of gender, domestic violence, HIV, and family planning. They were great and really enjoyed the conference.  After the sessions, they both came up to me and said, “Erika, this is really important.  Really important!  We need to do something about this.  But we need to start within our families.  We start in our houses then other people see us as an example.”  It was really cool to see how convicted they were about the topic.  We’re planning on doing a gender sensibilisation in July, talking to men and women about what gender is and the stereotypes that limit each gender.  They want to start with this because this needs to be understood before change in any of the other topics can happen most effectively. 

I also had the opportunity to do a lot of traveling. I traveled with fellow volunteers to Togo and Benin, mostly to hang out at the beach.  We left for Lomé on Thursday April 5 and arrived late that night.  We had an exciting trip down, almost leaving behind two in our group at various points during the journey. Once we arrived, it was a whole lot less stressful.  We enjoyed a few days at the beach and I celebrated my birthday in Lomé.  We found a beach resort (too expensive for us to stay, but you could pay for the pool and beach swimming for the day). We thought we were in heaven! We also thought the same of the espresso at our hotel. We went to one other beach town in Togo before continuing on to Benin.  Our first stop in Benin was Ouidah, an old slave trading port, where we visited the museum and the Door of No Return.  (The picture on the left is of the Door of No Return in Ouidah.)  The next day, we continued on to Cotonou to get a bus back to Ouaga.  One of the highlights there was the Thai food we ate (we don’t have Thai restaurants in Burkina). When we arrived, I saw signs for a half marathon, scheduled for the afternoon I was leaving.  I decided to stick around and get a bus the next morning so I could run the half marathon.  It was exactly how I expected a half-marathon in West Africa to be.  We waited in the sun from noon until 4 pm to register, which was a complete mess of people pushing trying to reach the desk with the computers to register where I was registered by someone who was using a computer for the first time.  The race started at 4 pm.  (Yes, it is still quite hot at 4 pm.)  I helped a Nigerian runner register because she didn’t speak a word of French.  It’s turns out she’s an aspiring Olympiad.  She was scheduled to run the trials in Canada.  She was waiting for me at the end to help her with a taxi back and had obviously been waiting a long time.  The most bizarre thing about Cotonou was the crocodile in our hotel. Live crocodile. In a cage, but a cage with openings wide enough for an arm.

I also traveled to Ghana with a few other volunteers in May.  We spent most of our time in a beach town, Cape Coast.  The town was charming and the ocean views were so beautiful. There was a vegan moringa restaurant that had amazing iced coffee!  I had some every morning.  (Moringa is a tree whose leaves are filled with lots of good stuff, vitamins, protein, etc. It’s used a lot for malnourished children, but everyone can benefit from it. A lot of Peace Corps volunteers work to plant moringa.) One of my favorite scenes of Cape Coast was the fishing boats. My first day there, I watched about 10 men in a boat paddle out trying to get past the waves.  Compared to some fishing boats in America, these were like ants lined up next to elephants.  We also visited a monkey sanctuary, where monkey’s eat out of your hand!  Got some great pictures there. 

Like Ouidah, Cape Coast also used to be a slave trading port. We visited the museum in the Cape Coast Castle (old fort). Especially compared to the museum we visited in Ouidah, it was very well organized and the artifacts were very well preserved.  Both museums had interesting sections on the African Diaspora. The site of the museum used to be the actual port where slaves were kept before they were sent out on boats, usually across the Atlantic. We were shown the rooms were slaves were kept waiting. Extremely cramped and not hygienic can not even begin to capture the conditions that slaves experienced while in the port (and on the ships). Anyone that gets a chance, I recommend standing in those rooms, standing under the Door of No Return, and trying to grasp the magnitude of the human cruelty, suffering, and injustice that happened in those places that today seem so serene and picturesque.

Despite the beach in Togo, Benin, and Ghana, I’m glad I’m in Burkina Faso.  In the handbook, it says the people of Burkina are its greatest assets.  We always joked, “Well, it’s that because there is nothing else here.”  But traveling to other countries has really made me appreciate Burkina, particularly the people here in Burkina. 

On May 26, I ran the Burkina marathon.  It was… really hard!  Glad I did it, but wow!  We started at 6 am, but unfortunately it gets hot here by 7:30.  My time was terrible, but I’m just glad I finished!  It was a brutal course – we were on a road with lots of cars for a bit, breathing in way too much exhaust.  Then we were just running out on pavement towards a random village with a pretty dry landscape on either side.  Not that encouraging.  But I finished, that was my only goal.  About 500 people were registered, but I don’t think 500 showed up that day.  Although 15 women were registered, I only counted about 7 or 8 that morning.  I’d say at the very most, half of the people that started actually finished the course.  Only three women finished, me, Sara (the other PCV), and a Burkinabe female.  

My goal for June and July is to enjoy the time I have left here, because, soon, the things I think of now as normal will be gone.  This is an experience I will never get again.  My favorite chore is going to the pump to get water.  I actually really enjoy it.  I like hanging out with the women.  They mostly speak in Bissa, so I don’t understand much, but I pick up bits and pieces.  I can’t really explain it, but it’s just this social ritual that happens every every night.  It’s fun to observe and soak it all in. I’ll never get this level of integration again – even just going to the pump is observing a social custom here than any other outsider likely wouldn’t understand. Living with a family has also provided me with experiences that no other foreigner can ever truly experience and understand. I’ve had the chance to not feel like I’m always looking on from the outside, but feel like I’m experiencing something from the inside.

Hot season has arrived…

And I swear it’s hotter than last year.  The nice, cool breeze has now turned into a heater blowing hot air at your face.  If I get water at the pump and leave it in my house, the next afternoon, it is too hot to shower with. 

Work is going great, still super busy.  We finished the HIV awareness project we were working on.  We did a mural at the primary school, an HIV lesson with the oldest primary school students, a community awareness day, and three theatre performances.  The picture to the right is from the community awareness day – it’s me with all the community health agents.  The other picture is from one of our theatre performances.  It’s been very interesting talking to people about HIV and seeing the cultural differences in how people view HIV.  One of the most interesting is talking about what advice you give to people living with HIV and their loved ones.  I was at the pump one day and a woman was asking me about HIV.  And she said (granted in Bissa so this is a rough translation,) that HIV wasn’t a problem anymore because now there is medicine for it.  Yes, ARVs are available (actually for free here at the district hospital), but it’s not a cure.  It makes sense why people might think that because in pushing for early testing, people always talk about the free meds and it can easily be misinterpreted.   So, while we were planning the theatre performance, I wanted the group to be very clear that the ARVs are not a cure, but something to prolong life and that once a person has HIV, they always have HIV.  It’s important for them to know that so they act responsibly and prevent transmitting HIV to others.  The community health agents took issue with that because they said culturally, you don’t tell someone so directly such bad news.  You should say that they will get better.  It’s a tough balance between being culturally sensitive but presenting correct and important information.  

I have continued health classes at the secondary school.  There are six classes, so I do each topic with each class before moving on to the next one.  This is probably my favorite activity because I really enjoy working with the secondary school students.  We are now doing an HIV/AIDS lesson.  I love how interested the students are, open, and willing to ask questions.  They can be challenge (for instance a lot of “well what if…, couldn’t that transmit HIV” questions), but it’s a good thing that they don’t just take what people tell them, but they think about it and challenge it.  And just last week, I started what will be a weekly thing with the English class at the secondary school.  We do activities so the students get a chance to practice speaking English.  I am trying to incorporate life skills and health topics.  Last week we discussed goal setting.  This week, we will have a discussion related to Women’s Day which is Thursday.

I have also started another malnutrition program.  We weighed babies in 2 villages and identified malnourished children.  We get together twice a week to do a cooking demonstration and talk about different health topics.  It’s been a lot of fun and the women involved are great.  They seem really motivated and interested in learning about health so they can help their children.  We’ve focused on malnutrition, but also incorporated other things that relate.  For instance, if a malnourished child or child at risk of malnutrition is sick, they will not gain weight.  Therefore it is really important that the mothers prevent against other sickness, particularly malaria and hygiene-related illness.  The only frustration is just people showing up late, but other than that, things are going well.

In honor of Super Bowl Sunday, I made buffalo wings (actually the whole chicken) and had ranch and hot sauce for dipping.  I explained to my family that men watch for the game, women watch for the commercials.  To the right is my Super Bowl chicken that I bought at the marche and biked home on my handlebars.     

This past weekend, I traveled to Dedougou with other volunteers to go to the mask festival.  It was awesome!  So they use the French word for mask to describe it, but it’s really full costumes.  They came from all over West Africa and the significance varies by region, but usually they appear at funerals and are in general associated with animist religious practices.  We don’t have them in my region, so it was interesting to see this aspect of traditions here.  There were performances, but then all the groups also walked around the town in their masks as well.  At a village ceremony, you are not allowed to take pictures, but for the festival, you were allowed to photograph.   One night, we were walking through the craft market and saw one of the masks walking around.  The picture to the left is while he walked by.  When you do take pictures, you give a small contribution.  So when he saw the flash from my first picture, he turned around and approached me.  We were eating dinner so under a tent.  I took the picture to the right as he ducked to leave the tent after I gave him some money.  The other photos are from performances.    

  

Only in Burkina Faso, Part 2

I know a little late, but Happy Holidays!  I hope that you enjoyed the season and got to celebrate with people you love.  The holidays here in Burkina were exciting this year.  For Christmas, I went with a few other volunteers to an elephant park.  We went out on one ride through the park and saw just about all the types of animals that are here in Burkina (no, there are no lions here, no there are no giraffes).  That included lots of elephants and a few different sorts of antelope-type animals.  On our way out of the park, we saw a baby elephant in a group of adult female elephants.  He was encircled by the herd as he played in the mud.  At one point, one of the adult elephants actually sat on him.  We were a little worried as he struggled, but apparently they were just playing.  After a little bit, one of the elephants noticed us, slowly walked away from the group, trumpted to warn us, and then charged towards our car.  I mean, what would you do if a bunch of people were watching your kid play? (Pictures coming soon – they charged per camera, so we shared a camera and I still need to get the pictures.)

I celebrated New Year’s back in village.  The day before New Year’s Eve, I went into my district capital for a traditional Bissa New Year’s celebration at the chief’s house.   There were TONS of people there – crowd certainly wasn’t as big as Inauguration Weekend in DC, but I’d say my fear of being trampled was equal.  They were doing crowd control on horseback.  And by they, I don’t mean a police officer trained in crowd control or even horse back riding.  I mean a few random guys in the chief’s family.  To get people to move back, they charge towards them on the horse.  It gets people to move, but is also causes people in the back to randomly start getting pushed back by everyone in front of them.  I went with a cousin of the director of the school in my village, and I clung to her for dear life.  The ceremony was pretty basic – the chief came out, walked down the aisle of tons of people, and sat down to make the sacrifice.  I was expecting a chicken or goat, but all I could see him put down were a few feathers, some dolo (local millet beer), and a few other random trinkets.  Not like I really would have watched a goat or chicken be sacrificed anyways.   Then, men played the drums for the chief and women danced.  I tried to ask my friend the significance of the ceremony, but I really couldn’t get more out of her than the basics – health and luck in the new year.  The next day, I went back to village for the real New Years.  I made a village version of Pad Thai for my family and then we went to see a concert.  So I thought that celebrating at midnight was a universal thing.  But apparently it’s not.  I was counting down, watching my phone.  But when it turned midnight, no one seemed to notice.  It took about five minutes for people to start realizing midnight had passed and slowly, people started cheering and celebrating in their own way.  Time is not as fixed of a concept here as it is in the States.  Sometimes for a meeting or activity, a sufficient meeting time to set is simply morning.   

So I usually think I’ve gotten used to most aspects of life here that seemed bizarre at first.  Chasing a chicken out of the maternity ward or my house, cramming onto bush taxis, the market.  But there are still those moments where all I can say is “What now?”  The other day, there was someone that was referred to the district hospital in Zabré from our health clinic.  They had called the ambulance to get him.  My brother, the pharmacist, who also raises and sells livestock, had some turkeys he needed to get to Zabré.  So he asked the head nurse if he could take advantage of the opportunity and put them on the ambulance too.  And yes, he sent his turkeys to sell at the market in Zabré with the ambulance.  How many health codes would that break in the States?   The next day, I had just arrived home from the market when my mom pointed towards the path leading to our house – there were two camels.  Now I don’t live in the desert, but the northern part of the country is the desert.  There were two men ridding the camels.  They had

left the north and were riding around the country begging essentially.  They go house to house asking for money or millet.  Camels are surprisingly tall.  They are also quite loud, particularly when someone tries to mount them.  Only in Burkina Faso.  

Only in Burkina Faso

November’s been an exciting, but busy month. It’s flown by! I can’t believe I’ve been here for 17 months already! Wow, and just thinking about the fact that next Thanksgiving I’ll be at home celebrating with my family, crazy.

At the beginning of November, we celebrated a Muslim holiday called Tabaski.  On Tabaski, Muslims sacrifice a sheep. It’s a big party in my village. I was on my way back to village that day – I was on transport in the morning, but got to celebrate with my family in the evening. The day before, I was in the capital city. It was really funny to see sheep and chickens invading the streets. Because of the upcoming holiday, people were selling sheep and chickens everywhere, and I mean everywhere. The sides of the road were lined with them. Here, it goes without saying that they’re live animals. People rode their motos, even bikes, with a sheep attached to the back or between their knees. I was in a cab on my way downtown to run errands. The guys in the cab happened to be Bissa, so we chatted as much as my Bissa would allow me to. All of a sudden, I heard a noise and pounding from the trunk. It seemed as if someone was trapped there and trying to get out. All I could think was “what sort of cab did I get into?” Then I heard what sounded like a baby screaming when I realized it was a sheep. Sheep’s “bah” sounds exactly like a baby. I could feel the sheep kicking in the trunk on my back against the seat. The weird part – none of this seemed unusual to me. When I realized it was a sheep, I was like, “Oh yeah. Tomorrow’s Tabaski.”

We also had a fantastic Thanksgiving celebration here in Burkina Faso. I went into my district capital and celebrated with my neighbors. It was a legit Thanksgiving. We bought a turkey, and when I say we bought a turkey, I mean we bought a live turkey, had a neighborhood kid kill it and clean it, and then we cooked it. It was so delicious! This was all accompanied by mashed potatoes, garlic cheese biscuits, green bean casserole, stuffing, cranberry sauce, and pumpkin pie. It was a great way to celebrate and I know I have a lot to be thankful for this year – I’m so thankful for the opportunity to be here, experience a place I never would have known otherwise, live in a fantastic community with a great host family, be inspired and encouraged almost daily, and most importantly, have all the love and support I need back home from my family and friends. I hope you had a wonderful Thanksgiving too with lots to be thankful for!

Stage, Part II

October 29, 2011

(Stage is French for training period. Also pronounced differently.)

We recently welcomed a new group of 25 trainees to Burkina Faso and I was lucky enough to host 3 of them for demyst, a weekend trip trainees do during their training to see the life of a volunteer. They came to my site about 2 weeks ago. They had been in country for one week and two days when they arrived in my village, so just off the plane. We had a lot of fun and they were a really great group – and really good sports about lots of biking! They arrived in my village on a Thursday. We ate lunch at the marche on the road and then biked back 9 km to my site. We spent the rest of the afternoon relaxing at my house and then went to greet a few people. Despite my insistence to the chief that it was proper for us to go greet him at his house, he insisted that he come greet us at my house (which is really bizarre and not at all traditional for a chief in Burkina, but it’s definitely refreshing to have a chief like him). On Friday, we did a family planning sensibilisation (health talk) at a mosque after the 1:00 pm prayer (Friday 1 pm is the big prayer where everyone goes to the mosque). It overall went really well. The imam was really supportive and I was really happy at the end when he added a comment about how using family planning methods allows Muslims to practice Muslim values but protect women’s health at the same time. Saturday, we went to the marche and then met with the CSPS (health clinic) staff and community governing board. I was really excited to share my experiences and my village because I live in an amazing village with an awesome family. It was also a cool chance for me to look back and reflect on the past 16 months. I don’t always see how I’ve grown, but moments like that, I can.

It was also exciting because I finally got around to doing something I’ve wanted to do for a while (well decorating my house too, but that’s not the important part). I’ve wanted to sensibilise men on family planning for a while. During the family planning sensibilisation, we focused on the importance of family planning and I particularly focused on the role men have in this decision. There’s this approach Peace Corps talks about called Men as Partners. It’s really important, especially here. You can’t empower women without getting the men on board. It would be dangerous to the social dynamics and brews resentment. Any time you talk about women’s development and empowerment, you have to talk about how men are involved, what role they play, and how you can encourage them to be supportive. Anyways, using this approach, I’ve wanted to talk to men about what people usually consider women’s health issues, such as family planning. Because it was successful, I am going to try it in other villages and on different topics (like the importance of giving birth at the health clinic versus at home).

I am now working the training for the new volunteers for a week. It’s exciting, but definitely lots of work. But again, also a good chance for me to reflect back on the work I’ve done the past 14 months, recognize success and see what I can do better and set goals for my last 10 months. It’s also cool to realize how comfortable I am here – I feel adjusted and integrated into my community. Things that I thought would never become easy are second nature now.

Projects in village are going well. Moving forward on the World AIDS Day project. We are doing an awareness campaign. We will train community health agents on HIV and then on World AIDS Day in December, they will do educational activities. We will also have a theatre performance and a soccer game. Right now, I’m trying to get the mayor’s office involved in this as well. School started mid-October, so I’m doing more health classes. Just last week, I went back to the school to do a health class. I am finishing up hygiene (which I started last year, but I wanted to do hygiene with the two newest classes before I move on to a new topic).

Last blog, I mentioned that I was doing the malnutrition program again, but with some modifications. It’s the same thing I did back in May – find malnourished babies and do a rehabilitation program with them. You met with the moms every morning for 12 days, make enriched porridge and do health education – mostly nutrition, but other topics as well as they are intertwined. It’s gotten off to a slow start this time. While it’s cool that I have 3 counterparts trained on the program and it’s a chance for me to be more hands-off and let them learn by doing and empower them, it’s also logistically less organized. While it may have more bumps along the way now, it leaves them with the skills to do this project when I’m gone.

One thing I’ve learned about malnutrition recently is how much it’s related to so many other health topics. I used to just think about malnutrition in terms of food. But what I’ve seen recently though is that children that are always sick become at risk for malnutrition or fall into malnutrition. A big issue here is hygiene-related illnesses. If a child is always sick with a bacteria infection, parasite, diarrhea, or other hygiene-related illness, they lose weight, lose their appetite, and can’t retain the nutrients they take in, meaning they don’t eat and don’t gain weight. Same thing with malaria. I had a mom come in with her child and the child was moderately malnourished. After talking to her, I realized she understood nutrition and tried to feed her child well, but the child didn’t want to eat and because she was always sick, she was losing weight to the point where she fell below the line into malnutrition. So particularly for malnourished children or children at risk of malnutrition, it is important to talk not only about nutrition, but preventing other illnesses (such as hygiene-related illnesses or malaria) so that the child has the opportunity to eat well and gain weight. That’s one thing we need to focus on more during this second try at the malnutrition program.

I harvested my peanuts finally! As usual, it turned out to be way more work than I expected. Seriously, every time I went to work in my field, I swear it grew larger. Because I only weeded once, it was tough to get to all the plants, but apparently they yielded really well (according to my brother, I have no frame of reference). I averaged about 10-15 peanuts per plant, although some had almost 30 peanuts. Of course, now I’m trying to figure out how to get rid of all these peanuts because I’ll never eat all of them. And I always get gifted peanuts because I live in the peanut region.

NY Times Article: Contraceptives and HIV in Africa

Last week, the New York Times published a front-page article with the results of a study on the effect of contraceptives on HIV tranmission in Africa (sorry, I know I am now a week late on this post, but that’s how things work in Burkina Faso – slow). A recent study suggests that injectable contraceptives, which are widely used in Africa, may increase the risk of HIV transmission and infection. The hormones in the shot seem to have some physiological effect on women, although it is unclear what exactly that effect is and why it doubles the risk of transmission and infection. The study followed couples where one partner was already infected with HIV. In couples where the hormone shot was used, the uninfected partner was almost twice as likely to become infected with HIV during the two years of the study compared to those that did not use the shot. (The study also recorded condom use. Couples using another method of family planning are less likely to use a condom. However, researchers controlled for that and were able to eliminate that as a cause for the increased risk in HIV transmission and infection.) Although the study focuses on eastern and southern Africa, it still applies here in Burkina Faso. While the HIV prevalence rate in Burkina Faso (and West Africa) is much lower than it is in eastern and southern Africa, it is still present and people need to learn how they can protect themselves.

Family Planning in Burkina Faso
Family planning is a huge priority health initiative in Burkina Faso. Education and awareness are really important. During pre-natal consultations, I commonly see women coming in on their 9th pregnancy (although usually not all 8 children are still living). However, especially in a place where maternal and post-natal health care are sub-standard and women generally have to do a lot of physical work often very soon after giving birth, multiple pregnancies without appropriate spacing exhaust a woman’s body and increase the risk for complications. In addition, there are economic and social consequences if you do not have the resources to support all your children. The availability of family planning methods greatly increases the health of women as well as the economic and social dynamics of a community. At the end of the day, there are some people in Burkina Faso that understand the importance of family planning. But there are also some that don’t or don’t accept it and don’t want to talk about it. And even among those who understand the importance, it is hard to translate that attitude into practice for many reasons. There are always exceptions (positive deviants as we like to call them in Peace Corps). I have many conversations in the market about family planning. One man called me over, knowing I work with the CSPS (health center), to show me his wife’s health card and confirm her next rendez-vous at the CSPS for the next dose of the hormone shot. He was involved and supportive of his wife. I have others ask me about the different methods available and where they can go to get them. While I haven’t done much work on family planning in my first year, I definitely want to in my second year and these instances of openness are encouraging, especially knowing there will be just as many instances of restraint and resistance.

According to documents in my health center (CSPS), about 13% of women of procreating age use some method of family planning through the CSPS (hormone shots or pills). This number does not include those who use only condoms, which are available at the CSPS as well as the boutique/store and one of the bars in my village. This may seem low, but considering the cultural norms, access, and education, this is actually pretty good, although there is still much room for improvement. The injectable (hormone shot, what the article is talking about) is by far the most common family planning method used. It is a much more realistic form of family planning here. First – it’s once every three months instead of remembering to take a pill every day. Second, for women whose husbands are not supportive, they can do it quietly at the health center, without their husbands knowing. If she has to take the pill, it is much more likely her husband would find out. (Just to be clear, this is obviously not ideal. It is much more ideal for the men to be supportive and implicated in family planning, not just leave it as a burden for the women or even worse, prohibit it. However, we do not live in an ideal world.) It is always important to emphasize that neither of these methods protect against HIV – condoms do. So even if another method of family planning is being used, condoms should still be used as well. But again, in the case of a husband who refuses to use a family planning method, the shot at least does something. There are other methods of family planning, like implants and intrauterine devices, however those are not available at my health center, but in our district hospital.

HIV in Burkina Faso
The HIV prevalence rate in Burkina Faso, like most West African countries, is much lower than other African countries. Here are some HIV prevalence rates from UNAIDS.

Burkina Faso: 1.2%
Ghana: 1.8%
Côte d’Ivoire: 3.4%
Benin: 1.2%
Togo: 3.2%
Niger: 0.8%
Botswana: 24.8%
Kenya: 6.3%
Uganda: 6.5%
South Africa: 17.8%
United States: 0.6%

Education and awareness are really important in Burkina Faso, both to prevent future transmission of HIV and lower the present rate. There are many misconceptions and just total lacking of information about what HIV is and how it is transmitted. In addition, knowledge on prevention is low and there is still a stigma against those living with HIV. While I do not have a rate for just my health region, I would guess (and it seems to be confirmed through my observations at the CSPS), that it might be slightly higher than the national average because we are by a border and the mines in the region attract many young men from my village to live and work there. These factors and the social effects of them make the population more vulnerable to HIV.

Impact of the study
It seems like officials are trying to be cautious – rightfully so. Sending out alarm signals too soon on the number one family planning method could unnecessarily place women in increased risk. While it is certainly irresponsible to knowingly do something that makes a patient more vulnerable to HIV, the dangers of discrediting or warning against injectable contraceptives in Burkina Faso (I can only speak from my experience here, but it can probably apply elsewhere) are also quite serious. It may mean some women no longer use any family planning method, increasing unwanted and improperly-spaced pregnancies, which would in turn increase injury, illness, and death from complications in childbirth. However, it is just as serious if it is proven true; the public health sector here would have to immediately educate people about other safe forms of family planning and make them available in addition to continuing education on HIV prevention.

Bikes, Bats, and Burgers

So I’ve had quite an exciting past two weeks. After finishing the malnutrition training in my district capital, I biked back to site to leave the next morning to join the Burkina Faso Bike Tour. It was so much fun! The Bike Tour is a fundraiser put on by volunteers in Burkina Faso to raise money for gender and development projects. The tour went around the entire country, although I only did four and a half days of it. They passed by one of my satellite villages, so I joined en route to Beka. I finished the tour from there into Ouaga (the capital) to celebrate the 50^th Anniversary of Peace Corps. Definitely hard and exhausting, but like every other part of our service, we got through it together and had some fun on the way! We were greeted by a huge welcome ceremony when we arrived in Beka. Literally, the entire village must have come out for it. There were drummers and dancers and of course tons of people just staring at us (we were about 20 people in total). As well as people taking pictures of us with their cell phones (yes, there is no electricity or running water, but don’t worry, you can still take pictures with your cell phone). After our two host volunteers thanked everyone, we presented the chief, mayor, and prefet with certificates to thank them for hosting us. Then we split the men and women and did a health talk – malaria with the men, nutrition with the women. It was really cool how excited everyone was to have us there and a great chance to educate lots of people.

The next morning, we packed up at 4:30 am to leave at 5 am for Pô. I had a rough day because my gears broke and it wasn’t possible to repair them – so I biked most of the day on a gear setting that was way too low. But we did stop in Tiebélé, which although you probably haven’t heard of it, is actually a tourist site.   There are traditional Gourounsi houses and after discussing for 20 minutes a good price, we went to tour. They were really cool. One of the things I liked was the pictures and symbols painted on the outside of every house that represented different parts of their traditions. They also use the pictures to teach the children things like not to mess with snakes. The doors are really unique too – you have to crouch to get into the house because they’re really low. And then you have to hop down into the house. It used to serve as a protection against warriors from enemy tribes. Because you duck under and then have to go over another ledge to get in, you could see the head of the person before they fully entered. So if it was an enemy, you could chop off their head. I did not however like the bats in the houses. Apparently in their culture, bats are a good luck symbol. They teach kids not to tease the bats. We were inside a house and going into the back room. I was next to enter when someone said, “Hey wow, look at all those bats!” To which I said, “Yep, no way I’m going in there. I’m leaving.” But then I decided, what the heck, I’m in the Peace Corps to challenge myself. I’ve already overcome my fear of chickens, why not bats too. S o just as I crouched down to enter the really small doorway, a bat decided to fly out at the exact same moment. It flew by just centimeters from my face, to which I naturally screamed. But I made it in the room and stayed despite seeing at least five other bats hanging out there too. Although later I felt bad for screaming at the good luck symbol, I’m so glad that’s not a thing in the Bissa culture.

The next day was the longest bike I did – Pô to Léo, which wound up being 124 km (77 miles). But we kicked butt that bike ride! Luckily, I was able to trade bikes with someone leaving the tour, which made the rest of the tour much easier. We of course left ridiculously early (4:30 am), so it was still dark. My headlamp broke my first week at site (which I don’t mind because it makes my forehead too hot anyways), but it made biking in the dark challenging. The first stretch was through an elephant park that was beautiful. We had a gendarme (police) escort through the park and we were required to bike close together for a good 15 km, I guess the danger zone. I’m still not exactly sure how they could have protected us from elephants, but we sadly did not see any. I arrived in Léo around 12:20 and was greeted with a cold Coke. The highlight of Léo was the tofu brochettes.  So they usually sell meat on a stick here, called brochettes. But this entrepreneur in Léo, on his own, researched soya beans and what you can do with it. He found the recipe for tofu and tested it out in his market. It has become really successful. He has done this project with young women for them to have a source of income. Many of the young women use the money to pay school fees. So not only delicious, but also for a good cause.

The next day, we biked to Gallo, a small village, so definitely a change of pace from Pô and Léo, which are bigger towns. The bike was only 80 km, much easier than the day before, although still far. And all paved. In Gallo, we had a quick welcome ceremony at the school and then had time to just hang out and relax. Some of the neighbors decided to come over and dance, so we had a small dance circle and they were of course entertained by us attempting to join in. Gallo is in the Mossi region of the country (Mossi is the dominant ethnicity in BF). They have a traditional dance where they bump hips. It looks quite painful actually because they do it with such force. The Bissa (my region) are more into stomping, so I don’t know how to do this hip bump thing, but it was fun watching others try.

The last day, we biked into Ouaga, the capital city, as the start of the 50^th Anniversary Fair. That morning, the newest group of volunteers was sworn-in. We biked most of the morning in rain. We meet at the edge of Ouaga and had a police escort to the Maison de Peuple. They had sirens and everything and we were running all the red lights – super legit and official. We arrived however, and there was only one person waiting for us – the swear-in ceremony was still going on, so everyone was inside. We did get to shake hands with the Prime Minister. As he left the ceremony, we were all lined up waiting outside.

As a celebration to the end of the bike tour, we made burgers. So to you at home, this may not seem so special. But if you only understood the food here, you would understand why we took this task so seriously. We were divided into teams (strike forces) to buy ingredients. Then we made burgers. I was responsible for dishes (fun, right). There was quite a lot of planning involved in this. We don’t joke about a good burger here (because the ones you actually do find in Ouaga do not suffice). So we had our grill masters make the cheese burgers plus an assortment of toppings, including BBQ sauce, bacon, avocado, tomato, lettuce, onion, etc. I can confidently say it was the best burger on the continent of Africa. 

There is an official Bike Tour Blog. Check it out for more pictures, stories, and info. You can also still support us with a donation! All the money funds projects done by volunteers here in Burkina Faso.

The next two days, I was at the 50^th Anniversary Fair. It was really cool. The Fair Committee did a fantastic job with all of it. The Fair was a chance for volunteers to showcase their work and bring their association/community group to sell stuff, network, or sensibilize. Committees also had tables (that’s what I was doing, helping out with the Community Health and AIDS Task Force table. I’m on that committee). There’s a ton of great videos up on YouTube. I unfortunately can’t get the internet to download them that easily so will probably watch them in 10 months when I’m back. But you should check them out!

After the Fair, I went back to site for a week and am back in Ouaga now for a training of trainers. We are welcoming a new group of health volunteers to Burkina Faso on October 11 and I will be working at some point during their training.

I’m excited to get back to site. Between the nutrition training, Bike Tour, Fair, and training of trainers, I’ve been out of site the past 4 out of 5 weeks. And now that rainy season is almost over, as is harvesting, I can start picking up speed on projects. I am doing another FARN (rehabilitation program for moderately malnourished babies, the same thing I did back in May). The cool thing is I am working with the same counterpart from before plus two new ones who attended my nutrition training, so it gives me the chance to be more hands off and really empower them to have the confidence to do the program on their own (and ideally after I leave too…). We are doing it in one of my satellite villages. I also received some grant money to build 16 latrines, so will start that process again (although it should be easier the second time around). And as soon as school has started next week, I will be doing more health classes plus a pen pal program with the English class. Then in December, CHAT (Community Health and AIDS Task Force, which I am part of) is planning an activity for World AIDS Day, so I am involved in that. We are trying to get tons of volunteers to paint murals. We’ve done all the work to get the funding and will buy the materials, to make it as easy as possible for volunteers. So I will be doing a mural in my village and helping other volunteers do murals. Sounds like I’ll be busy, but a welcome change of pace. That’s just how Peace Corps goes – your first year is slow, the second is packed.

Wow, I know, super long update. I’ll be here until Saturday and then back the next weekend for meeting, so I’d love to hear from you (e-mail, facebook, gchat if it loads with my super slow internet, whatever works). Miss you and hope you’re doing well!

Erika