Oh yeah, my job

But first, let me entice you with my new puppy, Buddah:


Buddah is about 6 weeks old--I got him a week ago, only to feel like a single parent with postpartum since he arrived. When hes not peeing, pooping, eating and whining, hes sleeping--he hardly bares and calming quality I hoped him to have when I got him. But I know in time it will pay off--a gaurd dog, a garbage disposal, and a cuddle/playmate all in one!

So I realize I’ve spent a lot of time talking about the culture and lifestyle of my village and my slow (very slow…) integration into the community, but I’ve done very little talking about what my job entails. For the first three months (until mid-March) I am not to do anything that my “real” job entails. The first three months is the “Etude de Milleu,” in which I am to spend my time—not only integrating into my community, which is paramount for the success of my next two years—but to perform various studies with my community to determine its needs (particularly health needs) and effective strategies to fulfill those needs and ensure their sustainability—even after I’m gone. Being that this is a village without the technological advances many Western countries have made to enable continuous, regular and stable livelihood throughout the whole year, this is a village (like most in Burkina and other African countries) whose inhabitants’ lives are incredibly interconnected with the seasons, crop production, religious holidays, money--everything.

So, now that I’ve been here for a full three weeks (I can’t believe it!) what have I learned? Well, there is one CSPS in my village, and that CSPS is not only the rural health clinic for my village, but for 6 other satellite villages—the closest being 13K away and the farthest being 25-30K away. The CSPS is composed of an infirmary (a room with a few small beds) a maternity (one birthing table)and a couple offices for medicine and consultations. Most CSPS clinics have pharmacies as well—mine does not; so if someone needs medicine, it might be at the CSPS—otherwise they would have to go to another CSPS or to the district hospital. There is one Major, my counterpart, who is the doctor and head of the CSPS; there is one infirmary nurse, one birthing nurse, and one assistant. These four people are responsible for the 2500 people in my village and the other hundreds of people that inhabit the other 6 satellite villagers. The clinic is closed every Sunday. Everyone takes a 3 hour siesta (called a repose here) from noon to three. There is no electricity and no running water. There is a solar panel, but I’m not quite sure of its purpose, because the refrigerator that holds vaccines runs off of a propane tank.

You would think this would cause complete chaos: if all the doctors in your community did this, there would be lines of people bleeding and crying and in labor and waiting for hours to see the doctor when he or she was available. That’s not so much the problem here, rather, it’s the exact opposite. Instead of a massive line pouring out the door to see the doctor (especially given the high rates of malaria, meningitis, upper respiratory infections, STIs, HIV and AIDS, and diarrhea), the four nurses here spend a lot of their time outside the CSPS, waiting for someone to show up. I go to the CSPS most mornings before the repo, and in the 3 to 4 hours I’m there I see no more than 4 people there at a time—maybe 7 or 8 people total during that time span. Perhaps its a bit more when its vaccination day. But none the less, when there are 2500 people in my village (so not even including satellite villages), and when the birth rate is much, much higher here than in the US, and when there is only 40 some babies recorded as having vaccinations for the year 2008, something is seriously wrong. I biked 13K and back to the closest satellite village for their vaccine day—maybe 15 mothers showed. If motivation is low to begin with, add an hour plus bike ride and no other real means of transport and you have a bunch of people who just aren’t willing to seek medical attention when they may really need it.

And what only complicates the problem is the livelihood of the villagers: they’re nearly all farmers, so they’re constantly planting, cultivating, harvesting, or selling their produce on the side of the road or in the marche. And if a rainy season doesn’t produce a healthy crop—that means less money, more work, and less time and money to spend on one’s health.

So what am I to do? Not only is it important for me to address specific health problems within the community (water, sanitation, STIs, diarrhea, infection, malnutrition, etc.), but I need to be able to get the message out to as many people as possible—probably the most important people being the ones who don’t go to the CSPS in the first place.

It most certainly seems like a very complex, complicated problem that an etude is necessary for. But just as my integration into the community is foundational to a successful two years, the community’s participation and active involvement in the etude is foundational to a successful future.