On the Endurance of Camels' Backs

A sad but true fact about life as a Peace Corps Volunteer: sometimes the people you are nicest to and closest with are the first take advantage of you. (Yes, there is a story here.)

Every Wednesday is market day in Fangasso. (Note: the town of Fangasso is the head of the commune of Fangasso, comprised of 41 neighboring villages. 29 of these villages report to the CSCOM (health center) in Fangasso for medical care.) Wednesday is also, non-coincidentally, the day when the women of these villages report to the CSCOM for their childrens' vaccinations and pre- and post-natal care. Every Wednesday that I have been at site for the last year (which has not been every Wednesday, but is still a lot of Wednesdays), I have assisted the vaccinator with his work. He is assigned the task of performing the actual vaccinations as well as recording them (in three places--the Malian version of efficiency). I do most of the recording (baby weights, vaccinations given, etc.) and he vaccinates. This work isn't ideal for me (and in fact I get bored with it quite easily), but I enjoy seeing the babies and talking to the women. I had hoped that by helping with paperwork, the vaccinator would have more time for counseling women on infant nutrition, which is part of his job.

So, when the women come to weigh their babies, I record the weights on personal growth-tracking charts. In most cases, the babies are heavy enough not to be a cause for worry. But every once in a while a baby comes in who is in need of help. This is obvious before you even check the baby's weight--sometimes they are just too small. When this happens, I tell the vaccinator that it is important to take a minute to talk to these women about the fact that their child is underweight; sometimes they aren't aware that it is something we can help them with.

The first time I brought it up with him, he told me he couldn't help because malnutrition consultations aren't given on Wednesdays because the CSCOM staff are too busy. This infuriated me but I tried to compromise with him by telling him to ask the woman to come back another day (nevermind that getting to Fangasso isn't easy for everyone, and who knows how far away she lives). The woman came back the next week (unfortunately on a Wednesday) and again he refused to speak with her. (And I do mean refused. Angrily.) So I sat down with her myself and talked with her about her child's eating habits and general health. She listened, but I knew this wasn't enough. She doesn't know me from Eve; a white stranger telling her not to feed her child what every other mother feeds her child isn't going to get very far. But I was proud of this woman for coming back. Her child was smiling and curious like babies should be. But unfortunately the CSCOM does not recognize or reward women for doing the right thing in cases like these. Really, she just got abused and yelled at by the staff and was forced to talk to me, in my bumbling Bomu.

This happened a few more times with other women, with the vaccinator's conversations with mothers being something like the following: Is he sick? Was he sick? Is he better now? Okay, see you in three months.

Besides never having been receptive to my attempts at improving malnutrition counseling at the CSCOM (which he is supposed to be doing already, mind you), lately I had been feeling that the vaccinator had not been appreciative of my help. This past Wednesday, another woman with an undernourished child came in and he refused to consult her, so she left the CSCOM without getting any help, except for a vaccination.

This did not fly with me. At the end of my fuse with him, I told him he was being irresponsible for ignoring a health problem. I said that if he didn't want my help, I would leave. And with that I left. I don't plan on going back.

To me, this is worth getting angry about. It infuriates me that the people who are in the best positions to positively influence villagers' care practices are the ones who are the least interested in helping. Whatever happened to people who care? If the one person who is most able to relay these positive messages couldn't care less, where does that put me?

To further prove my case: last week, two men from a neighboring village came to my homologue's house for lunch. Afterward, they asked me for money to buy three peanut shellers for their village. It seemed obvious to me to say no, but apparently this was the wrong decision, because my homologue became very upset. "You have to help them!", she said. (One of her favorite phrases. I have to help them, but she doesn't feel the need to help me.) Refusing to give people money but offering alternatives like setting up a savings system is unacceptable, I guess. Besides the fact that getting asked for money is always frustrating, the fact that my homologue, who has been "working" with Peace Corps Volunteers for three years, still doesn't understand what I/we are doing in Mali--and how Peace Corps is different from the NGOs in Mali--is almost heartbreaking. How is that even possible?

I like to think the problem with the health workers in Fangasso is bigger than me. Am I really so bad at this job that not even the people I work with most won't even pretend to listen to my opinion?

When I moved in I asked what the CSCOM's needs were, and they asked for a vaccination hangar. I said no. One year later, some NGO that not even the head doctor can remember the name of is funding the project. Is that a success? When we already have crystal-clear cell phone reception in town, do we really need another tower? Apparently we do, because one arrived not too long ago. When the water tower paid for by World Vision breaks, I should be the one to pay to fix it, right? And when the fence on the garden paid for by World Vision breaks, I should fix that, too, right? Ask anyone in village, and the answer is yes. I am a horrible, no-good, very bad volunteer for saying no. Apparently.

All this, combined with personal struggles like disrespectful neighbors and host family, is getting to be the straw that breaks the camel's back. With a job like this, it's almost impossible to separate work from personal life, and one thing can easily influence (ruin) the other. And when both sides of life are going poorly, it things that much harder. That said, I am still trying. Something needs to change. I am looking forward to the school year starting up again in two weeks--kids have always been the most receptive and willing to listen.

I will be in Bamako for the first week of October leading a committee to revise the PC Mali health curriculum, so check for an update then. Love to all!