I ni su. It means good evening in Bambara and is pronounced exactly as you would expect. Much simpler than the vocal gymnastics that Lauren and I were attempting in the CDG airport in Paris, trying to master the three tones described our 1977 Peace Corps Bambara textbook. Incidentally, Malians do not sing “Doe, a dear” when they speak!
Our pre-Mali Bambara attempts speak well for our pre-Mali month: valiant efforts to prepare ourselves and our project, but mostly just feeling through the dark. How could we predict that we would be the most under-dressed passengers in our jumbo jet to Bamako? While boarding, we had lined up in our jeans and cotton tees among the most glamorously dressed African princesses, our Reefs and Converse shuffling among high heels and men’s polished loafers. Less trivially, how could we know how to evaluate and (do I dare say it?) improve a program without ever having seen it with our own eyes, or without knowing the context? If only we could just be eyes and ears for a few weeks, two of many flies on the wall. This is an impossible wish though, for we are “toubabou,” the Malian expression that literally means “poor whites” but realistically translates to “money-bank.” We stick out like discolored foreigners, which we are.
This morning we woke up to a knock on the window from Rama, the HIV counselor from the clinic. We are staying at GAIA headquarters, a lovely house where Tounkara, our guardian angel who also happens to be the director, has his office. The house felt big and empty last night with just the two of us there, but it was nice to chat with Kara and Rama in the sunny front room this morning. We had not slept much (even counting the hours that we passed out on the airport floor yesterday) but we rallied for our first excursion. Hopping in Kara’s rattling car, we headed to the local health center called the CSCom, the lowest rung of the Malian healthcare system. GAIA recently renovated it and doubled its size, and it is bubbling with life, with a rainbow of women fanning themselves in the waiting room and children streaking across the courtyard. Though sleepy-eyed from jetlag, Lauren and I put our French to the test and spoke to Dr. Ton Ton, who is substituting as the head doctor this month, and to Salimata, the TB nurse.
We got their perspectives on TB-Bolo, the new program we have come to evaluate. The program sends out young Malian peer-educators, who teach the community about tuberculosis and ask people if they have experienced any of TB’s tell-tale symptoms: over two weeks of cough, fever, weight-loss. The educators then hand out special tickets to anyone who has had the symptoms, granting them an 80% discount to see a doctor at the local CSCom. Here’s the issue that the program is meant to address: “Ils se cachent.” About 75% of TB cases, for lack of knowledge or fear of stigmatization, do not present to the clinic, do not get treated, and spread the disease further. But TB-Bolo, as we already know, is far from a perfect solution. More on that later (rest assured, this will be our focus for the next 5 weeks).
Sitting under fans and reflecting on what we learned today, Lauren and I keep on interrupting ourselves with long pauses. It is all so surreal. As Lauren just said, pacing across the room, “we have just been airlifted into a completely different life.” Over the coming weeks, as jetlag wears off and Bambara begins to sound familiar, we can only hope to feel a little more part of that life.
Tuesday, June 30, 2009
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