Flying By The Seat Of Your Pants Just Looks Silly

This past week I received an invitation to go "En Brousse" with my friend and fellow health worker, Auror. She is a Belgian midwife, and works here in Nema as the director of the local operation of Sante Sud, a health education provider. The thrust of this particular trip was fistules, but for me, it was all about getting to know the region, getting to know the health system, and getting the hell out of Nema for a few days.

My four day trip was amazing, and I saw more than I can fit in this blog. Or, more accurately, more than I think you're likely to read. So here are the bullet points-

-The health posts are tragically understaffed. One doctor, a nurse, and a couple of informally trained assistants serving seven thousand people is just not enough.

-The health posts are dilapidated. Pots are scattered on the floor for the rainy season, which ended a month ago. Windows are broken. Doors are held shut with chains and padlocks. The materials are older than I am.

-The health workers are relentlessly positive. When I talked about the problems in the area, they talk about the success that they've had with education. Through basic lessons and with the help of UNICEF, malnutrition has dropped. AIDS is on its way, but is preventable. Tragedy can be averted.

-Doors are always open. When my team arrived, the people would feed us, house us, sit with us, talk with us, and make us feel at home.

-We are wanted. Doctors gave me their phone numbers and invited me to come back to teach health, and they promised to call me when they are in Nema.

-Locals want us there, too. A dozen times I had to say that I'm not a doctor. They would see me and come straight to me, speaking in Hassaniya about their eyes, skin, back. All I could do is say that I am not a doctor.

-If you offer a free dress that says "Sante Sud" on it, you are inviting a wave of frenzy that makes the Christmas shopping rush look like a leisurely stroll through the grocery store. I had to pry open a hand that had mistaken my shirt for a gift.

-I like a good adventure. The roads were treacherous, the seatbelts weren't much good, and bags and coolers were flying all over the van. I slept on the ground for four nights straight. I never knew what town was coming next, and I never knew my job at a lesson until it was about to begin. I can't wait to go again.

Which won't be too long. I head out again for the second leg of the journey on Wednesday morning. I'll see Oulata, an ancient city that is a tourist destination, and Djigeni, a small town on the Malian border where a friend of mine works as a school director. All I have to do is make it through Tuesday, and I'll get to have another adventure. Then I split off from the group, catch a taxi, and go to Aioun for Thanksgiving.

Now I have ideas of what I want to do, and I know better what I want to do with my time here. I'm going to talk with my director, and maybe I'll be able to spend some time en brousse working with the doctors and nurses to establish some health programming that will change lives and will continue when I'm back in the US, sleeping in a bed and wishing that I could see the stars.

Defining Cultural Exchange

I was leading leading a sensibilization on hygiene the other day. Wash your hands, wash your food, get sick less. Being American, I figured that these were simple concepts. I had no idea the subject was so controversial. One woman in particular was incensed that I would suggest that she was her hands. Isn't water good enough? Soap costs money! Why should she use soap to wash the hand that she uses to wipe her ass before touching the food that she feeds to her children? It's never been a problem before, says the woman who has just brought her child to the health center. Halfway through her rant, her baby started to cry. Without breaking from speech, she opened her top, pulled out one breast, put it to her child's mouth, and squeezed to start the flow.

This really opened my eyes. We have a lot to exchange with one another. I have lessons in basic preventative health to share. We Americans also have much to learn. We get up in arms about women breastfeeding their kids in fast food restaurants. Mauritania clearly has some of its priorities in order.

Dysfunctionally Functioning

I've been helping out at a couple of programs lately. The health center and a new, free kindergarten. To get started, I just walked in the front door and said that I want to help or I just started helping. I have yet to be told that no, it's not a good fit. The response has been that something needs to be done, and I'm just the man for it.

So at the health center, I lead a lesson in basic health every day. Because my French is so limited, I have two translators. One who corrects my French, another who conveys the lesson into Hassaniya. But every morning I go in, and I talk about the importance of washing ones hands or of not having a child every nine months. I try to talk with the women who work there, which is challenging, because we share no common language. But they are always happy to see me.

I tend to look at my surroundings. In the health center, the walls are covered with informational posters. They encourage polio vaccinations, AIDS prevention, general health. All are produced by international organizations. Some of them are marked for a vaccination effort from the late 90's, but they still hang today.

At the kindergarten I play with the kids. We can't communicate, but I know how to play. I show them how to assemble their Lego-esque toys. Then I hand them a few pieces. The kids then spring into action and put the pieces on their heads. One day I was handed a box containing the basic elements of a plastic tricycle. I borrowed a swiss army knife from another Peace Corps volunteer who works there and did my best to put it together.

At the kindergarten and at the health center, there are always more people seeking services than can really be handled by the centers. But the managers do their best to make it work. They take the help of whoever walks in the door and offers to help. They take in the aid that international organizations send. It's never enough, but no one is turned away. The programs generally function, the work gets done as best can be done.

Women's Lib Hits the RIM

While I am certainly here to be in the community and to be a part of the community, I can't help feeling at times that I'm an outside observer. The cultural differences are so profound in so many respects that relating can become difficult. I feel a bit awkward going to one friend's house every single day for lunch, even though I have an open invite. In fact, I've been told off for not coming over often enough if I miss a lunch or two. Shaking hands with women is a no-no. When I greet women, I just put my hand over my heart. There are enough of these differences that I feel a slight alienation, not in a bad sense, just a distinction that sets me apart as an observer.

This shakey stance is difficult to maintain at times. I am trying to learn to be a member of the community, to be an active participant, but at the same time watch what happens so that I don't do anything too stupid. Like try to shake a woman's hand.

It isn't always easy, though. There are instances where I can't, or perhaps don't want to, simply say that the local way is fine. I can visit more often than I am accustomed to at home, but when I do, I prefer not to expect the lady of the house to serve on me hand and foot. If it were a matter of being a good host, that would be one thing. But I eat with the man of the house, sit and watch television with him, talk with him, visit with him, while his wife brings us food, pours water when we wash our hands, clears the dishes, and sweeps up any rice or couscous that has fallen on the floor. I am simply not comfortable with this. She is his wife, not his servant.

I am often counseled to get married. Find a wife, a nice young woman, maybe eighteen. Have a bunch of kids. What's life without a wife and kids? I've had this conversation often. One of my local friends told me that I need to find a young wife, not one who is my age. A man, he said, should be his wife's teacher. When I told him that I wanted an equal instead of a student, he clicked his tongue and said that no, women need teachers.

The legal framework of Mauritania is remarkably advanced. The age of marriage is 18, women have every right and privilege that men enjoy, there is no distinction between a man's job and a woman's job. Officially. Socially, the rules are different.

I was raised a good, northeastern, liberal, cultural relativist. You have your culture, I have mine. But at times, it's difficult to maintain that stance. Women's rights aren't less important in Mauritania than they are in the US. The government has enacted many laws that reflect this. But the effects of those laws have yet to be seen in many places.

The people are wonderful, kind, and generous. I am frequently impressed by what I see. But these occasional breaks between my values and the local values continue to throw me.