Tuesday, July 14, 2009

I Predict A Riot. Or Also: Amber Helps Out With Mosquito Net Distributions

Malaria season has arrived, and so pretty much all of my work right now is devoted to malaria-related activities. The 20,000 nets that Peace Corps Senegal collectively raised money for have finally arrived in Dakar and are being brought out to our sites every day. Our country director recently sent an e-mail saying that he and my boss, the Health Education program director, presented to the USAID and CDC US-based President’s Malaria Initiative team this week, and they said that Peace Corps Senegal volunteers are doing more than any other group of PCVs in the world to fight malaria deaths and illness. That's pretty cool, right? Our country director has done a great job of collaborating with other NGO's. We are working with USAID, NetLife, Against Malaria, Malaria No More, and World Vision to hopefully be able to achieve universal coverage in health districts all over Senegal. He even said that there's a good chance that through this coalition it might be possible to have enough resources for a universal coverage campaign this year for the entire health district of Velingara, which just so happens to be my health district. I'm so excited for the next couple months. Malaria-related work is the area I am most passionate about here, and it is also the most fulfilling work I do. I just got a call saying that the nets for my village are being delivered tomorrow, and I couldn't be more excited! Well, actually I could maybe be a little more excited, and here's why:

A few days ago I went to my friend Jessica's site, Malem Niani, to help out with her mosquito net distribution. She had 1,000 to distribute, and so 2 other volunteers and I went there to help her out. She organized everything really well, and so it seemed like it wouldn't be that tough of a job. Man was I wrong. Her town has 2 neighborhoods, one has mostly Pulaar people in it, the other with mostly Mandinka. Jessica and the two other girls that came all speak Mandinka, so I was put in charge of doing the Pulaar half. There was one other girl that came with me to help, but she was just a friend visiting Jessica who obviously didn't speak Pulaar and so couldn't really do that much. Jessica's host father and another health worker from that town were also supposed to help me out with crowd control and whatnot, but they did not do anything that I would even remotely think of considering "helpful."

Here's how the distribution was supposed to go: I had a list of every head of household in the Pulaar neighborhood with the corresponding number of mosquito nets requested for each family. There was a little math involved, but nothing a first grader couldn't do. There was a column on the right with the total number of nets each family needed, a column on the far left with the number of nets each family received during a recent national distribution which gave mosquito nets to pregnant women and kids 5 and younger, and then a blank column in the middle. A + X = C. Not exactly rocket science. Sounds easy enough, right?

Logistically, we had a table to sit at in a fenced in area that would have been perfect for limiting the number of people in my face at any given time, but Jessica's dad and the health worker didn't agree. While we were still setting up our demonstration net and getting everything ready, people started wandering into the gated area where we were. I told them that we weren't ready yet and kindly asked them to wait outside, but in a trend that was doomed to happen over and over again, nobody listened to me. You know who they would have listened to? The two Senegalese men who were there for just that reason. So, I asked Jessica's father to ask the people to wait outside, and he responded by saying, "oh, it's ok, we haven't even started yet." It was the first battle in the people of Malem Niani's war against me.

We got everything set up, and I tell them that we should start. Well, not without Jessica's dad taking the paper from me and telling me how to do my job. I tried to stop him, but he ignored me. He seemed to be of the opinion that because I'm a woman and he's a man, he is automatically the authority and I automatically am incompetent and inferior. It's a nice feeling, really, to work with people who think you're an idiot. Happens all the time. Anyway, after he tells me how to do my job we decide to back outside and get started because, hey, the Senegalese people are already there.

As I walk back out to our table, I see at least 50 Senegalese people hanging out in the closed off area that I had planned to use as a barricade so that this exact situation would never happen. There's no way I could have got that many people out of there without the help and authority of Jessica's dad and the health worker, but they are both socializing with people and I can't even get them to look at me. As I take stock of the situation, the one singular phrase that went through my head was "Holy fing shit." However, those were not the words I spoke. I just sat down, looked around, and attempted to take control of the mob. I don't know why I thought it would work, but I attempted to get the mob of people surrounding me on all sides to form a line. That was a bad choice. Now that I'm thinking about it, I've been here for almost a year and a half, and I have never seen Senegalese people form a line. The closest thing I've ever seen to a line here is at the bank. There's a guard with a gun in there at all times, and he even has to hand out numbered tickets to get people to not swarm the poor tellers there. The guy with the gun can't even get them to line up by his own authority, yet I still tried. I guess it's just the American in me. The reason I wanted to barricade them in the first place is because I didn't even consider the remote possibility of allowing everyone in at the same time and thinking that they might be orderly in any way.

I immediately realized that I had no control over these people, so I just decided that I might as well get started. It can't be that bad, I thought. I looked up and asked the first person I saw for the name of their head of household, which proved to be more difficult than it seems. First of all, it was often the women or kids that came to pick up their family's nets. No matter how many times I said, "head of household's name only," people still would tell me names that weren't on the list. So, I'd ask if they were absolutely sure that the name they gave me is the name of the head of their household and then check the list numerous times, just to be sure. At this point, I realize that the person in question is just giving me the wrong name, but Jessica's dad is sitting on my right, and the health worker is standing behind me, and they both repeatedly insist that I just look harder. Say the name I'm looking for is Amadou Diallo. The list was in alphabetical order by first names, so all I had to do was look on the first page. The Senegalese men I was surrounded with did not seem to grasp the concept of alphabetical order, and therefore repeatedly yelled at me to look at the other pages, for chrissake. I finally got on as much of a roll as was possible, but iit was still way more difficult than it should have been.

An executive decision was then made by Jessica's dad, who, of course, knows what's best, and I am ordered to just start calling out each name on the list. I mean, by that point basically every person on that list was jammed all around me, so it seemed that it couldn't possibly be any worse of a method than the one we were currently using.


What ensued can only be described as unadulterated chaos. [Jessica came over to check on us at one point and was horrified at what she saw. She took the above pictures but was too overwhelmed by the mob to really capture the insanity of the situation.] I started yelling out each name, and would say it twice just to make sure that everyone heard me, or at least had the opportunity to hear me if they weren't engaged in their own conversations. For reasons I'm not quite sure, Jessica's dad was in a very big hurry. Senegalese people, especially those who live in rural areas, are never in a hurry. Literally never. This guy, however, was. I tried telling him to calm down, but by that point had learned that his ears were inaudible to my voice. In what I can only believe had to be an attempt to see just how much I could take, he then begins to alternate screaming at me to go on with yelling at me to slow down. I couldn't do anything right. It was without a doubt the most needlessly stressful experience I have ever had in this country. I found myself just wanting to take a nap right then and there. But I (of course) didn't do that. I could always sleep later, after I finished crying.

I could go on and on describing the ensuing maelstrom of events that continued to kick my ass that day, but I think I've said enough. Suffice it to say that it was a full-on horror show that made me want to thow things. Things like daggars at all of the people who didn't respect me because I'm a woman, or because I'm young, or whatever other myraid of reasons they might have had. By the end of it all, I barely had a voice, had absolutely no love in my heart for Senegalese people, was seriously questioning why I ever came to this country in the first place, and, for the first time in my life, was so stressed out that I wanted a cigarette.

The good news, though, is that I know that soon I will be able to laugh about it all. Sometimes, when it seems like things couldn't possibly suck any more, I just tell myself that eventually I will be able to laugh about whatever the situation is. And it's true. For example, at one point during all of the madness, I just couldn't take being yelled at anymore and decided to stop everything and count to ten. Out loud. In Pulaar. God, those people must have thought I was crazy, but at least the yelling stopped and I got to take some deep breaths. It certainly was not fun to have to remind myself to breathe. And think rational thoughts. But now, it's already pretty funny to me.

The one thing that I still am frustrated about, though, is how nobody said thank you at all that day. They didn't realize or appreciate how many people went in to making this happen for them, and it really bothered me. It made me realize that I am somewhat skeptical of the effectiveness of a program that hands out free nets to people, whether they want them or not. Yes, insecticide-treated bed nets can protect people from being bitten by malarial mosquitoes while they sleep, thus significantly lowering malaria infections and deaths. No one is disputing that. Of course the over 20,000 nets that we Peace Corps Senegal volunteers are bringing into our communities will make progress on malaria, but I can't help but wonder if giving out mosquito nets like Santa Claus is just too easy. Last year, mosquito nets didn't arrive at all to the entire region of Tambacounda, so people had an excuse for why they didn't have one. This year, mosquito nets are coming, inschallah (God willing). I just want these nets to get to those who both value them and need them.

Maybe my doubts are unfounded. Yes, I am personally delivering enough mosquito nets for every single sleeping space in my village. Yes, they may not in fact value their mosquito nets as much as ones they would have purchased with their hard-earned money. But guess what? I'll make them value their pretty new nets! I will make sure that every single net that you all helped raise money for is properly hung and utilized. I will harass them until they realize it's less annoying to sleep under a mosquito net than be bothered by my incessant nagging every night. I guess that's where this Against Malaria strategy wins and other aid agency's fail; whereas the majority of aid administrators and celebrities blindly give hundreds of thousands of nets away every year to god-knows where, Against Malaria nets go to specific communities where their effectiveness or lack thereof can be evaluated.

Now that I've had a few days to think about the distribution in Malem Niani and my upcoming distribution in my village, I've calmed down a lot about things. My mosquito nets will be here tomorrow, and I'm so excited! The driver is going to take them to my village tomorrow, and I will probably start distributing the nets on Thursday, that way I can have time to help out other volunteers in the region who have much larger distributions to do. I've decided that I'm going to go door-to-door to distribute the nets, rather than doing it all at once. I figure my village is small enough for that to be a feasible option, and by doing it door-to-door I will be able to make sure people hang their nets correctly and do mini health talks with each person. This way I will also be able to make sure that they don't have any standing water (mosquitoes breed in water) and that their compounds are swept clean (mosquitoes also like to hang out in dirty compounds).

After I get done handing out the nets, I am planning on doing a big health talk with the whole village about all things malaria. I'm going to show them how to make homemade mosquito repellent lotion and give lots away as party favors.

Thank you to all of you who helped raise money for these nets. My village is going to be so very happy, too. Check back here in a week or two and hopefully I will have pictures and video posted of my distribution. And thanks, again for making all of this possible.

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