Monday, January 2, 2017

Month One at Post


So I've already been at post for a month, which is still so hard to believe. Sometimes, it feels like just yesterday that I was hopping out of the bus with my 3 suitcases and giant footlocker--other days, it feels like I've been here my whole life. As mentioned in a previous post, I have been assigned to live and work in a small village in the southern half of the Adamawa region for the next two years. My village has a population of around 1,800 people, though this population fluctuates with harvesting seasons and other factors. The majority of people in my town are Muslim, and come from Fulbe, Mbororo, and Baya ethnic backgrounds. There is a small population of Christians of Yamba origin, and for the most part their quartier is fairly separate from the others, though relations are harmonious. Fulfulde is the primary language spoken in village, though I've thankfully found several individuals who are fluent in French as well--this has been really helpful so far, as my Fulfulde is very minimal. There is one main road that runs through my town, and is probably about a quarter of a mile long. This one part of the road is paved, though the road that leads to and from it is not. We have one small primary school and one technical high school with two rooms. We have a health center, which is where the majority of my work thus far has taken place, as well as an agricultural center. My town is host to two tailors, as well as several boutiques where you can purchase certain basic goods such as bottled water, soap, sponges, and occasionally onions. There is also a butcher stand which I visit at least twice a week for brochettes fresh off the grill. We are along the plateau that stretches across the Adamawa region, but slightly less elevated than northern cities in the region, so it can get very hot. Right now, we're in the midst of the dry season, so it hasn't been too humid--however, I've been told that come April the humidity will be rough. My town is in the brush, so we are surrounded by plains and forests, with several small mountains nearby. Our town has no electricity or running water, but there are several individuals who own generators to allow people to charge phones and other electronics. Our market day is every Saturday, and along with locals selling produce from recent harvests, it draws in salesmen from the two closest cities to sell pagne (cloth used to make traditional and modern clothing here), buckets, thrifted clothing, and many other goods. It's not huge, but I can get most of the basic things I need there--for more specific or larger things (like a bed), I have to hop in a cramped car for the 40K, or hour-long, drive to the nearest small city. There are usually two cars that leave from my village for the city every day, but occasionally you can find a car coming from the other direction that will allow you to squeeze into the back with 3 or 4 other individuals.
My view from the health center
The one main road that runs through town
Our primary school
The Cetic (our technical high school)
My home away from home (the health center)

My house is a small, bright white house that is part of another family's compound. My building is separate from that of the family, but we spend so much time together that it sometimes feels as though I'm just living in a spare bedroom. My family consists of a father, who works as a driver between our village and the nearest cities; a mother, who likes to be called "Tantie [Aunt in French] Mouna,"; and a fourteen-year-old son named Adamou. Tantie Mouna's sister's 4-year-old daughter, Aissatou, also is currently living with us. Adamou and Aissatou are two of my best friends in village, and are always playing cards or just hanging out at my house. My compound is also connected to that of my father's mother, who also lives with my father's nieces Aicha and Hawa, and Hawa's five-year-old son, Baba. I spend pretty much all of my free time hanging out in these compounds, or with my friends in my house. As I become more comfortable in village, and am making more and more friends, I've started noticing a spike in the number of people stopping by my house to say hi and chat. Looks like pretty soon I'll have to buy more than two plates in order to entertain my guests!
As if I don't stand out enough already... this is my house!
My stunning mother in our compound yard

Aissatou, my first friend in village
Mouna's sister Asta with her new baby boy!
Hawa with Asta's other daughter, Soumaiya, in my living room

My house consists of a front veranda, a large sitting room, a small bedroom, a tiny indoor latrine (yes, I poop in a hole), and a small back veranda. My supervisor, who organized my coming to village, asked for a large wall to be built around my house for security purposes. I don't love that it blocks my view of the street and people passing by--after living in New Orleans, I've become accustomed to porch sitting and chatting with friends--but I understand how important my safety is to both myself and my community. I'm about a 10-minute walk away from the health center, and approximately 5 minutes from the water pump where everyone in village fetches water. I also live one house over from our town mosque, which means I am woken up at 5:30 every morning for morning prayers. The loudspeaker there works surprisingly well in a village with no electricity!
My sitting room/kitchen... hopefully will be adding more furniture soon!

The health center gave me this desk to do work at home
The village mosque, aka my morning alarm clock

Life in village has been wonderful so far! My village has been so incredibly welcoming and receptive to my presence, and has truly made me feel at home. As my compound family helped me move in my first day at post, they noted I had no bed. I told them it was really no problem, and that I would just sleep in my sleeping bag on the floor. However, 20 minutes later, they returned with my supervisor (the chief of the health center) and an unused hospital bed for me to use. Though sleeping on that thin mattress for two weeks straight did not make my back too happy (I have mild scoliosis), it was incredible to see how welcoming and accommodating my new village was to a complete stranger. I also didn't have gas for cooking for my first two weeks, but my new family and friends refused to let me go hungry. My family invited me to join them for every single meal up until the day that I began cooking with my gas and tiny stove for myself. However, my family still offers for me to eat with them all the time, despite the fact that I am able to prepare my own food. These moments are just some of many that I've experienced thus far that demonstrate just how kind and welcoming my community has been to me. My first few days in village, everyone originally called me "Nassara," which basically means "white man" in Fulfulde. However, I quickly told everyone I interacted with that I didn't like that name, and told them to call me by my Fulbe name, Rachida. Thankfully, I've had this conversation with the majority of my village, and so I hear screams of "Rachida," "Madame Rachida," or "Tantie Rachida," anytime I step foot outside of my house.

The first week in village, I focused most of my energy on walking around to get to know my new home and its people. I introduced myself to what felt like thousands of people, and made mental maps of where everything important could be found. I introduced myself to the town chief, as well as the traditional chief, the administration at the local mosque, the local police, workers at the health center, teachers at the local schools, and anyone else I could find. I also tried to familiarize myself with the health center, its staff, and its needs by going to the health center almost every day. Though I often felt useless, and occasionally, like a nuisance, I really enjoyed getting to know the staff, observing activities and appointments, and occasionally helping out with prevention activities. After the first week of familiarizing myself with my community, I continued going to the health center and observing every day. This allowed me to recognize patterns and determine some of the most common diseases and health needs of my community, as well as to get to know my health center better. In doing so, I learned that my health center serves members of 16 other communities, as the majority of these villages don't have their own health centers. This means the region we serve--our "aire de santé"--consists of approximately 11,000 people. Some of these villages are way out in the bush, and can be difficult to get to, while others are on the main road but are 35 kilometers away. Though theoretically our health center should be swimming in work, a lot of sick people just aren't able to come in because it's too hard or expensive for them to get to. Besides collecting statistics and observing CPNs and other appointments, I've also helped out with distributing bednets and fortified flour to prevent malaria and malnutrition.
Just another photo of my beautiful town

I thought this would make for a lovely picture of our village church

As my third week at post began, I started going door-to-door with surveys to determine the health needs of my community. My original survey consisted of 72 questions, some of which were designed to determine the level of health literacy on certain topics within the community, while others directly asked individuals their perceptions of the health center and its services. I also asked individuals what they felt the biggest health issues in our community were, and what changes they would like to see implemented in our community to better support their health needs. I wrote the questions in French, but got the help of two different young women in my community to come with me and translate into Fulfulde. Each interview took roughly an hour to an hour and a half to perform, as it is customary in my village to check in and small chat for a bit before beginning any conversation. So far, I have implemented these surveys with 33 women and 1 man. In my community, it is common for women to spend most of the day at home cooking, caring for children, and spending time with friends, while men are often at work with cattle or in the fields. This is likely the reason for the gender imbalance in responses. I won't go into too much detail regarding the results of my surveys thus far, as I have a lot more left to go--however, I've definitely noticed that malaria, malnutrition, and lack of HIV knowledge are some of the major problems in my community.

As I reflect on my first month of actual service as a PCV, I'm beginning to think about what I want to do in the next two months in order to continue evaluating the needs of my community. I plan on continuing with my door-to-door surveys, until I have a good number of responses from both men and women in my community. If possible, I would like to hold meetings with men, women, and children in separate groups to determine how these populations experience health differently in our community. I also plan to hold informational interviews with important community members, such as the traditional chief, the chief of the health center, and the traditional healers. If possible, I would like to also determine the needs of populations living in the other villages that my health center serves. I will begin with informational interviews of key individuals in these communities, and then continue by trying to host meetings with different populations in each village. This may be difficult to complete within the next two months, but I'll certainly be trying my best.

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