Being Men in Mali

“Another man is just the façade of another you.” That, more or less, is what our friend Samassekou told us as we took tea in Sikoro, reflecting on a weekend full of cross-cultural laughs. After going out with the peer educators as usual on Saturday morning, we were invited to another “balani,” or block party, up on the plateau of Sikoro. In the midst of a cluster of mud brick houses, perched high above Bamako, music blared out of huge amps and a DJ pumped up the crowd. We set up camp with a couple of the peer-educators about fifty yards away from the dance circle, where we periodically retreated to take tea in between bouts of dancing. I was charged with the extensive ritual of making the tea, and spilled about half the tea pot in the process. Meanwhile, Lauren won her place in Sikoro’s dancing hall-of-fame, taking on three men in a dance-off in front of dozens of avid watchers. Ever since, we’ve been greeted by quite a few strangers as the “dancing toubabous!” Toubabou’s may not be able to dance the Malian jig, but they can, we proved, dance in their own way.

On Sunday, after a morning of taking surveys, we accompanied Samassekou and Ablo to a Malian wedding reception. We were surprised to find ourselves on a rooftop surrounded by seated men. “Where are the women?” we asked. The men pointed down to a gathering the next block over, where we could make out a large group of women dancing to live Malian music. We became very self-conscious and asked why the men’s and women’s parties were separated. The men shrugged. They said both groups just seemed to prefer it that way. But what about the groom, we asked. Didn’t he want to be with his bride? It turns out a bride in Mali does not even attend her own wedding reception! Rather, she must hide her face from the public for a full week before emerging as a married woman. Which brings me to another realization – our entire time in Mali, we have been treated like men. Sitting at the men’s grains, joining the men’s marriage party, and looking forward to careers without childbearing in the near future, we have much more in common with the men here than the women. Our friend told us one day that women here need a man to help them make decisions, but we (Lauren and I) were different, we were on a “another level.” So you think we were just born that way? we challenged. But I’ll save my tirade on gender norms for another day.

Later that day we sat for hours drinking tea (which I successfully made this time) on the Plateau overlooking Bamako. We laughed about our differences. Here, for example, it is rude to pass someone in the street without going through the extensive Malian greeting. But when it comes to saying goodbye, Malians tend to just up and leave without warning. We explained to Ablo and Sam how surprised we were when, during our first week, they had left our house so abruptly. Had we done something to insult them? We had racked our brains and even asked Karamoko about it. It turns out that the extensive process of leaving that we are used to (checking the watch, rattling car keys, explaining apologetically that one has to get back because of such and such, and then continuing to talk for 15 minutes on the way to the door) is just NOT the norm in Mali. Case in point: Mali’s lengthy hello’s are simply substituted for Americans’ lengthy goodbye’s.

On the work-front, things are moving right along. Last week we attended a training session organized by Group Pivot, the national health education organization, in conjunction with PNLT, the national tuberculosis program. It turns out that GAIA is somewhat ahead of the game with TB peer-education, and we presented the TB-Bolo education model (literally “TB hand”), which uses the five fingers of the hand as a mnemonic of important TB-related messages. The NGO representatives at the meeting expressed great interest in borrowing our model - our peer-educators may even be summoned to teach other educators how to use it!

We are almost done with our surveys, which evaluate baseline knowledge of TB in the community as well as the efficacy of the TB-Bolo education program. Aside from that, our other main project is an effort to streamline TB detection in Sikoro. We have found that though tuberculosis treatment is “free” in Mali and available at the local level, there are substantial hidden costs to initiating that treatment. A patient who suspects himself of tuberculosis must first have the means to see a doctor at the local health center, and then must make three trips to the referral center in order to undergo TB diagnostics and start on treatment. TB-Bolo has worked to break the first barrier by minimizing the cost of a visit at the local health center for TB suspects, but this is just the tip of the iceberg. Many patients who get referred to the hospital for TB tests are “perdues de vue” – lost from sight. Even those who do make it to the referral center are sometimes turned down, because the lab there is at full capacity. So we are now trying to bring TB diagnostics to the local level, in order to save patients those three trips, and keep possible TB cases from falling through the cracks. After visiting personnel at all rungs of the healthcare ladder, we have found a wide consensus that sputum analysis for TB detection should be brought to the Sikoro health clinic. Today, we got the head of the national tuberculosis program on board. Once the lab is furnished with a microscope, we are told, the service can start to happen in a matter of weeks!

Sadly, in a matter of weeks (one week, to be exact), we will no longer be here to see the outcome. The end is creeping up way too fast! I have grown to love this landlocked little country. The only complaint I have is the itch of mosquito bites on my ankles. And the marriage proposals, annoying as ever. Count of proposals: Lauren – 4, Julie – 4. Latest one was a police man. Thank you Sophie, our adoptive mother, for fighting off the suitors!

K’an b’u fo.

Julie