Project

This country has vast populations who are far from "the grid" of transportation, goods, services. So ideally the health system is set up to handle simple cases in rural health posts, referring to bigger centers as the need warrants. Needless to say, there are many barriers to its success.

There is little effective medical or nutrition care for children 0-5 yrs old, which is where malnutrition hits the hardest, so our work attends to this effort. We have tin-roof, almost tent-like clinics set up along side the state clinic buildings in various rural towns. Each site is staffed with a team of about 11 who triage, teach, weigh, register, consult, monitor, give medicines, and finally give plumpy-nut rations and mosquito nets to the children who come to our clinic.

I supervise two such clinics that lie to the north east of our town. They lie 100km and 60km from here, and in a place with few cars, that is a log way to travel on foot or animal. Their source of goods and services are the weekly markets that gather in various towns between. We see a mix of ethnicities: Peuhl, Tuareg, and Haoussa. So I can't speak much to the women who come, much more than the greetings in Haoussa. The staff are always trying to teach me their respective languages J besides my wanting French.

Since we know nutrition isn’t just as simple as sufficient calories, we also run the pediatric and maternity wards at the hospital in town as well as prenatal care in some rural centers. We also have an intensive therapeutic feeding center for children referred from our outlying clinics who are in serious trouble with nutrition and related illness.

The clinic set up is simple, the numbers served is impressive (thousands and thousands in yearly total), and offer tangible witness to the problem of malnutrition. Besides the physical need, our presence here is advocacy.

My work takes the role of a connector, communicator, supervisor in the project. Since I don’t speak the local languages, I could do very little directly with our beneficiaries. I oversee the work of the local staff, serve as a connector back to the base, and offer a perspective of an expatriate and as a (well-taken care of) volunteer, to compliment the perspective of our national colleagues.

That's a taste of what I am doing here.

Nutrition

Nutrition

I have not written a lot about our project here. Since this blog is public, I remain pretty general.

It is true. It is hard for all the kids (and adults) to get good nutrition here in the Sahel. The main staples are millet and sorghum and beans and around 80% of the population lives off the land and animals. It is a lifestyle that waxes and wanes with the provision of the land and weather.

The limited nutrition from eating only starch grains and little else is one issue, since kids need animal fats and proteins to grow properly. But factor in, then, the process of GETTING the food. Crops here are planted, travelled to (easily 2 hours to your field by foot or donkey cart), tended, harvested, and processed all by human power. Once the food portion of the crop is harvested by hand and carted home, stored or sold, then you go back out to harvest the stalks which, laced together in tight formation, construct your home and grain storage for the next year. Oh, let's not forget you still have to pound the grain to get it off the stalk to prepare the meal.If you do the math of energy consumption, this demanding lifestyle often leaves the human wanting for calories.

Why not drink lots of milk and cheese, you might ask? Well, the milk and meat production of the animals is directly linked to the availability of water and nutrition for the herds, which is parallel in its harshness to humans. The Sahel is not exactly a forgiving place to live.

So it ain't easy and handing out sachets of peanut paste is not the one and only answer. Families are large here, averaging about 7 children per woman, and up to 4 wives per man. In this environment, you can start to see the challenges to having enough to eat, let alone educate your children, let along take them for health care.

Sand

…makes things disappear
Living with the sand as my floor has piqued my interest in archaeology. You would never imagine how many and how quickly things get buried completely in the sand. A pen dropped can disappear in seconds if a careless foot pushes it deeper in. On market day, countless droppings litter our hoof-printed main street. By day's end when I come back from the outlying towns, they've remarkably disappeared…It helps me understand that a whole civilization can be buried in time, simply under foot and wind.

…reveals all
Walk as lightly as you please, but sand will imprint who was there and where they've gone. Just by observing the sand at my feet, I have picked a lot about my cultural surroundings. It's easy to tell if donkeys or goats or camels passed there and which way they were going, and if the truck passed through before or after them. At our house if the guards swept the sand during the night, leaving only neat brush strokes, I can tell if I am the first one up or not.

…is a chalkboard at hand
I hardly give a thought now to bending down to spell a word in the sand. Everyone does it. It's quicker than hunting a piece of paper and pen and erasing is easy. It also makes a nice artist's palate.

Open Air

(a picture of me and some friends on my 29th birthday)

There is something about open air that I just can't get enough of.

Given a choice between in or out of doors, I would undoubtedly take OUT-- mosquitoes, evening chill and all. It's hunger I have known since I was under 4 feet tall that has persistently drawn me closer to the Equator, where life in the open air is more possible year round .

Breezes past my face—the weather forecast; sun angles, tree shadows, and animal sounds—the time of day; sun and stars orient the four coordinates; seasons march on, by no effort of ours, marking years and the relentless passage of time, helping us to remember; tree tops suggest how to dress for the day; midday wind relieves suffocating heat…and whips me dry, sending me to search a watering hole.

Being out of doors reminds me I am not alone here, with the sounds of playing neighbour children, friendly greetings and aromas of meal prep. Breezes teach me to dance and bird songs prove that it's worth singing, period. Open windows put me at ease. Nature's palate of infinite colors expands my vision to infinite possibilities, lifts the spirit to joy and gratefulness.

This thirst for open air and colors became poigniant one day looking out my third grade bus window in Pennsylvania. As a nurse hopeful, I realized how I loved color and that if I had any say, that the four walls of a whitewashed hospital would be my last choice of where to work and live.

So here I am in Niger. I let the breezes, that are blowing my papers, ease the frustrations of a hard day; I smile at the sun that solely lights our clinics. I push dusty hair out of my face, happy that the weather had a play in my day. All these flavors answer an appetite that has shaped and drawn me towards life in the open air.

When I feel the pulse of the ecosystem I live in, there is no way I can think that it's meaningless, or that I am God. When I consider the heavens, the stars and moon You have put in place…

Ode to Postal Letters and Those Who Write Them

It was a midweek morning, in the land cruiser, geared with backpack, teammate, chauffeur, and we had already driven to our Pediatric unit at the hospital and the nutritional intensive care center to pick up anyone ready to return to their villages. Before we left town, I dropped back by the Base to hand something to a colleague…and to my delight, I was handed an envelope with my name on it. Instinctively, I squeezed it (like a Chompo bar) and smiled to know that it contained a pack of letters. I could not wait.

It was like Christmas. I opened my present like my sister opens care packages- Rip! Snort! And then she gobbles all the yummies all at once and it's so great! It was just like that. I bounced and jolted along and read them ALL in the back of the vehicle. I laughed, I teared, I re-inflated with joy and showed off the scribble-art by my niece.

I read every hand-written word; I visited your houses, your hammocks, and gazed from familiar hilltops; I looked at art on your walls and stopped on the landing of the stairs; I enjoyed your back yards and the neighbors; I started to feel the pulse of my country again; I visited my old work place and rambled through favourite haunts of home.

My gaze came to the end of the last letter…and lifted to the shimmer of pale prairie grass interrupted by dusty green thorn trees and animal herds passing by...and I soaked it all gratefully in. It was as if a big gentle light had slid onto stage and had shed its light on my day. My heart had filled quickly with this flood of love and brimmed-over all day.

The coolest thing was how perfectly preserved your thoughts were. There was no deterioration or settling during shipment! It mattered not a lick that the election already happened or the news was not "new". It was as fresh and dear as the moment you penned it. Like old journals, they are written in a different time, yet able to transport readers to the very present moment of its inscription.

The discourse of the seemingly "mundane" is not mundane at all! It's actually the "real" story most often untold. It's the beauty of life that is so easy to glance over and miss. So congratulations on writing some of history that has never before been written!

Editor's Note: Last week I asked the post man if anyone in this town gets as much mail as I do. He laughed and said "No". The post woman at the desk who'd worked in the system for 20 yrs said with the coming of the cell phone, the post has slowed to a trickle.

All Part It

Death seems to be part of life here. The newborn we brought from the health center to the hospital, whom I held against my skin to help him regulate his temperature, and whose brave and loving mother gave him drops of precious breast milk, died this morning. That makes me sad, even though he hardly had a fighting chance to begin with. She will probably ride back with us to her village on Monday, empty handed. I can read her eyes. I wish I could speak Haoussa.

My last Grandmother was buried and commemorated this week, and even though it’s good and right that she is at rest, I feel a mist of sadness hanging on after the sun has burned the chill out of the air.

Living here one is quite often aware that life holds few guarantees. The nearness of the elements and their power are constant reminders: the fierce energy-dense sun, the wind that brings dust and protein-rich grasshoppers, the ornery but nutritious and milk-producing animals, the open air breezes that allow you to survive the heat, and yet demand that you face the winter’s cold unprotected. Your fields may produce or they might not if the rains don’t come; The chance for employment means you leave your fields, but the pay may not be enough; the chance to study may be available, but then there may be no job to use it.

There’s no doubt about it that life is, at best, precarious. Something I appreciate about the atmosphere of Africa is that this precarious situation doesn’t stop the music we’re dancing to. You dance in the face of any odds, under the rule of any thumb, inspite of the pain of life’s losses. My western mind might interpret that and say “Life is too short, so live it up”. But being here, I wouldn’t strap the idea of time-pressure on this culture. Perhaps they’d say that “Life is life, so celebrate because it's good to relax and enjoy living!”

*any Africans reading this? How do you see it?

Misty Morning

Trust me, you really can picture Niger. Imagine with me: it’s morning and we’re driving on a road (okay, not paved) in the country, perhaps like the one that runs past my sister’s house in Illinois. There’s some undulation that gives relief to vast landscape stretching away under a big sky. As you might expect on a fall morning, a white shroud obscures the road and trees ahead and a fresh chill in the air has made you think about an extra layer. Knowing that it’s fall and it’s rural, your peripheral vision scans the roadsides for critters or animals whose path you might be crossing. Later on, the route will bring you past big fields of perfectly straight rows of corn stalks, harvested and brown perhaps with scraggly other plants along the edge. Your agenda for the day is full of activity, and it’s that and the routine of the commute that stirs a pleasant mix in your awakened mind….

…Now “Pause” this scene:

Switch color palettes for the sage, metallic, earthy and sun-baked tones; change the mist to 100% less humidity and close your window when you drive through it because it’s dust and not fog, kicked up by cattle herds; shrink and enlarge the roadside deer and foxes to make camels or goats, fatten some to become cattle, and let the dogs as they are (they chase cars and lose here too); change the crops to sorghum and millet which look awfully much like corn stalks; let bean plants vine and shade the ground; thin out the tree branches and add long spines between the leaves, and add a spare tire to the top of your vehicle (you're going to need it)…

…Press “Play”- you’re in the Sahel, in Niger!
The traffic you'll pass, I’ll admit, is not comparable. The majority is by foot, then donkey cart, public bus, motorbike, then bicycles, then big delivery trucks, and then by car. Yesterday outside our base office, two vehicles passed two other vehicles all at the same time- making 4 total and they weren’t NGO vehicles! It almost seemed like a two-lane road and made quite an impression in my memory!