Saturday, January 31, 2009

I can do a prenatal with you, but I can't explain why my eyes are blue

New French words/phrases I use often:

peser: to weigh
bassin: pelvis
ajouter: to add
trouver: to find
amener: to bring a person/animal
apporter: to bring a thing
lampe: flashlight
gonfler/enfler: swell, swollen
carnet: notebook
avortements: abortions (spontaneous or otherwise)
vertiges: nausia/dizziness
saignements: bleeding
sécher: to dry
néant: nothing
réanimé: resuscitated
ça peux aller, ça marche: that works, or that's good
aussitôt/tout de suite: right away
peau: skin
céphaliaue: head first
prochain: next
revenir/retourner: return, come back
decede: dead/died
montre: to show
enseigner: to teach
apprendre: to learn
presque: almost
Here are a few photos from my week:

Above, the children who come visit me at the guesthouse every lunch time. They live along the road I bike to and from the hospital, and as I come pedaling up to FDC, they grab hold of the back of my bike, or run along side, yelling. They are carrying their old bike tires and sticks (they chase the tire, and use the stick to keep it upright) which is their favorite game next to a great clapping game that involves a lot of jumping.

Above is the baby girl I caught. She will probably not have a name for a month or two, as people hesitate to name their babies when they are this young (because so many babies die in their first two months). She opened her eyes right away.

Below is Dr. Zacharia taking Madame Blandine's blood pressure with the cuff I brought for them. Everyone's blood pressure was taken and everyone thought it was very snazzy. I wish I had brought two, so that both maternities could have one.

Above is a kind of fish/snake, whose name I did not catch. This was one of those times in my life where I would have rather not known what the chunks were in my stew.
Below, water comes mostly in bags here-not bottles.

Baby Catching!!

It has been a fabulous, interesting, scary, intense, exciting, busy week! I have returned to Ouagadougou for the weekend, with plans to go out dancing and hopefully see some more of the city. A week in Saponé makes Ouagadougou feel like a whole different country (how exciting is it that you can turn a handle and water will come out into a basin in your room, no hauling involved!!).
The poverty in Saponé slows the pace of life considerably. Not a lot of people have jobs, so just being and living is what they do, and right now, because it is so dry, cultivating isn't part of that. Time is different here, so running an hour or two late (by our standards) is on time, and not showing at all is probably just fine. In a hospital this means that scheduling the next appointment with a pregnant woman is more like giving her a two week period during which she should come back.
Most women do not know how pregnant they are, the date of their last period, or their age (people know what year they were born in, but don't bother to count how many it's been since then, for example one may ask a woman how old she is, and she would answer that she was born in 1982). Sometimes, I feel a little like a detective, measuring the fundal height or figuring out how many months old the last child is to see when a woman could possibly have gotten pregnant again. (It is not unusual for women to become pregnant a month or two after they have given birth. This is difficult for many reasons, including further malnutrition of the mom, which leads to poor milk supply for baby number one and poor sustanance for baby number two in utero.) I am mostly doing prenatals these days, and have learned to document everything properly. The accoucheuses keep leaving me to do them myself, but it is very hard because I cannot communicate adequately with the moms.
The general rule in the hospital has been, if Natalie has seen something done twice, have her do it herself the third time under observation, and then leave her to do the following ones without supervision. This does not include surgery or important injections, for which I am very thankful.
This rule did apply to baby catching though. I observed one birth, helped at another, and then I caught a baby!!! The woman came in on the back of a moped practically pushing, the accoucheuse and I put on gloves and smocks right away, and then the accoucheuse, preoccupied with getting all the instruments ready, told me to grab the head when I saw it and pull. I grabbed the head, but refused to pull then (I was frustrated that I was not to do any perennial support), and pulled gently for the next push as the head came out and up, catching the little girl under her arms as her body came sliding out. I thought it was very appropriate that the first baby I caught was also the first baby girl I've ever helped birth.
A little context about birthing at CMA, for those of you who are interested: There is one birthing room, with two tables, a counter, and a big trash can. It has one light that occasionally works, when the solar pannels work, and four grated windows. All women birth on their backs, with their butts elevated over a basin, and all women birth alone with the accoucheuse. There is no pain medication, are no forceps or vaccums, and a limitted supply of gloves and gauze. All that said, birth in this room is infinitely better than birthing in the home, and the accoucheuse and doctors are very resourceful.
In four different loads, I biked the presents that I had brought (from the States) to the hospital. The things that were the best/most helpful/biggest hits were the gloves (big enough for men's hands-very exciting), the tension metre (the clinic maternity has never had one), and the face masks. The things that made everyone laugh were the one-time use cold packs (no one had any idea what to do with these, their is no ice, so using it to ease swelling was a new concept), the thermometer that only tells temperature in F (and so was returned to me), and the condoms (which the doctors wanted to keep for themselves, having a great time informing everyone that la jolie had given them out). I was disappointed to find that condoms (for either sex) are not very available, nor popular. For the most part, doctors just encourage people to get treated for STI/Ds as soon as they can, and try to save the condoms to give to couples with one HIV positive partner. I should include here, that couples is not exactly an appropriate word, as many men have more than one wife. There is a saying here that goes, "tu as l'argent, tu n'as pas de famille" (if you have money, you have no family).
I have to go to lunch now, so I will end my post here and try to put up some more vocabulary and pictures as soon as I can. Much love!

Sunday, January 25, 2009

la petite américaine

I returned to Ouagadougou yesterday morning after my first over-night shift at the hospital with Josione. Josione is an accucheuse in the clinic maternity, and I have been working a lot with her. She is quite large, and people like to tease her, calling her an American. Now that I have arrived, and am not that large, they call her the big American and me, the little American (I am actually quite small amongst the clinic staff, both in height and weight).
The shift itself was quiet, but the trip back was quite exciting. I rode on the back of Josione's motorcycle, one hand clutching a bag of yams and the other holding on for dear life. There is only one main road here, and it is not wide, and motorcycles do not ever have the right of way. Actually, I'm not entirely sure there are any rules, so maybe no one has the right of way. Anyway, it was exhilarating and terrifying. I survived, having learned a bunch of rich swear words and the word for helmet-casque (because I did not have one).

It has been very exciting at the hospital, though there have not been any births during my shifts. I have learned to do both prenatal and postpartum visits, which have been both fun and interesting. Generally, I do the physical check-up, while the accucheuse on duty with me does the talking in Morré. I work mostly with Josione, and we make a good team, laughing a lot. She has taught me to give injections, both vaccines and birth control. A lot of our postpartum visits involve counsiling women about possible birth control methods, which here include Deprovera, the Pill, and IUDs.

I have watched, but not preformed any HIV/AIDS tests. These tests are like pregnancy tests and only take ten minutes or so. One puts a drop of blood on the end of the stick, and if one line shows up it is negative, two means it is positive. So far, all the tests I have observed have been negative, and an accucheuse proudly informed me that these are the results of lots of hard work by the hospital to help birth HIV/AIDS negative babies.

To back up a little, I have given up trying to split my time equally between the clinic and the hospital maternities, and spend almost all my time at the clinic one. It became very difficult to get any decent experience with the male doctors, as they grew more comfortable with me and began to joke and talk to me more than teach me. It would be nice if I could have an interaction with them without myself in the way, if that makes any sense. Everyone is very nice though, and if there are things of interest which I should see, I am often sought out and shown. They are all very excited to show me a c-section, but there have been none so far. I gather that if there are any complications at all in the birth, they deliver the baby by operation.

There is an interesting mix of western and traditional birth culture in the hospital. On the one hand, it is believed that a woman should be left with her family, to labor as long as she needs to, and birth with no pain medication because pain is what makes a mother. On the other hand, operations and some medical physical interventions are thought to be the best options when something goes wrong, because that is what the Europeans and Americans do. I am saddened to think of all the great alternatives that this community once held in its birth culture, that it lost not because they were wrong or ineffective, but because they are not "modern".

French Vocabulary!

DPA (date probable d'accouchement): EDD (estimated due date)

Gloves: des gants

Blood pressure: tension artérielle

Attend: assister

Be present and helping: participer

Birth Assistant: accucheuse

Birth: accoucher

Pregnant: enciente

Stethoscope: stéthoscope

Foetus: fetus

Umbilical cold: cordon ombilical

Malaria: paludisme

A cold: un rhume

Anemia: anémie

Improve: ameliorer

Ultrasound: echographie

Family planning: plantification familiar

Weight: poid

Saturday, January 24, 2009

Learn Morré With Me!!

Note: no one seems quite sure how to spell the Morré words, so I decided to write them out as they sound.
Bonjour/Good morning/buenos dias: neeyeebeogo
Bon soir/Good afternoon/buenos tardes: nezahbray

ça va/how are you/como estas: yeebeogokibare
ça va bien/I'm fine/estoy bien: lafi bala
et la famille/and the family/y la familia?: yir damba

merci/thank you/gracias: barka

viens ici/come here/ven aca: waka
la blanche/the white lady/la gringa: nasara

laisse-moi/let me be, let me go/no me molestas: basmam

arachid/peanut/cacahuet: naguri

Tuesday, January 20, 2009

The tiny baby in the photo below is one day old and HIV/AIDS free. He is held by his mother (who is HIV positive), and to their left is Clarisse-a Birth Assistant. To their right is the mother's mother. Entire families come for births (or for that matter, any ailment) and camp out at the hospital, making family circles around cooking fires that dot the campus.

The baby in red is a neighbor of mine. He is very curious and often in the care of his (not much) older sister.

Mon Velo! (my bike!)

Selling tomatoes (and other assorted veggies) on the side of the road to Ouaga.

Comu jeesay, commo se llama? O-BA-MA!

There is a lot to tell, so I am not sure where to begin. Work at the hospital is going very well. I think at first people were worried that I would not be able to understand anything, and therefor not be very helpful, but I worked hard to show everyone that I am a fast and eager student and now I am invited all over the place to observe and assist. I am often complimented on my French, but I still miss quite a lot, and ask often for explinations. People are great at explaining a word with other words, and I have been taking frenzied notes that help me remember.

As I learn French, I am also learning Morré, one of the local languages. Most of the patients who come to the hospital know little or no French, so I have learned some key words so that I can at least greet them when I show up in their room. One of my favorite things here is the greeting process. If you smile and shake hands, say uunh huh! alot and snap, everything will be okay. People love to do the shake and snap with me because it always makes me laugh and then they poke their fingers into my dimples. I should add that this is a very physical culture, so being touched all the time (and pinched) is something I've had to become accustomed to.

The hospital itself has two maternities within its walls. One is officially the hospital maternity, and the other officially belongs to a clinic on the edge of town. Niether are well equipped, and both have festive clocks on the wall forever telling one obscure time, still sporting their store tags. My guess is that these, like the tiny refrigerator in the guesthouse, were well-meant gifts from someone with constant access to electricity and batteries.

So far, I have split my time as equally as I can between the two maternities, because I am often teased that I favor one doctor over the other. There are three Sage Femme Hommes (or male midwives) who work the hospital maternity and several Birth Assistants (who are closer to my usual definition of midwives) who work the clinic maternity. I love hanging out at the clinic maternity because there are only women there, and these women (when not in the presence of men) are awesome. I get more technical experience at the hospital maternity (for example, I have inserted an IUD, given breast exams, and done a lot of palpating under their careful observation) but I am not fond of the patient-doctor relationship there.

There have been a lot of things that are both shocking and upsetting about the hospital conditions and the care given there, and though I'm sure that sharing them would be informative and interesting, I feel that the raw manner I may share them in now is not how it should be written. I am taking pictures and writing extensive notes, so I hope you will excuse the absence of these details now.

I am loving the children here. Not only are they possibly the most beautiful in the world, but they are full of joy even as they suffer poverty and illness. It may seem strange to see it written like this, but it seems very much to me that the love and light that comes from them is directly from God or the spirit or whatever it is that may be Truth for you. I am much humbled by their shy handshakes and happy smiles.

I am in Ouagadougou just for this afternoon, having come to watch Obama's inauguration live from the US embassy's recreation center (it's 1,000 CFA or about 2 dollars to hang out there for the day). It was very exciting and the place was packed full of Peace Corps people. It was a bit of a shock to find myself surrounded by Americans all of a sudden, and I felt a certain amount of relief as I returned to the dusty street of the city outside the walls.

There is a blatant line between the rich and the poor in this country and it is green and red like the flag. The green side is of the wealthy, their palm trees providing shade for their manicured lawns. The red side is of the poor, their bike tires pounding out winding paths between their red clay houses. For a while now, I have harbored a distaste for lawns, but it has grown and turned into a deep desire to gorilla plant vegetable and fruit seeds in every one I see.

I return to Saponé in the morning, and look forward to taking a night shift at the hospital. As yet, I have not been to any births, but I have had the opportunity to attend a few women in labor and help at some post partum check ups with very tiny babies. Cute toes, let me tell you!

I hope your heart is as happy as the many Africans' who dance and clap and celebrate across the continent for the inauguration of the U.S.'s new president. Let us hope that this is just one step of many for turning our way of life upside-down and then right-side up, on which ever side that may be.

Saturday, January 17, 2009

There is no electricity in Saponé. The hospital is primarily solar-powered, with some supplimental gas power. As a result, most of my correspondence will be like this-during my weekend trips back into Ouagadougou.

Please believe me when I say I will write with lots more details soon. A very quick summary would include that I am well, have eaten many things I never had before, have ridden on a motorcycle, gotten a tour of the hospital I will be beginning work at on Monday, been proposed to many times, asked if I have met Obama, and bought a spectacular hat.

Those two buckets represent my shower, sink, and laundry machines at the guest house in Saponé.

Guess which is my toilet in Saponé and which was the toilet in the Paris airport:

I realized that I may not have explained what FDC/BF is!

FDC/BF: Fondation pour le Developpment Communautaire Burkina Faso (Foundation for Community Development Burkina Faso)

FDC/BF est une asociation nationale, philanthropique, non gouvernmental, non confessionnelle, a but non lucratif aui est tres active dans le developpment communautaire a la base.

FDC/BF is a national association, philanthropic, non-governmental, zithout denomination, non-profit that is very active in community development of the poorer population.

Its primary mission is to contribute to the improvement of the living conditions of disadvantaged groups zith their full participation.

Maria Kere (my host) is the director of FDC/BF, having worked as such since it was a Save The Children office. Save The Children is still involved, primarily through its office in Mali, but FDC/BF is now its own organization.

For more information, check out

The sign and office of FDC/BF

Yedi!!! (With his most prized possession)

To the right are the lovely laughing gentlemen of Hotel Belle Vue. They gracefully, with great tact and large smiles, taught me to politely say hello, with the proper timing of hand shaking and "enchante"

Below: the view of from Maria's roof

On the left below: the vegetable garden in the front courtyard.
On the right below: Maria's street, and the building's guard in the shadow. He likes to listen to football on the radio and sings along to the comercials in between.
The first photos in Burkina! I am going to upload a few at a time as the internet has been on and off, and I thought it be nice to get at least a few up.
This is Burkina Faso's international airport in Ouagadougou.

This is Ouagadougou from the sky.

Thursday, January 15, 2009

Learn French With Me!!

(French speakers, please excuse the lack of some-most-accents)

Hello!: Bonjour!
How are you?: ça va?
To understand: comprendre
I do not understand: je ne comprende pas

A party: une fete
To dance: danser
Music: la musique

Doctor: medecin or docteur
Blister: une ampoule
Bike: velo
By foot: a pied
The other side (of the road): l'autre cote

Arrive safely: bien arrive
Dangerous: dangereux
It's forbidden: c'est interdit (fumer dans les toilettes)
Seat belt: ceinture de securite
Luggage: bagages

To call: appeler or telephoner
How much does it cost?: combien ça coute?
Money: argent
Computer: ordinateur
The internet doesn't work: l'internet ne marche pas (est en panne)

roc, papier, ciseaux!

I leave for Sapone today! My stay in Ouaga has been lovely, but I am very excited to meet the doctor with whom I will be interning.

I spent the night at Maria's house, and had a great time playing games with her son, Yedi, who is seven. His all-time favorite game is "un, deux, trois, soliel!" which is essentially red light, green light, and he adored all of my shoes, all of which he insisted on trying on. Putting things in my hair and watching them slide out was also a big hit. After each item fell out, he laughed and laughed, and would put them in his hair and explain to me how I should fix my hair so like his, it would hold things.
Maria's niece Michu has also been very kind to me. She does everything around the house, including quietly show me how to do things correctly. I would have made a fool of myself at dinner without her showing me beneath the table how to open things and which utensil (or no utensil) to use. After our first encounter in which I understood everything, but was utterly incapable of replying with any clarity, she reverted to explaining things to me with wildly exaggerated hand gestures, which was great.
(I would like to include here that I have never eaten so much in one day. I do not know how to politely decline food, and so have probably consumed more meat-"you must be so hungry after so long a journey, here, please have more meat!"-and Coke than I have in the past ten years of my life. I gave myself gold stars for eating it all with a smile, but I forgot to leave some on my plate and was awarded-twice-another healthy portion.)
I gave Maria the gifts I had brought her from my family, including some family photos. She loved loved loved the photos and asked about every detail and was generally so happy to hold them and see pictures of "dear Spee" that I let her keep them. Everyone in the household has now examined the photos, and they are all especially fond of Will and Jesse (my younger blond-haired, light-eyed, super cute cousins). Yedi was very disappointed to find out that les bon bon (candies) were for the bureau and informed me, hands on hips, that adults do not like candies as they are for the children. Later, Maria disagreed. I succumbed to his big eyes and gave him a roll of Smarty's in the end.
Maria has sent her driver to "pick me" and take me to Sapone where I will "present myself well" and have a brief tour. I may come back to Ouaga to exchange money, but I will likely not have time to upload photos, I'm sorry-there are many! It is probable that in Sapone I will not have internet access (and possibly not electricity as well), so this may be my last post for a week or two.
Thank you all for your great emails! Even if I do not have time to respond to them all, I love to hear from you. I hope everything is well with you, much love.

Wednesday, January 14, 2009


After an all night flight to Paris, France, and an all day flight to Ouagadougou, Burkina Faso, I arrived safe and sound in the bustling city coated in orange dust. The setting sun glowed on the buildings, and as a warm breeze wrapped around my shoulders, a slow, round sounding French engulfed me. I was thrilled to have finally arrived!
I spent some time waiting to see my ride, but as it became dark, and my own personal crowd of on-lookers moved in, I decided (with the help of a kind taxi driver and a long-distance call to my mother) that perhaps it would be best to find a hotel for the night and call the FDC (Fondation pour le Développement Communautaire-the organization I will be working for) office in the morning.
The hotel was a breezy two-story building with a laughing host and doors that locked. I had a very nice room, with a fan, my own bathroom with a shower, and a huge misquito net draped over my twin bed. Without a watch, and the clock on my computer showing a strange other-continent time, I had no idea the time it was when I fell asleep, but it did not feel that I had slept all that long before the phone rang.
A cheery voice on the other end informed me in French that it was eight, and I had a call. It was a woman from FDC, she had recieved an email from my mother letting them know where I was, and was calling to apologize for the mix-up last night, and to ask if I was well. I assured her I was fine, and agreed to be ready to go in an hour.
It was in this hour that I had my first adventure:
I had not had the chance to change any money the night before, so I had to go find the bank in order to pay for my room. The nice men at the desk told me it was around the corner and down the road a bit, but down the road was more like through a sea.
There were people and mopeds and bikes and cars and carts going in every direction. It must have taken me 20 minutes to go a block. The bank as it turned out, did not change dollars, and my master card to my checking account did not work, so I was kindly directed to go in the other direction; the place I had really needed to be was right across the street from my hotel.
I changed my money and made my way back with a small crowd of men waving phone cards at me. A very exciting first outing!
By the time I got back to the hotel, someone from FDC was there to pick me up. As we drove to the office, she explained that a driver had come to the airport, but did not recognize me, and was very apologetic. I insisted that it really was not a problem.
I arrived at the office and was immediately shown around and met every single person in the building. It was a whirl-wind of Ca va? and Bonjour!, and I am sure I will not remember a single name. The woman who showed me around (she works for the sponsorship program-but I never caught her name) thoughtfully promised a list of people and names, so that I may be able to learn them all more easily.
Everyone in the office was very kind and welcoming. I met my mothers (I am sorry, I cannot find the apostrophe on this key board-every letter is in a different place) friend Maria Kerre who was kind enough to arrange this trip for me, and found her to be a lovely person. She thought it would be best if I stayed this night with her, and went to Sapone in the morning. I hope to spend some more time in Ouaga before I go, as there is so much to see and a misquito net to buy.

Basics About Burkina

Location: West Africa, landlocked. Neighbors are Mali (north), Niger (east), and Benin, Togo, Ghana, Cote dIvoire (south)

Population: 15,264,735 (2008 est.)

Capital: Ouagadougou

(Sapone, where I will be working is located almost due south of the capital)

Burkina Faso, formerly known as Upper Volta, gained its independence from France in 1960 (the 5th of August), and is currently under the long presidency of President Blaise Compaore. It is slightly larger than Colorado, and of its 33 airports, 2 have paved runways. There are more cell phones than landlines.

It has a tropical climate with dry winters, and hot, wet summers. Current environmental issues include drought, desertification, overgrazing, soil degredation, and deforestation.

The infant mortality rate is around 86 per 1,000 live births and the life expectancy is around 53 years of age. Adult HIV-AIDS rate is around 4 percent and literacy is around 22 percent (for men: around 30 percent, for women: around 15 percent)

Unemployment was around 77 percent in 2004; it is a country with few natural resources and about 90 percent of the population is farming for their own livelihood.

About 50 percent of the population is Muslim, 40 percent indigenous beliefs; and around 10 percent Christian. The official language is French, though 90 percent of the population also speaks other native languages.

(Numbers from CIA World Fact Book)