27 Octobre 2010

Lots of adventures this month! I’ve still been going around to different villages, doing cooking demos and baby weighing with the nutrition workers. More baby weighing than anything else, though, because it’s hard to do cooking demonstrations when the nutrition organization has no money to pay the workers. We’ve been telling the women in different communities that if they want to have us cook with them, they need to supply the rice or corn or whatever staple food is locally available. Since many of the poorer villages don’t really have any rice to spare, we’ve mostly been doing just the baby weighing and health talks. It’s still been really great getting a chance to see more villages and work with new people, though.

The new volunteers came this month as well. I have an English teacher just 90km north of me, a health volunteer a 4 hour hike from my site, a health volunteer in Antalaha and an English teacher in Andapa. Last week, I biked down to Ambavala (a market town/taxi brousse stop 20km south of me) to meet up with the environment volunteer who is 25km south of me. From there we biked along a windy, bumpy, hilly dirt road out to the coast to visit the new health volunteer. It was quite an exhausting trip (4 hours on a bicycle for me). Though the bike ride was tiring, it was really neat to go down a road I’d never been down before and to see a new town I’d never been to but often heard about.

Once we met up in Ambavala, the other environment volunteer and I biked through dense forest interspersed with small villages and rice paddies. After about an hour and a half the path flattened out and became sandy. We passed a coconut grove and a lot of vanilla fields and crossed many rickety bridges over small streams and rivers. The road was fairly dry, though I can see how it would be impassible during rainy season. The health volunteer there has a really nice set-up, but he is very isolated from any big towns. People have told him that during the rainy season, he might not be able to leave site for several months. When we got to his site, we had a very warm welcome from the mayor and other community members. We mostly just hung out and talked, as it’s always so great to converse effortlessly with other English-speakers. There was also another French aid worker from Medecins de Monde who is posted there for two months. He doesn’t know much Malagasy, but converses with community members in French and is currently working on a cyclone relief project as well as a Morenga nutrition project and other community development projects. I look forward to working with the health volunteer there, because the commune I live in borders his, and there are a few villages out his way that I’ve never worked in before.

Life back at my site has its ups and downs. The public taps broke again for several weeks, so everyone had to fetch water from the river. At first, I tried braving the treacherously steep path down to the water, but its way too hard to climb back up the steep, muddy hill with a pail of water in one hand. I’m not as skilled as the Malagasy women. Some of them can balance a bucket of water on their head while also carrying a huge bin full of dishes they washed down by the river in one arm and another small pail in the other. It’s really amazing how much balance and coordination they have. I however, gave up on trying to compete with them; I broke down and hired the lady who fetches my neighbor’s water to carry my water as well. It’s only 100 ariary a bucket (20 cents), although I feel kind of weird about it because the woman is middle-aged. At least I provided her with a little bit of income. The taps finally started working again after a couple weeks, though. I’m glad for that, since everyone bathes and washes their clothes down by the water, and no one bleaches their water that they use in the kitchen. I was worried there might be a rise in diarrheal disease if it lasted any longer.

Although I hired someone to carry my water, I still go down to the river to wash clothes. Even though the path is steep, and it’s still kind of hard to carry a big bin of clothes down to the river, I like going down there to hang out with the other women doing chores and to watch kids playing in the water. It also gives me something to do on Saturdays when everyone else is out working in their rice fields. It’s not uncommon for me to see kids fishing or a flock of ducks paddling by or children playing in a wooden canoe they commandeered from the man who makes a living taking people across the river when it’s too high to wade through in rainy season. The other day some kids were using large banana stalks to float down the river kind of like those foam noodles American kids play with in swimming pools back in the States. It was kind of a funny site!

As far as work goes, I’ve been pretty busy at the clinic and biking and hiking around to other villages to do health outreach programs. A few times I’ve biked to visit my friend who’s a nutrition worker 7km north of me. She likes to hike out to remote areas and weigh babies whose mothers don’t normally make it out to her weighing center each Tuesday. We’ve met up several times to weigh babies and give health talks to the mothers. I enjoy just hanging out and talking with her too, because she’s really sweet and helps me understand Malagasy culture better (which is also part of my job as a Peace Corps volunteer). One day she even took me out to her vanilla and rice fields. Her nephew taught me how to pollinate the vanilla flowers by hand (since Madagascar doesn’t have the natural pollinator for the vanilla plants that originally came from Mexico). It was really delicate and fascinating work. After pollinating the flowers, we hiked over to her cassava fields and she dug up a few cassava roots (one of the staple foods here) for me to take home. I don’t really like the starchy root very much, but she insisted that I take some as a “voandalana,” or, gift for the road.

This past week was health week, a government sponsored program to distribute vitamin A and deworming pills to all children under five as well as pregnant women twice a year. This time around we also distributed malaria prevention medication to pregnant women and measles vaccines to children under four. On Monday I went to the village 9k south of me that has a small rural clinic I frequently work at. There, I gave health talk and helped the clinic workers distribute the medications all morning. In the afternoon we went over to the one private school in the village and distributed vaccines, vitamin A and deworming medication to all the four-year olds in the kindergarten class. I was kind of on the fence about that one, because one of the workers was using a pair of scissors to threaten the stubborn kids who didn’t want to come forward for their medicines and shots. I spent the night at the doctor’s house there, because the next morning I, along with his wife and daughter and a few other workers, hiked two and a half hours from there out to a very remote village. We had to leave at 4:30 in the morning so we could get there early enough to distribute medications and vaccines and still have time to stop by two other villages on the way back to give out meds. By the time we got back to the doctor’s house it was 5:30 in the evening. I was so exhausted from having woken up at four in the morning and having hiked five hours that day. The hike through the dense forest and rice paddies was really beautiful, though, and I got a chance to see more of the commune that I hadn’t seen before. Going out to the remote villages was a eye-opening, because the poverty out there is much more visible than in town or even in the neighboring villages that I’ve been to. Almost all the houses were dilapidated shacks made of sticks and leaves and most of the children under 10 showed signs of kwashiorkor (protein deficiency). It’s unfortunate that the vitamin A and deworming distribution was only for children under 5, because the children over 5 were still, very clearly malnourished. Many had bloated bellies, ribs sticking out of their chests, skinny arms and reddish hair. Its amazing to me that even in an area as lush as here, where things grow so easily due to the frequent rains and heavily forested areas, that people still have a hard time finding the resources to farm and forage for adequate amounts of nutritious foods. I’m hoping that I can return to those villages again to do some gardening and nutrition projects if the communities are interested.

The next day I biked back to town and worked at the hospital, because we finally got HIV tests in to administer to all the pregnant women. Since I knew the midwife wasn’t going to do pre-counseling even though she’s had the training before, I made sure to talk to all the pregnant women beforehand about the HIV test, about the illness itself and about prevention measures. HIV/AIDS doesn’t seem to be as stigmatized here as it is in many other African countries, but the more concerning issue is that awareness levels are very low. Many simply do not know what the illness is or how it is transmitted, and those who have heard of HIV, think that it doesn’t exist in this part of Madagascar. Although the country-wide prevalence is still very low, it could easily spread very quickly, because nobody uses condoms, there’s a high rate of STDs and many are unaware of the illness and its consequences. Afterwards, the doctor gave a health talk as well. He stressed using family planning as he announced that on average, 60-70 births occur at the hospital per month. I knew there were a lot of pregnant women around, but I didn’t realize the number was that high! That’s not even including the many women who give birth at home or in the 4 other small, rural clinics in the remote areas of the commune.

In the afternoon I helped out with family planning. A lot of women showed up, but most of them were regulars who have been using the Depo shot for several years now. Every time I give a health talk to the women about the different family planning methods, I always stress condom use and talk about STDs and HIV/AIDS. Nobody takes the free condoms and too many of them are really young or have husbands that sleep around. It’s so frustrating when everyone here says that men won’t use condoms, but if I can just get one young person to take some home, it will have made my day.

Other than that, all three of my grant applications for funding health projects got rejected, since there’s not much government funding to go around here in Madagascar…so I resubmitted my well project under Peace Corps Partnership. If it gets approved, I’ll post the link to the Peace Corps website where interested donors can contribute online. I’m keeping my fingers crossed!

And along with other unfortunate news, I found out that I had Giardia for the past two weeks. At first I wasn’t sure what was going on because the symptoms were so mild in the beginning. After it didn’t go away for over a week but got worse, and after talking to other volunteers and to the Peace Corps doctors, I found out that I probably had Giardia. So I went around to five pharmacies until I found the last stock of Flagyl (Giardia medication) left in the whole town and bought them out of it. After a day of taking the medication, I no longer had to run to the bathroom five times every morning. So I’m guessing that was the cause of my mysterious GI problem. Yay for fun tropical illnesses! Hopefully my next entry will be a little more uplifting.