Well, I have survived another month of village life. And apparently I am now ugly. When I came back to my site after traveling, I discovered that Floria and her family (my old neighbors) had also moved into a new house—one that didn’t have rent. I still swing by their new house occasionally, though it’s out of my way enough that I can’t go all the time. On several of these recent visits, Floria has been very distraught over my physical appearance due to my having lost a little bit of weight since my arrival. Not much, but enough to be a bit slimmer than I was when I stepped off that plane six months ago. (I attribute this primarily to the removal of Chipotle burritos from my diet, but also have to give a bit of credit to the frequent intestinal troubles which my mother so eloquently described: “well with all that diarrhea you’ve been having, you can hardly keep anything in.”) Anyway, Floria keeps telling me things which translate roughly to, “You used to be fat. Now you are skinny and your face has gotten really ugly. What kind of food am I supposed to eat so I can have fat arms like you used to have?” I try to explain that we value the opposite in America and that I would be considered more attractive now, but she insists that I am not healthy and I would be much more beautiful if I got fat again. Oh well.
In other outrageous news, due to my marlaria prophylaxis I occasionally have dreams that are either entirely ridiculous or incredibly frightening. Last week I dreamt that my brother Ryan had enlisted in the Navy and was killed in combat. I share this with you not to be dramatic, but rather because, surprisingly, it was a bit of insight into Malagasy culture. Even though I obviously realized it was only a dream, I was understandably shaken up by it and it was still bothering me a day later. I mentioned it to one of my Malagasy friends and she told me, “Oh, that’s really good!” I wondered briefly about which words I had mixed up in my explanation that she misunderstood my meaning, but then she added, “We believe that if you dream about somebody dying, he or she will actually have a very long life. So it is a good thing if you dream about people dying.” Apparently you should all hope that I start having dreams you drop dead very suddenly. Interesting, eh?
In terms of work, I am still struggling to figure out what to do at my site, but I am very slowly beginning to find ways to branch out beyond the clinic. There is a local nutrition organization that trains health educators throughout Madagascar to weigh children, do cooking demonstrations for mothers, and other nutrition-related activities. There are several people who work for them in my village, but one woman in particular has been incredibly helpful and welcoming to me. So for the last several weeks I have been going out one day a week with Madame Vao to help weigh babies and distribute and explain the children’s health notebooks provided by the Ministry of Health. (The notebooks have growth charts showing target weight ranges, and also have pictures and information about a balanced diet, good breastfeeding practices, vaccination, and other crucial information for children under age 5.) I very quickly realized that Madame Vao is really on top of her game and doesn’t actually need my help at all. But I enjoy working with her—she helps me learn more Malagasy language—and I’ve found it’s a good way for me to interact more with people in my community. So to make myself a bit more useful, I still help weigh babies and add information I think is important, but I’ve also started giving talks about other topics such as diarrhea or malaria. I figure while I have a crowd gathered, I may as well take the opportunity to deliver more health messages.
This week I realized I may be able to help more than I had thought originally. Several weeks ago Madame Vao had casually mentioned something about “ananambo” (moringa) growing by her house. Moringa is an incredibly nutritious plant and fortunately grows very well in many parts of Madagascar. I pulled out some information I had from Peace Corps about the plant and mentioned that the seeds and leaves can both be eaten and the leaves can be dried and pounded into a powder to add to the food of young children. Even a small amount of moringa can provide kids’ daily requirements of calcium; magnesium; iron; and vitamins A, B, & C, and it’s great for pregnant mothers or women who are breastfeeding. She knew it contained calcium but hadn’t realized just how nutritionally valuable the plant is. Anyway, after mentioning it I hadn’t really thought twice about it. But this week, Madame Vao asked to see the information again and copied it down. She told some of the mothers with underweight babies about it this week, and if I understood correctly, we’re going to do a cooking demonstration with moringa at her house next week. I’m really excited about this because it’s pretty much the first time since I’ve moved into my village that I felt like I was actually providing a knowledge or skill that wasn’t already here. If things go well next week, I’m going to see if Madame Vao can help me gather some other health educators in the area who might be interested in coming to learn about moringa.
I also had another great day for work yesterday. When I first moved in I met a man, Severino, who told me he did health education and had worked some with a couple of Japanese volunteers who lived here a couple of years ago. I couldn’t figure out if he was affiliated with any organization, and I’ll admit I was a little bit skeptical of his intentions since Malagasy men are usually not timid about their desire to have a vazaha wife. But I had seen him helping with mosquito net distribution in November, and he was very friendly (though not too friendly) when I bumped into him a couple times by the market. Since I’ve been feeling a little stir crazy spending a lot of slow hours at the clinic, I decided I’d see if he’d be interested in going around the area to do health talks. I’ve really enjoyed working with Madame Vao and thought I’d be much more satisfied here if I could do work similar to that on a more regular basis. Anyway, Severino and I agreed to go around to houses yesterday and talk about malaria. I had no idea how successful it would be, but I was incredibly pleased with the day.
All along, I’ve assumed that knowledge and practices related to health were probably better around where I live since the clinic is right here and therefore people are more likely to come to give birth, receive vaccinations, and seek treatment when they’re sick. This is probably true, and I’ve noticed that most of the people at the clinic are from fairly close neighborhoods. So I figured once I got more acclimated, I’d spend most of my time trying to get into areas that are much farther away from the clinic and not do a whole lot of work in the area immediately around my house. I did make the mistake of assuming that most people actually utilize these services since they’re so close. Going around yesterday, I realized this is apparently not the case and that there is still a lot of work that can be done in the area immediately around me (and I’m actually a bit frightened of what I might see when I do go farther out!) Despite the fact that there was a Ministry-of-Health-sponsored mosquito net distribution in November, there were still a lot of households that did not have nets. And there were an alarming number of families that had nets (multiples even!) but were not using them—they were stored in boxes or bags in a corner. Although the net distribution went really well, I’m not sure there was any follow-up after the fact to make sure people were actually using them. This is probably something I’ll try to initiate the next time a distribution happens. In addition to being able to see things for myself, working with Severino was great. He explained new vocabulary to me and helped me correct mistakes I made speaking Malagasy. He’s also a very good educator—he had people really engaged and laughing a lot of the time. It was also useful for me to see how he did the talks at the houses. I’ve been doing talks on the exact same information for the last few months at the clinic, but doing them at people’s houses added an element of visibility, and I hadn’t realized how helpful that could be. He was not at all shy about pointing out to people spots where they should sweep up messes or get rid of standing water or cover buckets in their house. I felt like the talks yesterday were infinitely more helpful to my community than the talks I’ve been giving at the clinic. And I don’t think at any point in time we were anywhere farther than a ten-minute walk to the clinic. We’re heading out again next Wednesday to go to areas we didn’t hit yet. I’m hoping he’ll be willing to do this every week so we can go really far and talk about lots of different topics, but we’ll see!
I also got some insight from him about possible future projects. I’ve been struggling for a while to figure out how the health educators are organized, what they’re trained in, who they are, etc. etc. Everybody seems to have a slightly different answer (which in some ways probably is an answer). But Severino said there used to be a lot of people who went out a while back, but things are disorganized because of the recent political struggles and people don’t want to work anymore since they’re not paid. This gives me some things to ponder with regard to how I can potentially help get a health educator system back up and running. There are clearly people who have knowledge about doing health eduation, and there are several organizations around Madagascar that help train and equip health educators to do work, so I’m hoping that during my time here I’ll be able to get a really good program going in my area again.
As usual, I’ve written an encyclopedia, so I think I’ll cut it off here. Haven’t taken any pictures lately, but I’ll try to get some for next time. Before I sign off I want to send special birthday wishes to my Grandmother Walling today and Grandpa Hanna tomorrow. Also, a rather belated congratulations to my brother Ryan who has been accepted at Auburn and Kansas University!! (Although the booger won't ever answer his telephone, so I had to find this out a couple weeks late via an email from my father. Sheesh.)
And to the new group of trainees arriving next month—WE’RE SO EXCITED FOR YOU TO BE COMING!! Hopefully my answers to some of your questions have been helpful. Looking forward to meeting all of you eventually!