Death, divorce, and drinking tea.

The past few days have been full of adventures for myself and quite frankly everyone around me! First things first, on October 26th was Tabaski, a day jam-packed with meat, fancy boubous, and biking. I do not have a host family, so instead of spending the day hanging out in one compound, I traveled around Tamba visiting families I had grown close to. I biked out to Tamba Soce with Nic and James, and there we ate with several work partners and two researchers from the organization Simenti. After that, we went to visit another work partner, who, unfortunately, was not at home but we took a picture with his beautiful wife instead. After this, I went home and fell asleep for a few hours, and then moved onto house number 3, the home of Camara, who was a former guard at USAID/Yaajeende. Then, before going to sleep, I moved on to Djibi's house, a traditional Pulaar family that took in Nic and I. There are two girls that live in Djibi's compound that were my girls camp girls last year, and those two girls also come over to do laundry from time to time. At the end of the day, I had three meals composed entirely of meat and onions, maybe with some bread and pasta, depending on the family, and then, I had leftovers the next day! It was overall a great day, and it felt good just to go around and greet people.

James, Nic, and Madame Koulibaly in Tamba Soce

A few days later, on the 1st, the new volunteers for the Tamba region came up for their volunteer visits. It was incredibly fun, as having new volunteers in the region is rejuvinating. It is nice meeting new people and having new energy come into the region. The following Saturday we went to Bolou, a Bambara village 10K outside of Tamba where one of the new volunteers will be living. I was very impressed with the village. It was beautiful, full of trees and small gardens, friendly people, and lots of watermelon. Fatu, the new volunteer's host sister, took us around to greet people in the village. Overall, the village is 99% Bambara, but I kept trying to speak Pulaar, and sure enough, I found the 1% of Pulaar speakers, and one of them lives in the volunteer's compound, so I was pretty happy about that.

Volunteer visit in Bolou with our lucky new agriculture volunteer!

Yesterday was an emotional day for me. For the past few days, my neighbors have been fighting like crazy. I mean, serious fights- yelling, screaming, throwing things. There was one morning when they were fighting so bad that I did not leave my apartment until they were done fighting- I did not want to accidentally step into the middle of a potentially violent situation. So yesterday I was talking on the phone with one of my friends when my neighbor came over to get meat from my freezer (did I mention that there are lots of frozen sheep heads in my freezer? Because there are, and they are not even my sheep heads!). Then, the neighbor's husband came over and told me not to give her the meat, then returned the meat to me, and told me I could only give the meat to him and never to give the meat to his wife. I was generally confused over the weirdness of the meat ownership argument, then went back to my phone conversation. Later that day, my neighbor showed up to tell me that him and his wife were getting divorced- AHA! I thought. THAT explains the meat argument. It turns out that his wife was moving out, and both of them wanted to keep the meat for themselves. I actually had a long discussion with the husband about the situation. Divorce in this country, while becoming more common, is still pretty rare, so he told me all of the procedures that he went through to try to prevent the divorce. He took his wife to religious leaders, and paid traditional healers large amounts of money to create medicine that would "fix her head." In the end, I feel that the divorce will be better for both parties, especially the wife in this situation as the relationship was becoming potentially dangerous for her. However, I was heartbroken, because I had grown close to the wife and her two adorable kids, and the wife was the only Pulaar speaker in my apartment complex. I miss the kids already. Now, the kids and wife are totally moved out, and I have no way of contacting them. Eugh.

It's hard living in the city without a host family due to the simple instability of the type of friendships that I develop- I hang out with teachers, principals, NGO workers, students, farmers, and housewives, all of which are randomly moved by the government to other regions for work, moved by their family to other schools, spending all of their time in the fields, or, getting divorced and moving randomly to an undisclosed location. The principal at the college at Tamba Soce was recently moved to a different school as well, and I had spent alot of time hanging out at the school getting to know the staff- but now I have to start over and develop a friendship with this new principal. It will be fine, but all of these mini-goodbyes (or mini not goodbyes) can be challenging emotionally.

On a positive note, Fatu and her friend Tenne came over and hung out yesterday, and we drank tea, and played with the cat.

This is Tenne. About half an hour before this picture was taken, she was so scared of the cat that she literally ran from it screaming whenever it walked by her. One of the funnest/coolest things about my job is teaching kids that animals are wonderful companions and will be nice to you if you are nice to them! Tenne = convinced, nonetheless cat = not so sure.

Fatu and Tenne think they can guess Nic's password. Nope.

Today I went to the T.S. school and met the new principal for the first time- and he's Pulaar! He seemed very sweet and hardworking, and made a good first impression. I hope he will be good for the school. I paid the inscription fees today for my nine Michele Sylvester Scholarship girls as well, which I feel very good about. I have gone to the school several times, and one of my friends went to check on the school as well, but the school seemed no longer functioning. The makeshift school buildings were collapsing, and vines had started to grow on the collapsed structures. The teachers were not there, there was no trace of a staff, and only a few of the students were milling around. The school is doomed, I thought to myself- but no! Today, the school was buzzing with students. The teachers were back, and were teaching classes! The principal was meeting with parents! The parent-teacher association president was enrolling his daughter! The secretary was keeping track of students and filling out paperwork for the new students that just came from elementary school! I gave my prize student her certificate of honor for being a scholarship recipient, and she had the biggest smile I had ever seen!!! It felt good. I'm hopeful that Tamba Soce is on the up and up.

On the way back, though, I committed a major social blunder. I live in an apartment complex that is behind the local cemetery, and although I know it is an active cemetery, I have never seen a funeral service there or seen any bodies or burials at this particular cemetery. Today, I accidentally rode my bike through a service. I turned onto the road to my apartment complex, like I do every single day several times a day. To be honest, I bike that road so many times a day that turning onto that road is completely automatic. I notice some guys praying, but don't think too much about it- people are always praying in that area, which is also near a large Koranic school and truckers usually stop there to rest. It is only when I ride closer do I notice the white-wrapped body shaped bundle in front of them. I panic. I was in the situation that I had already biked so close to the ceremony that it would have caused more distraction if I had stopped, but also realized that what I was doing was NOT ok. I covered my field of vision with my hands out of respect, kept my head low, and veered as quickly as I could to the side as far away from the service as I could get. I will not make that mistake again, that is for sure. I feel strange about the whole deal. Funerals are so private- the last thing people want is a foreigner riding their bike through your service, more or less a female (the service was being held by all men.) I am just glad my head was covered and hope that I did not cause too much of a distraction. Yikes. Lesson learned. Apologies.

Oddly enough, the shock and distress I felt at accidentally interrupting this ceremony has left me nostalgic for Taiwan. I was in Taiwan several years ago during Ghost Month, where people celebrate their ancestors in various ways. I sometimes felt awkwardly voyeuristic observing Ghost Month traditions, even though I was welcomed to observe these traditions and sometimes these displays were very public. The same shock brought back waves of emotion from Taiwan, and thus, I am craving cold sweet green tea and milk, which I found very comforting while in Taiwan.

Alas! The day is young. I am going to have some tea, reflect on this funeral incident until I feel less weird about it, drop by the PEPAM office and shop for marathon supplies!! The marathon this year is happening on December 9th, so everybody come on down!

And! Here is a not in any way related photo of some of the many candy bars available in Senegal!

PEP, 30 days later

Yesterday, October 8th, was my last day of post-exposure prophylaxis. In truth, it was not as bad as I was expecting it to be, but man, those 30 days were a roller coaster of (predicable) side effects. According to the Combivir informational booklet, about 9% percent of patients experience malaise/fatigue, which I definitely did. About halfway through the treatment, I got so down and tired that I actually called my PCMO to ask if I was experiencing this depression and exhaustion as a consequence of the medicine, or if something else was going on with me. Long story short, after the discussion with the PCMO, we (the PCMO and I) came to the conclusion that I was pushing myself too hard on a medicine that was really hard on my body, and, as such, was feeling much more exhausted and frustrated than usual. She was right, of course- I did not reduce my work load when taking these meds, even though I was really tired much more often, and definitely felt frustrated at my inability to function fully.

The cycle of side effects went something like this:

One to two weeks of nausea, with incidents of nausea decreasing over the month. However, throughout the entire 30 days, I did occasionally have spontaneous vomiting, which was really strange and something I have never experienced in my life. One minute I would be finishing up my breakfast, getting ready for work... two seconds later, I would be vomiting in the sink. This apparently is a pretty common side effect (up to 13% experience vomiting as a side effect). I am usually not someone that vomits easily, so that was very strange for me.

Two to three weeks of general fatigue. I spent a few days so completely worn out that I literally slept 18 hours a day.

Three weeks of feeling slightly off. In general, the Peace Corps makes a person feel a little off- one's emotions are exaggerated, highs are higher and lows are lower. For the past few weeks, I felt blunted. I found that my normal coping mechanisms did not work as well. Usually, during my emotional highs, during good language days, or during good transport days, I feel proud, confident, and inspired. During my emotional highs while dealing with the fatigue associated with Combivir, I felt just happy to get through the day.

Your body eventually adjusts to the side effects of taking this medicine; However, I was/am in the position that I am not taking the medicine long enough for my body to fully adjust to the long-term presence of combivir in my body. Thus I took it long enough to feel the side effects, but not long-enough to know what it's like to be on the medicine for extended periods of time. I feel that I can better relate to future patients or peers that are taking Combivir for HIV, especially if they, too, suffer from side effects similar to mine. However, I will have difficulty relating to patients or peers that are on this medicine long term. Currently, combivir is listed as an "alternative" for HIV treatment, and usually in combination with an additional medication.

In short, these past 30 days have been interesting for me. Even AIDS.gov (wait, that's a real website? Oh.... yes it is) says that PEP can have side effects that make completing treatment difficult, and I definitely understand why some people stop treatment.

Just for future reference: Post-exposure prophylaxis IS available in the United States, and can be accessed by anyone who suspects exposure to HIV. So if you come in contact with a dirty needle, have risky sex, experience condom breakage, were raped, or exposed to any of the bodily fluids which may transmit HIV (that's semen, blood, vaginal fluid, and breast milk) and are not confident in the sero-status of all parties involved, you may chose the option of taking PEP. Talk to your doctor, gynecologist, or head down to the local ER within 24 hours of exposure. Remember, PEP is most effective if taken within 72 hours of exposure to HIV, so do not hesitate to pick up some PEP if you feel you have been exposed to HIV.

Caving and anti-nauseating

Days three and four: Without a doubt Combivir is causing ongoing nausea, headaches, and muscle aches. They were so bad today that I couldn't nap- I already have some problems with muscle aches in my back, and they have just been exaggerated by side effects. I also have been pretty tired but this could be as a result of either traveling or meds; it's uncertain which. Due to ongoing nausea and a general sensation of blah, I decided to start taking the anti-nausea meds, which I initially was uncertain about taking. Here's what I'm on:

Ondansetron, 4mg orally dissolving tabs, taken 3 times a day in 8 mg doses.

Ondansetron is a serotonin antagonist with a chemical formula of C18H19N3O. Serotonin, most popularly known as the brain's happy happy joy joy chemical, can actually make you vomit your guts out. Here's how (short version): If your digestive system is content, certain cells in your guts, known as enterochromaffin cells, will release serotonin in response to the presence of food. Normally, this serotonin will be absorbed; however, if your guts are filled with bacteria/chemotherapied/stuffed full of anti-retroviral meds, your body will release more serotonin than the body can absorb, and this will activate certain serotonin receptors in the central nervous system, known as 5HT3 receptors, which will cause you to vomit. The anti-nausea med that I am on blocks 5HT3 receptors, meaning that the excess serotonin produced in my body is never detected by my brain. Conclusion: I don't get nauseated and don't throw up, at least for a few hours after taking these meds!
Here's what it looks like:

It's interesting taking the same type of medication that a person undergoing chemotherapy might take, as several members of my family have undergone chemotherapy; it's a strange way to relate to someone (hey- we took the same meds! Wow!), but I am glad for any ability to have more compassion for those around me, even if it is bonding over the funny taste or (in)effectiveness of a particular medicine. This particular med also has several uses outside of nausea relief, which I personally to find pretty interesting and quite unexpected, as these tiny white pills seemed innocuous enough.

Here are some additional (occasionally off-label and controversial) uses of ondansetron:

1)Treatment for alcoholics. Ondansetron has been shown to significantly reduce alcohol cravings, esp. by alcoholics.

Ondansetron: All-American.
2)Bulimia treatment. Ondansetron use reduces urges in young women to binge. Here's a short study about it: Study here!

3)Relief of tardive dyskinesia. Tardive dyskinesia, notoriously hard to treat, results in uncontrolled repetitive movements of the human body, similar to a twitch. Tardive dykinesia is usually induced by long term (or high dose) antipsychotic drug use. After 4 weeks of use, patients that participated in the study received a significant reduction in symptoms of tardive dykinesia.

4)Relief of schizophrenia symptoms. Ondansetron acts on 5-HT3 receptors, which are the same receptors that are involved in development of cognitive impairment associated with schizophrenia and schizophrenia itself. Thus ondansetron may relieve some of the symptoms associated with schizophrenia and the cognitive impairment affiliated with it.

(P.S. Even though I myself am not a paranoid schizophrenic, my handle all through junior high and high school in all chat rooms/icq/irc/Palace/virtual interaction was “Paranoid Schizophrenic Duck Girl.” I went by P.S.D.G. for short. The name came from a comic book featuring Daffy Duck in a therapy session. I cut this comic out of a newspaper and carried it around for years- I only lost it when moving around a lot during college. I still hope to come across it in my stuff one day.)

5)Relief of opiate withdrawal symptoms. Once again, ondansetron acts on 5-HT3 receptors which are associated with the withdrawal symptoms of opiates, although ondansetron itself does not reduce cravings. However, it is the only drug out there right now that can potentially treat withdrawal symptoms that does not itself pose a risk of addiction. For example, a heroin addict treated with methadone may just become addicted to methadone. Let's be honest here- I have dealt with friends that have skipped the other opiate addictions and became addicted to methadone directly. But ondansetron? Not addictive at all because it does not get you high- it just takes away the vomiting.

And all that is just for starters! Turns out this drug has been targeted in many rudimentary studies, and much of the potential use for ondansetron has yet to be fully fleshed out. The future is bright!

Accidental adventures in anti-retrovirals

Well, it’s official- my mom’s worst nightmare about my Peace Corps service has happened! I’ve gone and gotten myself stabbed with a dirty needle in a hospital in West Africa, and now I have to take HIV prophylaxis. What do you know! I remember when I was first applying and was pushing really hard to be placed in Francophone Africa, and hearing all kinds of reactions, a chunk of which directly related to potential HIV exposure. I with full confidence told everyone I would neither get stabbed by any dirty needles nor have sex with any HIV positive people, yet here I am, stabbed!

Don’t freak out, Mom! I am HIV negative and will stay that way, and here’s why! I am taking proper preventative action and will be completing my 30 day course of meds- Ivy Renfro, HIV free and content with that- but I do want to take full advantage of this experience, so I am going to blog about it! I am taking a fixed dose of 150 mg of lamivudine and 300 mg of zidovudine, marketed commercially as COMBIVIR tablets, twice a day for 30 days.

So, what happened? I was working at the Eye Clinic in Ourosogie at the Ourosogie Hospital, sponsored by the NGO Right to Sight and Health based out of US. Basically, a group of American doctors and nurses come to Senegal to perform cataract surgeries, distribute glasses, and teach local doctors improved cataract surgery techniques. A woman needed to be taken to her hospital room. Myself, Nic, and her son were put in charge of taking her to her hospital room. The woman was really woozy, scared, and spaced out, so after walking several yards with her, Nic rushed ahead to grab a wheelchair. There was a bit of trash on the wheelchair, which I thoughtlessly brushed aside with my left hand, which I pulled up to discover was bleeding everywhere thanks to a stab with a dirty needle. Oops! I went and rushed to stick my hand in a vat of alcohol (die everything die), then, with Nic’s counseling, I called med, who called me back and said “RUN TO DAKAR, RUN BABY RUN.”

Back in America in my previous life, I spent 8 weeks serving as an HIV/AIDS counselor in Arkansas via an organization called Future Builders. This experience has shaped much about my perception of medicine and sexual health, in collaboration with a six-month experience as a "movie person" during my employment with Cupid’s. So I was trained by the Arkansas Department of Health (and my old boss at Cupid’s) to speak frankly about everyone’s fetishes, genitals, sexual practices, and diseases without giggling, hesitating, or judging. To be honest, both of these jobs were easy in some ways for me because I do not judge people’s sexualities anyway, but receiving training confirming that I should have an open heart and open mind is quite frankly refreshing. Now, I have HIV positive friends that I hug, I have had scares, had tests, had conversations, and asked lots and lots of questions. I have tested and counseled teenage girls, little boys, college students and homeless women. However, I have never been able to attest in any serious way to what it feels like to be on anti-retrovirals. When it came to legitimate post-exposure treatment, or lifetime treatment options, I was at a loss for words. I was taught to say that the anti-retrovirals make you sick, make you feel awful- and I was taught to say this partially as what I interpreted to be a scare tactic, and partially as a testimate to reality. Some people are aware that they are HIV positive but chose to avoid anti-retrovirals due to the fact that they make you feel like total shit for a while. Others have no problems with them, and take them willingly. For all HIV- positive parties involved, they are lifesaving pills at some point in time in one's life. I am the type of person that likes to have some experience with what I am telling people, however, I am NOT the type of person to take anti-retrovirals for a while just to talk about it.

I am, however, the type of person that is going to celebrate this unusual accident by fully embracing and taking advantage of this 30-day adventure in anti-retrovirals. Ready, folks? Lots of journaling for me.

Day 1: After a 12ish hour car ride from Ourosogie to Dakar, most of which I slept through due to the fact that anxiety about Heb C and HIV and a 3 hour long Bright Eyes listen-a-thon kept me most of the night, I arrive at the med office. Dr. Ulle takes tubes of my blood to take to a lab. I get an HIV test and a liver panel, and am given a bag of pills. I am taking a combination of lamivudine and zidovudine, standard anti-retrovirals. I will be starting an anti-nausea medicine, but I have not taken one yet. I am waiting to see what is going to happen to my body before I start them. However, judging by how these last two doses have gone, I will be starting my anti-nausea medicine here in a few hours. So I took my first dose after a dinner of French fries and schwarma, and things were fine for about 45 minutes. I was settled into a long facebook chat with a good friend from back home when I was hit by this wall of pain and dizziness. It started with mild cramping in my left side that made me pause and think, “man, so much for fries…” and then it took over my body, leaving me totally floored. Nausea radiated out of my intestines and towards all directions in my body, my feet, arms, and head alike. A pounding headache blossomed like a rose in what felt instant, and I had to stop what I was doing. Muscles that I rarely use ached and burned and made me acutely aware of them. All of this happened at once. The wave came and went, parts of the wave lingered- the cramps, the headache, and the mild muscle aches. I went to sleep with the residual cramping, headache, and aches.

Day 2: So about two hours ago I took my second dose of anti-retrovirals, and sure enough, within about half an hour to forty five minutes, the same purging wave of nausea and headache came over me, and my body wanted to drain itself of itself. Shaking hands, blossoming headache, evacuating guts. The headache and muscle aches from yesterday did not go away, and today’s episode seems to have amplified what lingers. We will see what the evening brings. The meds I am on are commonly prescribed anti-retroviral medications and are frequently given to HIV positive mothers to prevent the transmission of HIV to their unborn child, and they are given in lower doses to children born of seropositive (HIV positive) mothers to prevent them becoming seropositive due to bodily fluid exposure during childbirth. So why is this entire disaster kind of a good thing? I am very interested in pediatrics and obstetrics/gynecology as a medical professional, and without a doubt want to work with underserved/marginalized populations (and I mean it, we are talking the homeless, drug addicts, child runaways, and troublemakers). As such, I do anticipate at some point in my medical career I will be in the situation where I will need to talk to a seropositive pregnant woman about her options for keeping her baby safe during pregnancy and delivery. Although I anticipate that by the time I am settled into a medical career, these meds will have shifted and changed some, I will be able to speak frankly, honestly, and realistically about what it feels like to take this medicines, how you can manage a life while on them, and what helped me cope with the issues associated with the medicines for the brief period of time that I was on them. I will also be able to attest to whether or not side effect subdue over time at least in a 30 day period, but as of right now, these side effects totally blow.

First things first, how does this drug even work?

Here comes the science!

Well, COMBIVIR is a nucleoside/nucleotide reverse transcriptase inhibitor (NRTI). What?! Long story short, the HIV virus gets into your cells, copies its own genetic material into your cell’s DNA, and then our body’s DNA becomes an unwitting copy machine for the HIV virus. Smart virus, eh? The genetic material carried by HIV that jumps into our cells (specifically those little suckers called CD4) is in the form of RNA, or ribonucleic acid, which looks like this:

RNA and its BFF DNA, posing for the camera. Thanks, learner.org, for this great photo! Science is sexy, isn’t it?

So basically, NRTIs contain busted-up non-functioning versions of the building materials used to convert RNA to DNA, and the HIV virus picks up these broken building materials and tries to use them to create DNA. HIV, even Bob Dylan is face-palming at how hard modern medicine is owning you, but I’m celebrating, because thanks to HIV’s tendency to use these these faulty versions of DNA building materials, the HIV virus cannot transmit it’s genetic material into my cells. This means my CD4 cells will not become unwitting copy machines for HIV.

Thanks to deviant artist Ayame Lawliet for creating something that truly expresses how HIV feels right now.

Now, this led me to wonder, what do these chemicals that travel through my body and fight crime look like? Well, lamivudine looks like this: And it has a molecular for

umula of C8H11N3O3S, with a molecular weight of 229.3, and is an off-white crystalline solid. Beautiful, ain’t it? Zidovudine looks like this:

With a molecular formula of C10H13N5O4, and molecular weight of 267.24, it is a white or beige crystalline solid. Alright, who is ready to make this stuff at home?! Any takers? Anyone? (Disclaimer: I DO NOT PROMOTE DIY ANTI RETROVIRALS. Seriously. This is not stuff to mess with.)

However, I am including an alternatively organized periodic table for you science heads out there to take a look at and think about while you contemplate what is racing through my body. Science rules. So does wikipedia commons, provider of this great image. Love y’all!

Marathons and Masons

Hey ya'll! Things are getting really busy these days in the bustling city of Tambacounda!! PEPAM has really started to mobilize the community, and after three Community-Led Total Sanitation triggering ceremonies, we're organizing a mason training to teach over 60 masons how to construct three types of latrines, all three of which meet World Health Organization standards for good latrines. But prior to this... we had the first annual Tambacounda Race for Girls Education, which went insanely well in spite of all of the difficulties we thought we'd run into!! Get it?

Anyway, March 3rd was the highly anticipated registration day for the marathon. Although our primary audience was intended to be high school students, runners, and government employees that worked out (for example, the police department and the fire department), initially our audience consisted of talibe (Koranic students) and flat out crazy people. Students came through eventually, though, and we registered tons of students to run. An English teacher brought in his classes to perform, and they sang 3 songs in English, which was fantastic. This particularly motivated and dedicated teacher actually sponsored several of his students (both girls and boys) to run. The inscription fee was 1,000 cfa, which was a bit hefty for students, but thanks to several sponsorships we had many students running in the end (lesson learned: student rate for next year). Like any good party hosts, we had speakers blaring and a rotating cast of random dancers, which meant that even if people didn't come to register, we had many people come and just ask what we were doing. This was a great opportunity to say that we are raising awareness of girls education needs in Senegal, and raising money for gender and development activities. Which, sure enough, we actually did. I was a bit concerned with all of the overhead costs (speaker rental, water for the runners, table chair and tent rental, etc) that we wouldn't end up making any money at all, but we came out ahead! 137 runners signed up for our three races, a half-marathon, a 10k, and a 5 k.

The next day, on the day of the race, everyone showed up with their numbers pinned onto their shirts and ready to go. We had our safety and security director kick off the events and a local government representative ran in the 5k in honor of his awesome city (have I ever mentioned how much I love Tamba? Because it's awesome). Students, military dudes, and PCVs alike ran like crazy and we closed the day with a ceremony with several speakers, including a local women's speaker that spoke to the importance of girls education. We had sashes made for the 1st and 2nd place winners of each category out of shiny satin, and had them embroidered with TAMBA 2012 plus the category of the race and their respective place. Various important community members presented the winners with their sashes, and every student winner was presented with a backpack full of school supplies. We also gave away tons of free ORANGE brand t-shirts, which people put on immediately over their clothing. All in all, it ended up being tons of fun, and the Tamba region volunteers have already started planning for the next race, which is happening the 1st week of December. We hope it will have a level of awesomeness turned up to 11.

I started a series of health causeries at Tamba Soce, only to realize that unfortunately it may not be possible to do this series of causeries because they conflict with my office time in the temporary PEPAM office. I started doing them just last week (although they had been planned with the school director for over a month), only to have to cancel this week because I needed to be in the office filling out my job description. The first two days went really well though- the format was as follows: Teach the CM2 students the lesson. Pick out 4 or 5 CM2 students to teach the rest of the classes the lesson. Shadow the CM2 kids as they teach the lesson to all of the other classes at the school. It worked really well as the younger students listened very well to their peers. We did a two-day hand washing lesson, and talked about how germs are spread, what some examples of “microbes” are, and proper hand washing techniques, all guided by 5 lovely CM2 students. It was heartbreaking to cancel this morning- this type of work I love- but my priority right now needs to be making sure this mason training not only happens, but happens well, and that nobody wants to choke anyone during the process of it happening (or, if they do want to choke someone, then making sure that they don't actually do it (the stress potential is high).

So about that mason training! If things go as planned, 60+ masons, 20 from Peace Corps villages, will be trained in the villages of Bira and Kouthiaba on latrine building techniques. If things go as planned, the first day will be the 20th, and everyone will be meeting in Bira, our model demo site. After a day in Bira, the masons will split into two groups, one of which will spend its time in Kouthiaba, and the other will stay in Bira. Each volunteer will be bringing 2 masons, and while we will be staying with our volunteer hosts, the masons will be staying either with host families or in a community room. The masons will be learning how to make Sanplat , VIP, and DLV latrines. A Sanplat is a basic latrine with raised food beds so that your feet do not come into contact with waste. The VIP is the “ventilated improved pit” latrine which is a beautiful brick latrine with a nice roof, and the DLV, the “double ventilated latrine,” which has two pits and an expanded life span. All of these latrines will help the communities raise their sanitation standards, as many of these masons are coming in from communities where open-air defecation is an issue. The last day should be the 28th, if things fall in place.

There have been some difficulties with planning the training due to the fact that our PEPAM office is just now starting operations, and our staff are in various parts of the community right now and we have been planning primarily via email, phone calls, and text messages. I think the hardest part of this actually has been getting only small bits of information at a time- my job at this point is to ensure that the volunteers have all of the information their community needs to prepare for the training, but I have only been getting the information in tiny tiny chunks. Normally, the trainings are planned when the staff is all together and can work together, but not this time around- we're all over the place. It will only get easier from here, but working in this type of chaos can be really stressful, especially coming from an American mindset. I expect things to work on a schedule and be at least vaguely planned. Things probably will not be 100% concrete for this training until, well, it's happening. I have faith that it will work out, as I have seen USAID trainings work out really well in the past. It's just a matter of waiting around for that next little morsel of important information so that I can pass it on to the volunteers who need it.

In the end, even if things are stressful now, we will have over 60 village and small-town based masons trained in a skill that they previously did not have, which will make it all worth it.

Well, that's all for now. Peace only!

On the home again

Hello! The past two months have flown by with record speeds that I can only account for by saying my brain must be slowing down. I swear, this old age is catching up to me. Anyway, Nic and I, after finding a suitable apartment, spent three weeks in the states enjoying friends, family, and of course fine foods! We ate so much that Nic gained a chunk of his weight back, and I haven't had any totally off the wall cravings since returning. Before our vacation to America: Nothing sounded better than beef jerky dipped in canned nacho cheese. After our vacation to America: Sure, peas sound awesome. Thank goodness for good nutrition!
After returning from America, Nic and I spent a few days putting together things for our house. As it turns out, even though we had been waiting for three weeks, the electricity still had not been turned on. This wasn't too big of a deal, but we live in a second story apartment, and whenever there was no power, even the moon couldn't light those dark walls. Our volunteer support guy told us that Senelec was out of power boxes, but within a few days and many phone calls later we were able to get the electricity turned on. Quickly, however, we discovered a major sanitation issue existing under our own feet.
The apartment reeked to high hell, and we couldn't figure out why, so I took to exploring the water routes in this apartment. It appears that all of the waste water drains to one main drain in our bathroom under the showering space, and this water includes our very own raw sewage, which has been building up right in our shower drain. Talk about disgusting. Nic called our landlord who sent us a plumber, who said that apparently a release pipe failed to be installed. Huh. We have the seeming convenience of more-modern-than-not plumbing, without the complete infrastructure to support it, which means a gross smelling apartment. It isn't too big of a deal, because if we pour enough water down the drain everything flushes out of the apartment, but I was pretty surprised to discover the cesspool growing under my own shower shoes.
After settling into our house, I left for Eye Clinic in Bakel, a two-week eye clinic ran by two eye doctors imported from America, two sons, a sterile nurse, a Senegalese doctor/tech, and hordes of Peace Corps volunteers. In short, this was a medical mission to provide people with glasses, information about the condition of their eyes, cataract surgery, and a handful of other eye related plastic surgeries. The experience was fantastic. I arrived for week two and asked to be in the operating room, which meant I got to give people shots of steroids in the eye socket. In addition, I have seen more eyes operated on than I ever thought I would ever see. The clinic was pretty chaotic at times, and we had to call in back up to prevent a riot from happening, as the doctors were unable to see everyone that wanted to be seen. Imagine: Doing your thing in the operating room, cleaning eyes and passing supplies, and then leaving the room and almost walking into a giant man in uniform with a huge rifle in your face. Oops! Keeping the peace is terrifying.
The desperation of some of the patients combined with the knowledge holes in the hospital demonstrated to me how great the need for better medical training is. The doctors were attempting to train the Senegalese tech in a technique of cataract surgery, but it was clear that the tech will need much more training and follow up than what could be provided in two weeks. Unfortunately, our capacity to provide such intense, highly specific, and technical training is severely limited. We need more professionals on our side that are capable of doing this training. Eye doctors, come to Senegal please, and teach our doctors!
Also, we need some dentists to come out too. Dental mission anyone? My heart breaks at the number of rotten teeth I see even in the youngest of kids. And sugar consumption is through the roof! I used to think I had a sweet tooth until I came to Senegal. The amount of sugar that goes into everything is unbelievable! A single tiny teapot will have 15 sugar cubes! We need someone to fill teeth, do cleanings, pull rotten ones, and give out lots and lots of tooth brushes- AND teach people why they are important. I'll tell you what- you come down and pull the bad teeth, and I'll teach folks why brushing your teeth is important. Deal?
So now I am back in Tamba, home sweet home, and have started to follow up with my work leads. Or I guess they are following up on me. I was literally chased down the road by an English teacher yesterday, who turned out to be a cool guy that wants me to work with his English clubs once school starts for the spring semester in early January. Senegalese poetry slam, anyone? I also went to la Lumier, an NGO that works with disadvantaged populations, but much to my dismay the people I was supposed to meet with were not there. One of them should be returning today or tomorrow, so I will be checking back. I have also been working on registration forms for the Marathon for Girls' Education in Tamba, and once our final route and dates are set, I will be going to schools in the area and advertising. We want runners and we want as many students as possible running to support the education of girls in their area! In addition, there is a nurse that works with Talibe that is interested in working with a Peace Corps volunteer. I plan on following up with her this week. I was given her contact information by a fellow PCV, and I am incredibly grateful. This nurse seems to do exactly the type of health outreach that I am interested in. Things are coming together slowly slowly. Nic and I really are back at the integration phase of our service. Today's big victory was being recognized and called on by name by one of my neighbors.
Oh yeah! And we adopted a kitten from the trash! It's not uncommon for unwanted animals to be dropped in trash areas and dumps, unfortunately, This means that PCVs can often find friends among the garbage. This is the 3rd trash kitten I've heard of adopted by PCVs just in the past few months. They make great pets, once they figure out that you aren't going to hit them with rocks. Her name is Poullundu, a mixture between poubelle (trash can in French) and ullundu (cat in Pulaar). She is tiny, cute, and black and white. When we found her she was filthy, oily, dirty, and exhausted. After shampooing, feeding, toweling off, and several days of TLC, she is a happy energetic kitten. She has also taken to Nic very well. This morning I woke up to find the kitten literally asleep on his head. Aww.
That's all for now. Hope everyone is well!

The big move!

Yesterday, we finally did it. We made the big move from the north to our new home in Tambacounda!!! I'm so happy words cannot even begin to explain it. Yesterday we were really worn out because we were in a car for 11ish hours, but today has been wonderful. We woke up this morning and went to the main road for an awesome egg sandwich from a guy named Osman. After this, we came back and spent some time pulling all of the thorns out of our bike tires. Oh, thorns...souvenirs from the north. After this, we went on a wild goose chase for new inner tubes, but all of the stores nearby are sold out. Luckily, the guard here at the Tamba house is an awesome guy who is going to pick us up some new inner tubes from a bike place far away from here, and we will be in business. The main parts of the town are totally bike-able, including an awesome burger place that has been written up in the Lonely Planet, a fantastic warthog restaurant that we ate at today and enjoyed thoroughly, and a giant market with the biggest cucumbers and watermelons I've seen since being in Arkansas. Life is so good! Fruits and vegetables are cheaper here, too. In Ourosogie for a small cucumber I would pay 500-600 cfa...here, a large cucumber is only 200 cfa. WOW! Thank you, moderately warm climate, for making vegetable production so much easier for all of the farmers in the area.
In addition, we met with our local volunteer support person, who is an awesome guy that spent some time in the United States and as a consequence has a very American sense of humor, which I can appreciate in a Peace Corps staff member. He took us to some of our potential work sites, including an NGO that works with runaways and Koranic students, the health post, and the Yaajeende office (where Nic will primarily be working if things line up). I am going to go on Monday to the NGO that works with runaways and Koranic students and speak with them specifically about their needs and potential projects. The volunteer support guy told me that he will give them a call and let them know that there is a Peace Corps volunteer that wishes to work for their organization. I am so excited. The work available to me in this region is plentiful and seems to be rewarding stuff. There is also an orphanage here I could potentially work at, and maybe two but the volunteers in the area are unsure about one of them. I am going to go myself and check out the situation. One of the benefits of being relocated is that I can pretty much choose my own work, but this comes with the difficulty of having to find my own counterparts and make my own work connections. I am optimistic, though. It's a good opportunity to test my language!
We are going to be in the regional house for at least one more week while we are waiting for our house to be ready for us to move in, so we will have the internet for a while. Be in touch!