I've been wanting to use that clip on my blog forever. I think it captures the ambiguity involved in Peace Corps work. I know you have all thought at one time or another, "ohh, so she's a Peace Corps volunteer! So, uh, that means..." And I have definitely thought to myself, "wait, what is it that I do here?" over the past year. Before I got here, I really really didn't know what I was
It's taken me a while to write this post because I've been waiting to have a marginally substantial answer. I've written a bit about nutrition work in this sappy post and talked about Peace Corps goals 2 and 3 in this post, but I haven't really said much about what kind of work (goal 1 work, that is) a Health Extension Volunteer does.
Naturally, the work you do here varies by person, by site, and by country. Peace Corps is, by nature and design, both a top down and bottom up organization. Its essence is grassroots on-site work with Peace Corps Volunteers identifying and filling needs, mostly through building the capacity of host country nationals. After all, Peace Corps goal 1 is "to help the people of interested countries in meeting their needs for trained men and women." But Peace Corps is also (increasingly, I believe) working as a top-down organization. We are trained in specific areas and assessed in our completion of tasks. I am a health extension volunteer, so I am given a framework with three goals relating to malaria, maternal and child health, and water and sanitation. A total of 31 indicators mark and track my progress towards completion of these framework goals. Some people love the rigidity of the top down aspect, some people hate it. As a pre-med who majored in Gender and Sexuality Studies, I'm fairly used to sometimes contradictory forms of experience expression or the often messy intersections of quantitative and qualitative data. I guess I'd say I enjoy the way Peace Corps is structured these days. Tangential trajectories aside, this is the situation a Peace Corps volunteer starts with.
Then you are dropped in the middle of nowhere with a village of very nice complete strangers and you go from there.
These are things I have done or am working on right now:
Case de Sante (also called a Health Hut)
Getting the Case de Sante* up and running is my primary work in village. I took a long time to start this because I wanted to feel out my village's commitment and make sure the project would live on far beyond my time here. Up until now I've been working with the health workers (called relais) on their duties, just without a functioning central structure. Luckily, I have a wonderful village and great relais and we are finally really ready to get the Case open. I will be posting a "before" picture soon, hopefully followed by an "after" in a few months. Materially, we need furniture, paint, basic medications,and trees and an outdoor structure for shade. Functionally, we need the relais to come to work every day and we need the village to be aware of us as a reliable resource. (Opening day party? I think so.)
Causeries, Weighings, and a Hearth Model
As I mentioned above, I have been working with the relais on the usual Case duties even though we don't have a functioning Case. The biggest part of this was getting the Health Committee in my village to communicate with each other and the village, an ever ongoing project. Information transmission seems to be extremely difficult in Senegalese culture, and it's not just me or because my language is bad. I can't tell you how many times people have complained to me about not hearing about things. "O tinani kam" ("s/he didn't inform me") is one of the most common phrases in my host mom's vocabulary. So, one of the first things we started was monthly meetings for the Health Committee to plan all of the monthly activities together. It has worked fairly well, but is still a struggle to keep it regular and we are still working on the best way to inform the village about activities. Hopefully having a working structure where we can base our efforts will help those problems in the future.
Once we do have a schedule set, things go fairly smoothly. We have about two causeries each month on topics like exclusive breastfeeding, diarrhea, family planning and nutrition. We have monthly baby weighings and every three months we go house to house for arm band measurements. We schedule in regional and national events like vaccinations and bed net distributions. We are struggling on the consultation side and many women go to our Poste de Sante for birth control instead of talking to our relais, again something that should hopefully improve with an open Case.
SeneGAD
I am pleased to announce that I have recently been elected as the Senegal Gender and Development Board (SeneGAD) President! The elections occurred at SeneGAD's 6th annual West African Gender and Development Conference coupled with the quarterly SeneGAD meeting, both held in Thies. See, you thought that majoring in Gender and Sexuality Studies would never come in handy! Far from it! I have found a position amazingly, beautifully, fantastically tailored to my interests and experiences and I couldn't be happier.
For more on SeneGAD, visit http://senegad.wordpress.com/
So far as president I organized a radio broadcast of Senegalese Peace Corps staff talking about women's issues for International Women's Day. The spot was recorded in three different languages and sent out to PCVs for use on their local radio. Here is me and SeneGAD Communications Coordinator Juliana at our radio in Ourossogui.
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| It was sunny out |
Next up is the April Quarterly Meeting, a GrassrootSoccer partnership training, the Michele Sylvester Scholarships and a whole bunch of other things I'll save for another post.
Girls Camp
March 27th-31st is the Matam region's annual Girls Camp! All of the Matam volunteers invite girls from our villages to a five day camp in Ogo where we talk about staying in school, goal setting, reproductive health, domestic violence, and life skills. We also do fun stuff like making collages and friendship bracelets, doing dance routines, and watching movies. These are topics that girls here almost never get to explore or learn about and it is a favorite Peace Corps experience for many volunteers. I am co-coordinator this year and I can't wait for it to happen. Stay tuned for a blog post about this special event.
Malaria Tourney
Before I know it, its going to be June with Ramadan and after that July with rainy season. A fellow PCV and I are currently writing a grant to visit up to 10 villages to talk to people about bed nets, rapid diagnostic tests, signs of simple and grave malaria, and precautions to take when you are pregnant.
Trees
If you have seen any pictures of my village or of Northeast Senegal in general, you know that there are few to no trees. I started a moringa intensive bed at my Case de Sante and will be working on a 400 tree pepiniere for the Case and the elementary school soon. Getting trees to grow in the desert is a serious undertaking so this is a pretty big project for me.
Well Project
I have talked to some people about a well project in my village and as eager as I am to improve water sanitation and village hygiene practices, this one is going on the back burner for now. I may return to it next winter depending on how everything else goes, or I may leave it for my replacement.
Books
I read a LOT in village. When I am at my busiest, my work includes house to house tourneys, village meetings, and travel here and there for supplies. It can be exhausting, but some days it can really only take a few hours... for example, if I have a big meeting in village it is a big deal and can mean a lot of progress, but that only happens every couple months and it only really takes 3-4 hours. I have 20-21 more hours to kill that day. I do other village-y things like pull water, water my plants, and sew blankets but I also do a lot of reading. My book count since May is around 40.
Whew. Well, this list will probably change (and hopefully grow) as I go on, but hopefully it gave you a taste for the kinds of things a health volunteer can do in Peace Corps Senegal. Back to village now to keep working!
*The Case de Sante is a fixture of the health system that works on the village level. Larger towns and cities have hospitals that can do surgeries, have more complex equipment and have trained doctors. The next rung down is the Poste de Sante, present in towns and usually overseeing a large local area (my local Poste is 4km away and covers 11 other villages around us) and is staffed by what we would consider a nurse. They organize vaccination tourneys, treat minor wounds, have consultations, have a maternity ward staffed by a trained midwife, prescribe medications and have an attached pharmacy. The Health Hut/Case de Sante is the lowest health structure present in some villages (but not all) and staffed by volunteers trained in basic health issues. The Case is supposed to diagnose and treat the most common ailments found in village, such as diarrhea or malaria, do baby weighings and monitor malnutrition, consult on family planning, and give health demonstrations (causeries). I say that a Case is "supposed" to do these things because while the model makes sense, getting everything actually functioning can be a challenge. There are breakdowns in the system at every level (don't even get me started about the medication distribution clusterfuck) but especially when the entire structure relies on volunteers like a Case does, reliable work can be tricky.
