More Dancing

The dancers: Sadiya is in the orange shirt, Saratou the red scarf, Oweli in yellow, Mumuna, Tahirou, Rifaidi, Alhassan, Sofiani, Kadir, and Rabiatou are all in the background. Dela's sitting up front with Miniah on her lap. When the camera swings around, you see Mariama, Amu, and Salmata, and then Lahadi, sifting through some leaves that she'll use to make sauce.

Moms and kids

Here are some photos of the people I see the most, mothers and children.









Below is a video taken while walking into Narba's compound one morning. It shows a typical scene of kids hanging out and women working.

Illela, again

And here I am...again! Probably would've come to Illela anyway to see Habi and Salamu and their babes, and then ended up bringing another woman and her baby this morning too. Enter Hawali and her son, Abdu Lawa'asu. But first- the really good news- Habi and Samsiya get to go home! Samsiya is now bright eyed and has a round face, and Habi is radiant and relieved. The two of them will come home with us in the truck this afternoon. So that leaves Salamu and her son Abdu Zaidi, who is also looking great. I never knew you could get chubby cheeks in 6 days; apparently, with Hajara's attentive help, you can. I wouldn't be surprised if Salamu gets to come home next week.

Hawali, the new arrival, is a gorgeous young mother. A few days ago, Gwallo came over and said she wanted me to visit her that afternoon (you may remember Gwallo- she's a firecracker on the grain bank committee and I've mentioned her here before). My first thought was 'aw shit, what have I done now?' I thought I was in trouble...I almost didn't go to her house. But I did, and she sent for Hawali, who brought her son, who is very sick. He's 9 months old, and has the familiar signs and history of malnutrition/dehydration/illness that ruin little kids here: diarrhea that started 2 months ago, causing severe weight and water loss. To try to speak objectively- these babies come to resemble insects more than they resemble babies. Fragile little limbs, ribs, no butt, thin skin hanging off of their stick legs, hollowed eyes, skull...I will not take pictures of the sick babies, but I'll send some of the recovered ones. Deal?

So- you know the drill now, if you've been reading these entries for the last few weeks. Pack everybody up and head to what I am fondly referring to in my head as Hajara's Haven. Hajara, nurse of nurses, who knows when to yell at you and when to praise you. I think this woman may be an angel. Scratch that, she is. Hawali and her son are settled in the infant malnutrition ward, and I'll swing by to see them again before leaving Illela. Hajara warned them that they will be there for awhile; Abdu Lawa'asu weighs 4.4 kg and should weigh 6, so he's got a ways to go.

An unplanned trip to Illela (Part 2)

9/17/09

So. This morning was the longest time I've spent at the infant malnutrition ward. There are five women staying there right now: Habi (in her 3rd week!) with daughter Samsiya, Salamu with son Abu Zaidi, and three women with their babies from other bush villages. One of the women has eight month old twins; one is a normal weight and well developed. The other, a little boy, has bright eyes and seems alert but weighs less that 2 kilograms. While these women stay at the hospital, they are under the stern but compassionate eye of Nurse Hajara. Hajara administers medicines, weighs the babies every day, tells the mothers when and what to feed them. Depending on the age and ability of the babes, they are fed fortified milk, or a peanut-butter like paste, or a combination of the two. Babies who won't drink are force fed; babies who will eat eventually get fed bits of fish and egg. When they reach a weight and health that Hajara approves, they are allowed to go home. Everything is paid for by the government.

When Habi came with 5-month old Samsiya 2 weeks ago, the top of Samsiya's skull was so sunken in you could have filled it with a half cup of water. She weighed 3.8 kilograms (sorry guys, how much is that in pounds? 8?). Today I got to watch Hajara weigh her again- she is now a whopping 4.0 kilos and will be released when she makes it to 4.3. Hajara said that Habi is the best of all of the mothers at making sure Samsiya is getting better. I was really, really happy to hear that. Salamu was smiling this morning; Abu Zaidi already looks better. She told me today that he had passed out three times yesterday, and she thought he had died. But now he's drinking canned milk and getting a whole smorgasbord of medicines and vitamins. It is too soon so guess at how he will do, but I sure do trust Hajara, and I think she'll know what to do for this babe. Habi and Samsiya will probably be home within the week, and hopefully Salamu and Abu Zaidi won't be far behind.

Some of you who read this blog last year may remember that September, October, and November were hard months for mothers and babies. One difference this year is that women seem more aware of where they can get help. It could be my imagination, but I think that perhaps some of the negative stigma- associated with revealing that your child is malnourished- is fading in my village. I hope so. I'll probably write about this again; I sure think about it a lot.

An unplanned trip to Illela (Part 1)

I wasn't planning on coming to Illela today, although I did want to
come up here sometime soon to visit Habi and Samsiya at the hospital.
What happened was: yesterday evening at about 6, an older lady found
me at Narba's and asked me if I'd take another woman and her son to
the hospital.

I got up to go see what was going on; it turned out the woman and her
baby were already sitting in a truck on the road.  The woman, whom I
recognized but didn't know that well, had tears all down her face and
was holding her son, a tiny bundle on her lap.  Someone handed me a
note from the nearbly clinic; it had "severe malnutrition, admit to
hospital immediately" written on it in French.  People were all around
us, staring at her and watching me to see what I'd do, shouting advice
like "Throw your bike in the back, you can come back in the morning!
You're in charge of things like this, you should go!"

I didn't feel like I could just jump in and go. Maybe if I had had
even 10 minutes to get ready, I could've.  But the driver was revving
his engine, impatient.  What I decided to do was run back to my house,
grab some money for the woman, Salamu, wrap it in paper, run to the
truck and give instructions on where to go when she got to Illela.  We
got Hajiya, the older lady who came to find me, to go with Salamu.
They sped off.

I joined them this morning, via my bicyle.  When I got to the hospital
I found a whole crowd of people from our village: Salamu and her son,
Abu Zaidi, plus Hajiya, and Salamu's husband Sa'idou and one of his
friends, all together with Habi and little Samsiya.  My village is
filling the infant malnutrition ward!  Not exactly something you want
to feel good about.

But.
If it's the truth that there is infant malnutrition,
which it is, then it IS good that the women are getting help.

Green: Generally Food Secure
Yellow: Moderately Food Insecure
Orange Highly Food Insecure
Red: Extremely Food Insecure
Black: Famine
Gray: No Data

Here is the FEWS map for the way things stand in Niger now. Compare it to the map from July and you can see the difference. Foloa is in the yellow zone. Although harvest season is beginning, we now face the most difficult season for infant malnutrition.

Kid pics

Toothbrushes!

Here is the headmaster, Shaibou, giving a lecture on dental hygiene to a primary school class. We handed out toothbrushes, courtesy of my generous dentist in Corvallis, to over 200 village students.

Shaibou insisted that the students raise their new brushes into the air for the photo-hence the salute. We salute you, Dr. Kendall Wood! Thank you!

What Sahara went through

Today was alright. I translated for my first surgery. The doctors are doing all of the most complicated surgeries first, so the women have more time to heal while the doctors are still here. So I got in at 8 and right away jumped into surgery clothes (scrubs, plus funny hairnet and boot covers and face mask and goggles), and brought Sahara in for surgery. Her story, the more I think about it, brings up red hot anger from the pit of my belly, and I despise whoever did this to her. She's probably about 15 years old. She was married at age 10. She was pregnant and had her baby at age 12. Her labor lasted five days; her child didn't survive childbirth. And she was left with a gaping hole from which she leaked feces and urine, as well as damaged nerves in her left leg. I hate thinking about what she went through.

So that is the worst part. The best part is that three months ago, she came to Niamey (all by herself, no family with her, not to mention her husband. Where is he? Does he even know what happened to her? Does he care? I'm sorry to lash out like this, but not sorry enough to not do it. Where is her family?). And today, three surgeons performed surgery on her for five hours-- they took some muscle from her leg and used it form a 'sling' that will hold her urethra up so she won't leak (which they accessed through the vagina and a hole they cut in her abdomen), and then they cut out a bunch of scar tissue and reconstructed her rectum. They said that everything went as well as they could have hoped, and are confident that she will see a major improvement. They gave her an epidural, so she was only numb from the waist down. For the first hour she was really anxious (so was I), and it didn't help that we had no sheet to keep us from seeing what the doctors were doing. She started to get more panicky, so I asked her if she'd like to be more sedated, which she did. The anesthesiologist gave her some meds to keep her drowsy. I stayed with her, anyway, because every once in awhile she would be more lucid and I didn't want her to feel alone. Now she's in the recovery room, on lots of pain meds, with an ice-pack I made out of three bags of frozen juice. Please send Sahara some comfort and some love.

After surgery I went back to our little meeting room and laid down for a long time. Eventually I went back out to talk with some of the women awaiting surgery, many of whom are making stacks upon stacks of beaded bracelets while they wait. I will buy tons and tons of them, to bring home and give to you all, who are helping by just thinking of us over here.

And that is what I did today.

Where Narba was

11/30/08
You might have noticed that Narba's name wasn't on the list of the women who came to the training, although she is one of the grain bank committee's presidents. The reason she couldn't be there was because her granddaughter died that week. And the reason that her granddaughter died was, to my eyes and my understanding, because of severe dehydration and starvation. It's difficult for me to write about this, and so I haven't written about it to anyone. I haven't written a single letter to anyone for this whole month, because I'm unsure of what words to use to describe what is going on in Faloa and Niger right now. I hate not telling you about it, because it's been part of every day of my life for weeks now. But I also hate telling you about it, because I don't think you will understand. That's not fair of me, so I'm going to try.

The big picture, which is easy to explain: By this time of year, people-- farmers, meaning villagers, meaning my people-- have been working their bodies, hard, for six months straight. They have used their bodies and nothing more than a few handmade hand tools to turn sand into fields of millet, sorghum, and beans; they have battled acres of weeds with their backs bent over in 120° heat, they have spent weeks harvesting giant bundles of heavy stalks of grain, they have clocked hundreds of miles on their feet that are either barefoot or in crappy flipflops, and for a month of this- all September- they did it without food or water, for Ramadan. As the doctors at four of the clinics and hospitals that I have visited in the last month have explained to me, by this time of year, nursing mothers' bodies are exhausted and broken, and they stop producing milk. Babies who weren't weaned yet get weaned abruptly, and babies who weren't ready to be weaned yet get weaned anyway. They are given more water than they would normally drink, which results in higher incidences of diarrhea. And that, for a baby, or a kid even, in this country, is close to a death sentence. I wouldn't have, couldn't have, believed it before coming here. But it's real, and it's been happening all around me this month, and I have never felt more helpless, devastated, or furious.

Narba's granddaughter, Foziya, was about 16 months old. When I left the village in early October to help with Peace Corps training, she had a fever and I put a damp cloth on her hot little body. When I returned at the end of the month, I didn't recognize her, except as a child that I could've seen on the news in a report about famine or war. By then I think she was not entirely conscious. She was just bones in a small, rigid shape on her mother's lap. I sat with her mom, Dela, and Narba, and the other women in the family in their hut- I knew they were there because that's what you do when you are waiting for a person to die. It was confusing and shocking and upsetting, and I didn't know what to do, or if I should do something, or if I could. I told Narba, please let me take her to the doctor, but Narba said that it was in God's hands. Foziya died in the evening, and the wake lasted for the next three days.

So that is why Narba couldn't come to the training. I sat at the wake in the mornings and all evening after the training was over each day. I am a part of this family, and I felt like it, and my presence was never questioned.

I'm not sure what else to tell you about, because Foziya's story is the first in what has become way too many children who have died in this village. I can't just list off these names like that's all they are, names. I don't want to do that. They're a lot more than names, they're babies that I am used to holding and carrying around when their moms are pulling water, they're babies that were learning to sit and walk and talk. It's so messed up, it's not fair, it's the cruelest thing in the world that this is true. My friend Mariama, who is lovely and clever and whose daughter Harira was born the week I moved here, is now walking around without her baby on her back, with her breasts leaking milk. Mariama is healthy- she wasn't weaning Harira and didn't have to, she had plenty of milk- but Harira got diarrhea, and even though Mariama took her to the clinic-- three different clinics, all hours of walking away- they couldn't help her. They didn't help her, and her beautiful baby, whose picture I've taken a hundred times, died in less than a week.

As this has all been happening, I've been struggling to understand it and working to find out what the options are for mothers- where can they take their babies, and what help can they expect to get? The two closest clinics have one person on staff at best, who's not usually there, and who just hands out oral rehydration salts like that's going to fix everything. The clinic in Tajae is better, but gets absolutely flooded with people. I've been there a lot lately-- I've started going with women, because they like it when I come, and I think it makes it easier for them to go. I started going a few days after Foziya died, because one of the kids who is closest to my heart started really going downhill. I know I've told you about him before-- Rahman, Zuera and Salla's son, another grandson of Narba's. He's the kid who always toddles up to me yelling 'habba!' and who squeals when I lift him high in the air.

Rahman is 18 months old, and was still nursing until October, when Zuera's milk dried up. Rahman started getting diarrhea, and throwing up, and he started to refuse to eat or drink. He'd been like this before I got back, and was losing weight and acting listless, limp. Zuera and I went to Tajae, where they gave him antibiotics, but he didn't get better. He lost his baby cheeks, his eyes started sinking farther and farther in his head, and the skin on his legs hung like paper. He just got worse and worse, so we went back. We went on a Wednesday, which is when an Irish NGO called Concern sets up at the clinic and administers a whole lot of help- all for malnourished kids. I'd never seen them in action before, and I was overwhelmed and grateful to the point of tears. I mean, you walk into this big cement building and it's full of hundreds of women holding on to their skinny babies, waiting in lines to have them weighed and measured, and then to get a week's supply of high calorie super-nutrient life-saving food. It takes courage to take your kid, you know? They want, like every mother, their child to be healthy. But it's still hard to get the guts to take them, because everyone sees you and sees your sick baby.

Zuera and I were told that Rahman was "broken", and that if he refused to eat the special food at that instant, they would write him a referral to the Concern Hospital in Tahoua. He wouldn't eat anything, and so Zuera and I returned home with him to ask for Salla's permission to take him to Tahoua that afternoon. And you know, this was really strange and disorienting for me, because I don't have authority over this child, or his parents, and if Salla didn't agree, Rahman wouldn't be going to the hospital. It was painful for Salla to decide- he was surrounded by all of the women in his family, yelling and watching, and there I am, terrified he's going to say no, and then he does, he says no. He said no, because he heard that if your child dies there, the hospital doesn't give you your child's body back. I was devastated, and Zuera started crying (people don't cry here), and the women went crazy...I told him, okay, let me call them and ask them if that is true, because if it is true, I understand. But he really didn't want me to call them, and he excused himself and consulted with some other men, and then he gave us permission.

Relief.

Zuera, Rahman, and Narba ended up spending nine days at the Concern Hospital in Tahoua. The doctors showed them how to force feed him highly nutrified milk, and they were kept on a strict feeding schedule every hour. I visited them there twice, and got to see Rahman get better and better. Everyone in Foloa knew he was there, and constantly asked me if I had any news. When they finally got released, Rahman had his chubby cheeks back and even started smiling every once in a while. He'd been back for four days before I left to come in to Konni for Thanksgiving, and he seemed better each day. He still qualifies for the supplements given out in Tajae every Wednesday, so he and Zuera and I will keep going, along with the other five or so women from Foloa who have started going. Last week, a new mom joined us, Tahira, with her son Aziz. Going with them, and helping to connect them with doctors who can and will help them, makes me feel less helpless. I feel like I finally know where to go, and I'm getting to know the doctors. Best of all, women who felt helpless can see Rahman and how much better he is. And that is what really matters.

Not a rabbit

9/2/08
Five boys, about age 7, are over to look at books. (I got these in care packages...there are otherwise no picture books in the village.) The boys' names are Turjani, Malaru, Halilu, Ousman, and Alhassan. Their banter is just terrific. I gave them each a book to look at and here's what they are saying:

"THIS DOG ONLY HAS 3 LEGS!"
"That's a lion! It has 4 legs, but we can't see one of them." (Darn 2-dimension.)
"YOU SURE?"
"Pretty sure, but even if he's just got 3 legs, he looks pretty happy."

"WHAT'S THIS, SAMSIYE? WHAT'S THIS?"
"That's a rat."
"SAMSIYE, WHAT'S THIS?"
"That's a rat."
"SAMSIYE, WHAT'S THIS?'
"That's also a rat."
[Can you tell what book he was looking at? (Your Friend the Rat)]

"HEY LOOK, A BIRD!! IT'S HUGE!!"
"That's not a bird, actually. It's kind of like a fish because it lives in the ocean! But it's also like a cow because it has breasts and feeds milk to its babies." (Glad I paid attention in science class...it was a photo of a seal...)
The response: silence. Awe? Or disbelief?

"HEY SAMSIYE, SAMSIYE, WHAT IS THIS?"
"That's a rabbit!"
"NO WAY, THAT IS NOT A RABBIT!"
"Yeah, it is! Why isn't it a rabbit?"
"Because it's STANDING UP, and everybody KNOWS rabbits run on the ground!"
"Well, yeah...but it's supposed to be a rabbit."
"But it's wearing PANTS! IT'S NOT A RABBIT!"
"OK, then what is it?"
"I dunno."
(This was a Richard Scarry book.)

Beloved

Narba and granddaughter Harira

In Niger, a typical woman has less than three years of education, and the life expectancy of a girl born today is only 45. Only four per cent of Nigerien women use modern contraception, and one child in four never reaches the age of 5. At this rate, every mother is likely to suffer the loss of a child during her lifetime. Source: CBC News

6/10/08

Lately I've really been appreciating the evenings. It's a time when more people are gathered at home, talking or sitting or eating (women with the kids, men separate, of course). I find myself staying out a little later each evening, picking up strands of conversation, contributing some, mostly listening, laughing at the kids, whose antics--in the dirt and ash and whatever they can roll their naked little bellies in--are often the focus of our attention. Children are so precious here. I don't know why I was surprised to see the tenderness with which Narba treats every one of her grandkids, great grandkids, and neighbors' kids. Maybe because there are SO MANY babies, kids, everywhere, 4,5,6,7,8 per woman, as many as 10,20,30 per husband if he has several wives; maybe I assumed that they were somehow less special, less treasured in the eyes of old women, who in their lives have held hundreds of babies. But it is not that way; it is the opposite, and it squashed my assumptions absolutely. To see Narba goyo (tie to her back) her daughter-in-law's baby, Harira, of 4 months, and carry her all over the village proudly, is seeing a happy woman doing what she has done since she was a girl herself.

I will often come upon Narba at her home, sitting on a mat in the shade, with a half dozen of her family's babes napping or crawling or playing around her--and Narba is totally into it, singing for them or clapping or chuckling. Last night Rabi had batteries for a radio, so we listened to some afro pop, and immediately a crowd of bouncing toddlers was gleefully stomping in the dust...Narba, delighted, rushed to get her flashlight to shine on them in the dark. Together we watched them, their brown legs and arms, pumping, kicking, bottoms falling into the sand, turning them a lighter brown. They were so funny. But mostly I watched Narba, who had eyes only for them; she clucked and sang and held that light over them, exclaiming "Toh! Gareka! Toh!" (Hey! Yo! You got it! Yeah!))

So, you see, these babies, all gazillion of them, they are beloved. And it's not just Narba, it's everyone, all of the women who dote on every baby, the men who hold friends' babies in the afternoon, and the kids, who as soon as they're big enough, hope to carry a baby around, too.

Me in my village, and kids in Hamdallaye

Suna

Boys and men at the suna; a goat has just been slaughtered behind the boys

Women preparing food at the suna

4/29/08
Today has been a busy day. This morning I got up at 6, rushed through a bowl of oatmeal, and dashed outside so as not to miss the baby naming ceremony of the daughter of the school headmaster, Shaibu, and his first wife, Aisha. Baby naming ceremonies (sunas from here on out) range from being a big deal to being a really big deal. Because this one was the headmaster's family, it ranked as a Really Big Deal, and there was no school today. There are lots of babies born here...lots of sunas...the rituals that they all share make them fairly predictable programs, and everyone in the village shows up at some point. They go like this: baby is born on day one; momma of baby stays at home with baby for 7 days. On the 7th day, early in the morning, lots and lots of men crowd into the family's courtyard, sit and wait. Someone brings in a sheep or goat, which is slaughtered there in front of the men (they cut its throat). Then, the town prayer man leads everyone in a long prayer-type thing (in Arabic--I don't know what he says!). At the end of this he announces the new baby's name (which was previously chosen, I think, by the father, but maybe not always). Then most of the men get up and return home/to work, while the women of the house begin preparing food, lots of food, to feed everyone who comes by that day. The 7th day after birth is also when the barber comes and shaves the baby's head, and he'll also do any ritual facial scarring that the family wants: sometimes two lines on the cheeks or by the edges of the mouth. A lot of adults in the village have these scars, but so far I haven't seen it on any babies.

This morning, Aisha's baby girl was named Malika; she's a tiny little thing with waving fists and a big baby wail. She is her mother's 8th child.

Kids

I know this picture is blurry and gray, but I love it. A group of sweet, enthusiastic boys helped me clear the remains of an old shade hangar one evening, just before sunset. They ran back and forth, all of them flushed with the excitement of helping.


You might wonder: what about the kids? There are a lot of those. Some of them go to school for a couple of hours a day (mostly boys), but a lot of them play and goof around with neighbors and friends. There are no structured "activities" outside of school for kids in my village. The end result is that kids are able to entertain themselves for YEARS with little more than a companion, and perhaps a can or stick. They make awesome toys out of used tomato paste cans: at night I can hear them racing down the street with their little metal "ponies."