It's shocking to realize how big a city feels when you've just arrived from living in a tiny town for nearly two months. Kayes only housed 10 000 and i was plenty big; the advantage was that you could often run into your neighbors or colleagues at the market or in the bar ("the" being correct here, there was 1 reasonable bar, the rest were non-active countertops serving warm beer). Bamako is home to over 1 milion people, so it's comparatively VERY busy and far less friendly, even though our impressions had been precisely the reverse when we first arrived in Kayes. But then again, somewhere along the line, you have to admit that 10 hours of travelling on a cramped bus, sweating into an already damp seat and eating peanuts for lunch does tnd to leave one a bit drained from the trip, and thus prone to judging their destination a but harshly. At least, that's what it seems.
Right now, I am sitting on my bed in my hotel room in Bamako, typing this and very much enjoying the MUCH cooler Bamako climate. I hardly flinch at temperatures in the early thirties anymore. The neighborhood we're staying in is named Torokorobougou (now "bougou" just means "neighborhood", so that makes the name less intimidating), and this time, I'm hoping we'll be able to enjoy it more than when we were under the shock of arrival. There's a diversity of people, little cantinas and beauty salons and shops, not to mention the occasional goat taking a nap in the street!
Today, we're heading to the artisans' market in the city center. This is where all the regions of Mali send their arts and crafts to be sold, from pottery to fabric to instruments and sculptures. And because Mali isn't touristy yet, the quality is wonderful and there's never any risk of getting something kitchy.
Must also stop at the travel agency and buy more luggage credits. I have no more room!
Love all of you guys, and I'll post probably one more time from Paris, then I'm home!
I really want a glass of milk. Not powdered. 1% cow, limpid milk in all its cold glory.
Monday, August 17, 2009
Friday, August 14, 2009
Final Days in Mali
As our journey comes to close in these last days of summer, I find myself reflecting on everything we've learned and seen in these past two months, and while I feel ready to come home, I find it difficult to believe I'm going to be leaving this place in less than a week.
In two days, I leave Kayes.
In five days, I leave Mali.
In seven days, I will be home.
And then, back to family, work and school. A third and final year of nursing, the beginning of a job search for after graduation, and most of all, the all-important task of trying to transplant the African values I've come to admire into my everyday life. Little things such as saying hello to one's neighbors; keeping an open-house policy; not being afraid of being unafraid, and so on.
As much as we think, in our Western minds, that we can help Africa and the various difficulties facing its countries, the reality is that if we could look for a moment beyond our delusions of grandure, we would see that not only can we learn extraordinary things about community living and human decency, but we would realize that we are not the ones who hold the future of this continent.
Only Africans will make their future brighter. No one else can, and no one else will do it in a sustainable and truly African manner.
I will try to write more before I reach Paris, but from here on end, I mostly look forward to being able to regale you with adventures and anecdotes in person.
In two days, I leave Kayes.
In five days, I leave Mali.
In seven days, I will be home.
And then, back to family, work and school. A third and final year of nursing, the beginning of a job search for after graduation, and most of all, the all-important task of trying to transplant the African values I've come to admire into my everyday life. Little things such as saying hello to one's neighbors; keeping an open-house policy; not being afraid of being unafraid, and so on.
As much as we think, in our Western minds, that we can help Africa and the various difficulties facing its countries, the reality is that if we could look for a moment beyond our delusions of grandure, we would see that not only can we learn extraordinary things about community living and human decency, but we would realize that we are not the ones who hold the future of this continent.
Only Africans will make their future brighter. No one else can, and no one else will do it in a sustainable and truly African manner.
I will try to write more before I reach Paris, but from here on end, I mostly look forward to being able to regale you with adventures and anecdotes in person.
Monday, August 10, 2009
National Women’s day
We took part in Panafrican Women's Day on July 31st, 2009. A wonderful day in solidarity, this day is celebrated by the women (and many men!) of every African country each year, and each year has its own theme. This year's theme was "The Prevention of the Exploitation of Women and Children".
Unlike many marches and assemblies we have in North America, no Womens's Day goes by without the deposit of one law proposal per region. In Kayes, we carried a proposition regarding the prohibition of female circumcision, or excision. At last.
With the support of the local and regional governments, these proposals then get to be examined by the high officials of Mali, who then determine a vote. Bear in mind however, that a law only has power if the people have the knowledge and education to know and enforce the rights granted to them by this law. With literacy rates skimming only 25%, there's still a lot of work to do.
We were especially touched byy the current status of women in this country: the laws currently in place make a woman only worth 1/3 of a man. In concrete terms, if a man beats a woman and she presses charges, it takes her and two other victims to testify to make the crime as serious as if he had assaulted another man. Even then, the prosecution isn't always as stringent as it could be.
One of the other reasons for this year's theme was that with modern times, more and more young women (ages 14-25 on average) head to the big city from rural areas to earn their dowry. Unlike our concept of a dowry, a girl must have in her possession all she needs to set up a household before she gets married. Consequently, she must find the money to purchase a coal stove, pots and pans, utensils, etc., as well as clothing and bedding. With limited time and little education, many girls work for unregulated salaries or worse, must prostitute themselves to earn the necessary items to be an honorable bride. This, of course, puts them at risk for contracting HIV, experiencing violence or worse, never being able to leave the city to accomplish their primary goal: get married and have a family.
Mothers often have even less education than their daughters and are thus in a disadvantaged position when faced with the decision to send the girls to the city or not. Fathers may find it more important to marry their daughters than to consider the potential dangers of the urban environment.
And so we marched, together, through the streets of Kayes, singing, dancing and showing our solidarity in the face of womens' issues throughout the country. It was an incredibly powerful moment of unity and we were very honored to be a part of it.
Saturday, August 8, 2009
Yesterday, Laurence and I, as the two remaining troopettes, went to the regional hospital ER to observe and help out. Observe, we certainly did. Here are a few of the cases to consider.
The first case we witnessed was a 34 year-old man who had been in a motorcycle collision (I’m unaware of whether I made it clear before: EVERYONE drives scooters and motorcycles; cars are a minority. There are no helmets). Now the collision had been with an gas truck, so you can imagine the impact. He had experienced inner ear hemorrhaging (in french otorragie) and was lapsing into a coma. Most of us imagine a comatose person as being limp, calm and unresponsive. This patient looked as though he was having a panic attack, and was in major respiratory distress, probable because his brain was shutting down. So they gave him mannitol, a substance to reduce the pressure between his scull and his brain (thus minimizing the damage should he survive) and monitoring him. Unfortunately, due to equipment issues, monitoring, in this case, means only checking his pupils and taking his blood pressure (which was at 230/170, which for those of us who aren’t in a medical field is critically HIGH). We asked if they planned to intubate, and I was brought back to the harsh reality that Malians face most days. They have access to the equipment needed to intubate, but nothing to hook him up to.
He will most likely die in the next 24 hours.
He was struggling to breathe so much you could see his jugular through his neck muscles when he inhaled. His lower ribs protruded sharply from his thorax with each seemingly agonizing breath and despite my medical rationale, I couldn’t help but fear for him, because it looked as though he was AWARE of the fact that his own brain was suffocating him and there was nothing he could do about it.
I’m officially thankful for my bike helmet, but I wonder how much more could be done in a modernized, equipped setting. Could we save him, rehabilitate him? His Glascow (coma) score was 6, what were his chances upon impact? We’ll never know, and certainly he won’t.
The second case we saw was one that reminded us of how deep cultural roots really go. Much like the taproot of the great baobabs, they seem indestructible, and just as unchanging.
This patient was a 25 year-old man who had suffered a stroke. It isn’t uncommon to see high blood pressure in people as young as 20, due to both environmental (dietary) and genetic (people of African descent are much more prone to HBP) factors. High blood pressure, in layman's terms, often occurs because of reduced blood vessel size. Blood tends to take a bit longer to get though, and the slower the flow, the more odds there are of platelets and cholesterol and all sorts of little debris to collect into a neat little blob that adheres to the vessel wall, like a ticking bomb. The formation of blood clots is also much, much more frequent (ladies, this is why most African girls our side of the ocean have to avoid high-dose contraception, as this increases the risk of blood clot formation).
When a blood clot forms, it has three destinies:
1-it remains attached to the vessel wall where it formed
2-it detaches and travels to the lungs and you suffer a pulmonary embolism
3-it detaches and travels to the brain and you have a stroke (most of us are very familiar with this)
In his case, it chose Door #3.
When we did the rounds, this man was paralyzed on his entire right side (known as hemiplegia) and had emerged from a coma only a day earlier. Now here's where our notion of medecine has to go take a coffee break:
His family wanted to have him discharged and take him home because they believed his condition was caused by a djinn, or evil spirit.
Their belief was that while coming home on his bike, he passed through the house of a sleeping djinn (these are assumed to be invisible, in case you're wondering) and the djinn cursed him for disturbing him.
Fair enough, I can understand the futility of trying to explain thrombosis to people whose spirituality permeates their health. No problem, really.
The problem is that the medical staff here refuses to do anything other than insist of the scientific interpretation of the situation and the family isn't about to give any leeway to science either.
The patient's condition, regardless of its source, ISN'T any different, so why the difficulty.
I wonder how interesting it would be, just for a moment, to develop a compromise: let them take him home as he is, and encourage them to help him rehabilitate. Show them way to stimulate his mind and the right side of his body to eventually regain maximal use of it. Don't discuss magic or science, just give them tools accessible enough to help the patient.
I'm seriously contemplating doing a master's degree in Intercultural Mental Health Nursing. Now there,s a challenge (imagine that in Mali, there's 1 psych hospital, it's expensive, and it's much more of an asylum. Therapy for burn out and depression just isn't available, and furthermore, it's possible people would not be receptive to therapies we use in the West)
Our third case of the day was a young woman of 26 years with the following symptoms (see if you can guess what she has before I tell you. Remember, this IS Africa):
-severe weight loss
-opportunistic infections
-very anemic
-very low T-cell count
-exhaustion
-no appetite
5...4....3...2...1...time's up!
She had HIV that had progressed to AIDS. she never even had a chance, because she had progressed to full AIDS ( the phase of the disease where any bug you catch can potentially kill you) by them time she was diagnosed with HIV. Traditionally, the earlier you identify the virus's presence, the better the person's chances are of slowing his or her progression to AIDS.
She will be evaluated by Dr. Touré, the regional HIV case worker (for whom everyone here has great respect, because he is highly dedicated to his patients and the cause itself), then probably put on anti-retrovirals (the same ones as us, luckily Mali doesn't have a supply problem) and transfused to give her strength the fight the infection.
She was blood type A+. So am I.
So, in highly sterile conditions, I went to the lab to offer up a pint of blood, much like all the other girls in the group had done, inspired by Maude's initial gift to a critically ill mother. That patient had hemorrhaged behind her placenta, the baby was dead and she needed surgery, but because of blood loss was going into shock. Maude offered, was crossmatched and within one hour, a pouch of fresh, healthy blood was given and the woman pulled through. I've never felt more honored to know my colleagues.
At the lab, they tested me for syphilis, HIV and Hepatitis B, all clear. Yay! Then A+ blood type was confirmed and my baggie of blood was popped in the fridge. I'll never know whether she got the blood or not, but I do know that as opposed to North America, where 44% of people are Type A, the proportions are reversed here, making Type A both rare to find in a patient and just as rare to get for a patient in need. Because they also have no blood bank facilities, blood (when there is any) is stored in a standard fridge with the vaccines, giving it a lifespan of 10-15 days only before too many clots form and it is rendered useless. The older the blood, the more clots in it and the less helpful it is to the patient.
In Mali, most people are extremely hesitant to give blood, and finding a donor often implies dealing in a sort of informal black market. The families of patients hospitalized all come to the hospital and camp out during their stay, so most of the time when blood is needed, a family member will do the rounds, looking for a match. If the donor consents, and fee for the donation is set. On average, a person may earn around 4 000 CFAs per day on a good day. A single pouch of blood may sell for anywhere between 10 000 and 60 000 CFAs.
Sometimes a family must choose between giving life-saving blood and the medication that will treat the actual disease.
I really hope she got the blood.
The first case we witnessed was a 34 year-old man who had been in a motorcycle collision (I’m unaware of whether I made it clear before: EVERYONE drives scooters and motorcycles; cars are a minority. There are no helmets). Now the collision had been with an gas truck, so you can imagine the impact. He had experienced inner ear hemorrhaging (in french otorragie) and was lapsing into a coma. Most of us imagine a comatose person as being limp, calm and unresponsive. This patient looked as though he was having a panic attack, and was in major respiratory distress, probable because his brain was shutting down. So they gave him mannitol, a substance to reduce the pressure between his scull and his brain (thus minimizing the damage should he survive) and monitoring him. Unfortunately, due to equipment issues, monitoring, in this case, means only checking his pupils and taking his blood pressure (which was at 230/170, which for those of us who aren’t in a medical field is critically HIGH). We asked if they planned to intubate, and I was brought back to the harsh reality that Malians face most days. They have access to the equipment needed to intubate, but nothing to hook him up to.
He will most likely die in the next 24 hours.
He was struggling to breathe so much you could see his jugular through his neck muscles when he inhaled. His lower ribs protruded sharply from his thorax with each seemingly agonizing breath and despite my medical rationale, I couldn’t help but fear for him, because it looked as though he was AWARE of the fact that his own brain was suffocating him and there was nothing he could do about it.
I’m officially thankful for my bike helmet, but I wonder how much more could be done in a modernized, equipped setting. Could we save him, rehabilitate him? His Glascow (coma) score was 6, what were his chances upon impact? We’ll never know, and certainly he won’t.
The second case we saw was one that reminded us of how deep cultural roots really go. Much like the taproot of the great baobabs, they seem indestructible, and just as unchanging.
This patient was a 25 year-old man who had suffered a stroke. It isn’t uncommon to see high blood pressure in people as young as 20, due to both environmental (dietary) and genetic (people of African descent are much more prone to HBP) factors. High blood pressure, in layman's terms, often occurs because of reduced blood vessel size. Blood tends to take a bit longer to get though, and the slower the flow, the more odds there are of platelets and cholesterol and all sorts of little debris to collect into a neat little blob that adheres to the vessel wall, like a ticking bomb. The formation of blood clots is also much, much more frequent (ladies, this is why most African girls our side of the ocean have to avoid high-dose contraception, as this increases the risk of blood clot formation).
When a blood clot forms, it has three destinies:
1-it remains attached to the vessel wall where it formed
2-it detaches and travels to the lungs and you suffer a pulmonary embolism
3-it detaches and travels to the brain and you have a stroke (most of us are very familiar with this)
In his case, it chose Door #3.
When we did the rounds, this man was paralyzed on his entire right side (known as hemiplegia) and had emerged from a coma only a day earlier. Now here's where our notion of medecine has to go take a coffee break:
His family wanted to have him discharged and take him home because they believed his condition was caused by a djinn, or evil spirit.
Their belief was that while coming home on his bike, he passed through the house of a sleeping djinn (these are assumed to be invisible, in case you're wondering) and the djinn cursed him for disturbing him.
Fair enough, I can understand the futility of trying to explain thrombosis to people whose spirituality permeates their health. No problem, really.
The problem is that the medical staff here refuses to do anything other than insist of the scientific interpretation of the situation and the family isn't about to give any leeway to science either.
The patient's condition, regardless of its source, ISN'T any different, so why the difficulty.
I wonder how interesting it would be, just for a moment, to develop a compromise: let them take him home as he is, and encourage them to help him rehabilitate. Show them way to stimulate his mind and the right side of his body to eventually regain maximal use of it. Don't discuss magic or science, just give them tools accessible enough to help the patient.
I'm seriously contemplating doing a master's degree in Intercultural Mental Health Nursing. Now there,s a challenge (imagine that in Mali, there's 1 psych hospital, it's expensive, and it's much more of an asylum. Therapy for burn out and depression just isn't available, and furthermore, it's possible people would not be receptive to therapies we use in the West)
Our third case of the day was a young woman of 26 years with the following symptoms (see if you can guess what she has before I tell you. Remember, this IS Africa):
-severe weight loss
-opportunistic infections
-very anemic
-very low T-cell count
-exhaustion
-no appetite
5...4....3...2...1...time's up!
She had HIV that had progressed to AIDS. she never even had a chance, because she had progressed to full AIDS ( the phase of the disease where any bug you catch can potentially kill you) by them time she was diagnosed with HIV. Traditionally, the earlier you identify the virus's presence, the better the person's chances are of slowing his or her progression to AIDS.
She will be evaluated by Dr. Touré, the regional HIV case worker (for whom everyone here has great respect, because he is highly dedicated to his patients and the cause itself), then probably put on anti-retrovirals (the same ones as us, luckily Mali doesn't have a supply problem) and transfused to give her strength the fight the infection.
She was blood type A+. So am I.
So, in highly sterile conditions, I went to the lab to offer up a pint of blood, much like all the other girls in the group had done, inspired by Maude's initial gift to a critically ill mother. That patient had hemorrhaged behind her placenta, the baby was dead and she needed surgery, but because of blood loss was going into shock. Maude offered, was crossmatched and within one hour, a pouch of fresh, healthy blood was given and the woman pulled through. I've never felt more honored to know my colleagues.
At the lab, they tested me for syphilis, HIV and Hepatitis B, all clear. Yay! Then A+ blood type was confirmed and my baggie of blood was popped in the fridge. I'll never know whether she got the blood or not, but I do know that as opposed to North America, where 44% of people are Type A, the proportions are reversed here, making Type A both rare to find in a patient and just as rare to get for a patient in need. Because they also have no blood bank facilities, blood (when there is any) is stored in a standard fridge with the vaccines, giving it a lifespan of 10-15 days only before too many clots form and it is rendered useless. The older the blood, the more clots in it and the less helpful it is to the patient.
In Mali, most people are extremely hesitant to give blood, and finding a donor often implies dealing in a sort of informal black market. The families of patients hospitalized all come to the hospital and camp out during their stay, so most of the time when blood is needed, a family member will do the rounds, looking for a match. If the donor consents, and fee for the donation is set. On average, a person may earn around 4 000 CFAs per day on a good day. A single pouch of blood may sell for anywhere between 10 000 and 60 000 CFAs.
Sometimes a family must choose between giving life-saving blood and the medication that will treat the actual disease.
I really hope she got the blood.
Friday, July 31, 2009
Cuisine et Médecine (bilingual)
Cooking diaries - Girls’ Night
Not that we’re prone to excess, but by the end of week one of interning, we were all a bit homesick, but I figured it would be a good idea to pull off a girls night. So we found oursleves the fixings for our two biggest comfort foods (within reason, the ice cream cravings are still pretty pungent!).
I still had two chocolate bars in my bag from Bamako, so we chopped those up and wound up with the world’s biggest bowl of chocolate chip cookie dough. One spoon each, life was good.
Then we discovered the joy of popcorn made with palm oïl. Wow. Perhaps it was because we were so sick of the usual, or maybe it was because the evening had all given us a soft, inner glow, but that giant kettle of popcorn hot from the stove top and a couple of cold Cokes was the best damned snack we’d had in a long time.
This time, I get to quote Anne-Isabelle on my popcorn:
“On dirait que ton pop-corn a une âme!”
Way to boost the ego. Life was good.
Of course, the sugar high later crashed, and we passed out for the night. A nice little break in the gloom.
Crounch va l’épisiotomie et la naissance
L’épisiotomie est une technique généralement réservée aux cas extrêmes, et nous avons appris à l’école que l’épisiotomie est à éviter, car le risque de déchirure sévère augmente avec l’emploi de l’épisiotomie, particulièrement lorsqu’elle est latérale (verticale).
Au Mali, l’épisiotomie est une pratique courante, et elle est effectuée en médiane. Alors que notre première réaction est souvent une d’horreur, il faut admettre que dans certains cas, les femmes donnent naissance si jeunes qu’elles sont simplement trop petites pout donner naissance toutes seules. Évidemment, l’excision n’aide pas, car l’infibulation (cicatrisation des petites ou grandes lèvres) rétrécit l’orifice vaginal, parfois jusqu’à ne laisser qu’un trou la taille d’un pois pour laisser passer l’urine et le sang menstruel. On effectue donc l’épisiotomie lorsque la tête est entièrement engagée dans l’orifice vaginal.
Malheureusement, on coupe souvent à la course, de travers ou encore avec des ciseaux si vieux que leurs lames ne sont plus alignées. L’entaille est souvent très profonde, allant jusque dans la fesse et pour ceux qui ne le savent pas déjà, toutes ces procédures se font à froid. Il faut d’ailleurs très souvent tenir le bassin de la patiente contre la table pour qu’elle ne se débatte pas, car elle peut se blesser encore plus si elle sursaute au moment inopportun. Dans ces moments, nous sommes avec ces femmes dans leur douleur. Nous leurs tenons la main, nous les encourageons à bien respirer, à prier, à faire tout ce qui les soulageraient dans leur souffrance.
Après l’accouchement, la réparation est le geste médical le plus difficile à observer, voire effectuer. Souvent à vif, la lidocaine étant réservée à celles dont la famille peut payer (et veut payer), le médecin recoud le périnée avec du fil de nylon et une aiguille de 2.0 (se rappeler que le gauge le plus petit est du 6.0, imaginez que du 2.0 ressemble plus à un hameçon de pêche). Selon le degré de lacération ou d’épisiotomie, cela peut prendre 5 à 20 points.
Il semble ridicule à première vue, de ne pas insister sur une césarienne, car pour certaines mères, elle meurent avant même que l’épisiotomie puisse être fait (la cause la plus fréquente de ce drame est qu’elles ne sont admises à l’hôpital que lorsqu’il est trop tard). Cependant, selon les conditions et le matériel disponible, le risque d’infection suite à une chirurgie telle qu’une césarienne est plus élevé que la douleur suite à l’épisiotomie. Il faut se rappeler qu’il n’y a pas deux mois de convalescence suite à l’accouchement; souvent la femme retourne au travail dès qu’elle tient sur ses jambes, et d’ailleurs, dès qu’elle a accouché et a été réparée, elle doit se lever, se rhabiller et se rendre elle même à la chambre de repos, où elle s’allongera avec toutes les autres femmes ayant accouché dans les 6 heures la précédant, et elle obtiendra son congé 6 heures plus tard à moins de saignements importants.
Effectivement, c’est un peu plus bref que chez nous. Il n’y a pas d’enseignement pour l’allaitement, ni les soins du bébé; cette information est passée de mère en fille. Le placenta, les pagnes souillés et les caillots récupérés de l’accouchement sont mis dans un seau et remis à la famille, laquelle a la responsabilité le ramener à la maternité propre.
Cette approche très simplifié fonctionne, malgré les limites de l’environnement. Les bébés en revanche, sont d’autant plus extraordinaires, venant au monde avec de grands cris and de grands yeux. Leur réflexe de succion est triomphant, alors qu’ils sont mesurés, pesés et laissés sous un incubateur jusqu’à ce qu’on ait fini avec la mère. Nous passons le plus de temps possible à les tenir et les cajoler; les matrones rigolent un peu en nous regardant, car l’attention que nous portons à ces petits doit sembler terriblement excessif comparé à la norme sociale. Ils n’ont jamais critiqué ce geste, par contre, alors au moins nous n’offensons personne.
Le gros choc que nous avons toutes eu, étant toutes éduquées selon la philosophie du caring, est justement l’absence de celui-ci. Les femmes se font tenir les lèvres fermées lorsqu’elles veulent crier leur douleur. Elles se font traiter de désobéissantes et les matrones (un compromis entre une sage-femme et une doula) les giflent si elles se plaignent. Les lits de naissance sont trop courtes et les femmes manquent de s’assommer sur la barre à la tête du “lit”. Les avortements (suite à une fausse couche) sont effectuées sans cérémonie, la canule d’aspiration pleine de caillots souvent visible à la mère durant la totalité de la processus. Lorsque le médecin a fini, c’est hop! Debout et au tour de la suivante.
Et pourtant personne ne proteste. La naissance est une réalité, un élément de la vie d’une femme, pas un miracle ni un évènement spécial. Et tant bien que je sens dans mes mots un jugement que je me suis juré de garder pour moi-même, je sais que lorsque je suis en salle d’accouchement, m’indigner n’aiderait pas la patiente et ne changera rien. Je m’abstiens donc des commentaires et je fais ce que je peux dans la limite permise: massages dans le bas du dos pour soulager la douleur, une compresse froide pour une primipare terrifiée, quelques mots de bambara pour encourager une jeune femme dont l’agonie se prolonge des heures de plus que prévue, une berceuse pour celle qui se fait avorter...
On fait ce qu’on peut. Les yeux des patientes en disent beaucoup.
Not that we’re prone to excess, but by the end of week one of interning, we were all a bit homesick, but I figured it would be a good idea to pull off a girls night. So we found oursleves the fixings for our two biggest comfort foods (within reason, the ice cream cravings are still pretty pungent!).
I still had two chocolate bars in my bag from Bamako, so we chopped those up and wound up with the world’s biggest bowl of chocolate chip cookie dough. One spoon each, life was good.
Then we discovered the joy of popcorn made with palm oïl. Wow. Perhaps it was because we were so sick of the usual, or maybe it was because the evening had all given us a soft, inner glow, but that giant kettle of popcorn hot from the stove top and a couple of cold Cokes was the best damned snack we’d had in a long time.
This time, I get to quote Anne-Isabelle on my popcorn:
“On dirait que ton pop-corn a une âme!”
Way to boost the ego. Life was good.
Of course, the sugar high later crashed, and we passed out for the night. A nice little break in the gloom.
Crounch va l’épisiotomie et la naissance
L’épisiotomie est une technique généralement réservée aux cas extrêmes, et nous avons appris à l’école que l’épisiotomie est à éviter, car le risque de déchirure sévère augmente avec l’emploi de l’épisiotomie, particulièrement lorsqu’elle est latérale (verticale).
Au Mali, l’épisiotomie est une pratique courante, et elle est effectuée en médiane. Alors que notre première réaction est souvent une d’horreur, il faut admettre que dans certains cas, les femmes donnent naissance si jeunes qu’elles sont simplement trop petites pout donner naissance toutes seules. Évidemment, l’excision n’aide pas, car l’infibulation (cicatrisation des petites ou grandes lèvres) rétrécit l’orifice vaginal, parfois jusqu’à ne laisser qu’un trou la taille d’un pois pour laisser passer l’urine et le sang menstruel. On effectue donc l’épisiotomie lorsque la tête est entièrement engagée dans l’orifice vaginal.
Malheureusement, on coupe souvent à la course, de travers ou encore avec des ciseaux si vieux que leurs lames ne sont plus alignées. L’entaille est souvent très profonde, allant jusque dans la fesse et pour ceux qui ne le savent pas déjà, toutes ces procédures se font à froid. Il faut d’ailleurs très souvent tenir le bassin de la patiente contre la table pour qu’elle ne se débatte pas, car elle peut se blesser encore plus si elle sursaute au moment inopportun. Dans ces moments, nous sommes avec ces femmes dans leur douleur. Nous leurs tenons la main, nous les encourageons à bien respirer, à prier, à faire tout ce qui les soulageraient dans leur souffrance.
Après l’accouchement, la réparation est le geste médical le plus difficile à observer, voire effectuer. Souvent à vif, la lidocaine étant réservée à celles dont la famille peut payer (et veut payer), le médecin recoud le périnée avec du fil de nylon et une aiguille de 2.0 (se rappeler que le gauge le plus petit est du 6.0, imaginez que du 2.0 ressemble plus à un hameçon de pêche). Selon le degré de lacération ou d’épisiotomie, cela peut prendre 5 à 20 points.
Il semble ridicule à première vue, de ne pas insister sur une césarienne, car pour certaines mères, elle meurent avant même que l’épisiotomie puisse être fait (la cause la plus fréquente de ce drame est qu’elles ne sont admises à l’hôpital que lorsqu’il est trop tard). Cependant, selon les conditions et le matériel disponible, le risque d’infection suite à une chirurgie telle qu’une césarienne est plus élevé que la douleur suite à l’épisiotomie. Il faut se rappeler qu’il n’y a pas deux mois de convalescence suite à l’accouchement; souvent la femme retourne au travail dès qu’elle tient sur ses jambes, et d’ailleurs, dès qu’elle a accouché et a été réparée, elle doit se lever, se rhabiller et se rendre elle même à la chambre de repos, où elle s’allongera avec toutes les autres femmes ayant accouché dans les 6 heures la précédant, et elle obtiendra son congé 6 heures plus tard à moins de saignements importants.
Effectivement, c’est un peu plus bref que chez nous. Il n’y a pas d’enseignement pour l’allaitement, ni les soins du bébé; cette information est passée de mère en fille. Le placenta, les pagnes souillés et les caillots récupérés de l’accouchement sont mis dans un seau et remis à la famille, laquelle a la responsabilité le ramener à la maternité propre.
Cette approche très simplifié fonctionne, malgré les limites de l’environnement. Les bébés en revanche, sont d’autant plus extraordinaires, venant au monde avec de grands cris and de grands yeux. Leur réflexe de succion est triomphant, alors qu’ils sont mesurés, pesés et laissés sous un incubateur jusqu’à ce qu’on ait fini avec la mère. Nous passons le plus de temps possible à les tenir et les cajoler; les matrones rigolent un peu en nous regardant, car l’attention que nous portons à ces petits doit sembler terriblement excessif comparé à la norme sociale. Ils n’ont jamais critiqué ce geste, par contre, alors au moins nous n’offensons personne.
Le gros choc que nous avons toutes eu, étant toutes éduquées selon la philosophie du caring, est justement l’absence de celui-ci. Les femmes se font tenir les lèvres fermées lorsqu’elles veulent crier leur douleur. Elles se font traiter de désobéissantes et les matrones (un compromis entre une sage-femme et une doula) les giflent si elles se plaignent. Les lits de naissance sont trop courtes et les femmes manquent de s’assommer sur la barre à la tête du “lit”. Les avortements (suite à une fausse couche) sont effectuées sans cérémonie, la canule d’aspiration pleine de caillots souvent visible à la mère durant la totalité de la processus. Lorsque le médecin a fini, c’est hop! Debout et au tour de la suivante.
Et pourtant personne ne proteste. La naissance est une réalité, un élément de la vie d’une femme, pas un miracle ni un évènement spécial. Et tant bien que je sens dans mes mots un jugement que je me suis juré de garder pour moi-même, je sais que lorsque je suis en salle d’accouchement, m’indigner n’aiderait pas la patiente et ne changera rien. Je m’abstiens donc des commentaires et je fais ce que je peux dans la limite permise: massages dans le bas du dos pour soulager la douleur, une compresse froide pour une primipare terrifiée, quelques mots de bambara pour encourager une jeune femme dont l’agonie se prolonge des heures de plus que prévue, une berceuse pour celle qui se fait avorter...
On fait ce qu’on peut. Les yeux des patientes en disent beaucoup.
Les noms de famille maliennes
Il existe peu de noms de famille au Mali; en quelque sorte il faut s’y faire avec une trentaine de noms de famille, et tous ceux ayant le même nom de famille se reconnaissent comme cousins (à ne pas confondre avec la notion de cousinage, sorte de lien d’amitié entre deux membres de clans différents). Les moqueries douces en résultent: les Traorés sont toujours pressés, les Koulibali sont l’ami de tout le monde et sont simples, les Sidibés sont des Peuls arrogants mais intelligents, etc...
Il va sans dire que nous avons maintenant été baptisées maliennes:
Maude R. = Mariam Diakité
Vanessa L-M. = Samaka Koné
Laurence L-B. = Binta Koulibali
Christine N. = Nana Sidibé
Leyla D’A. K. = Aminata Koulibali
Jenny W.= Salimata Koné
Karelle D.= Aramatha Djarra
Vanessa R.= Oumou Keita
Où que l’on aille, l’emploi du nom malien aide à bâtir des ponts transculturels et à faciliter la connaissance. Imaginez l’effort requis pour un malien de prononcer un nom tel que “Christine” (qui d’ailleurs incite un peu la moquerie, puisque la majorité des maliens trouvent que de se nommer d’après Jésus Christ est arrogant, sans compter que le pays est à plus de 75% musulman) alors que “Nana” est facile et approuvée.
Le système de castes est encore très vivant au Mali, et même si l’esclavage n’existe plus officiellement, il en demeure des exemples dans les interactions entre clans (par exemples, une Kanté serait “propriétaire” d’une Keita) et l’esclavage est encore présent dans le nord du pays, chez les Touareg.
La famille d’où l’on vient suggère parfois la profession, bien qu’avec les temps modernes les jeunes prennent plus de liberté et choisissent une carrière selon leur instruction (mais souvent avec le coup de pouce de la famille). Kayes est la région la plus pauvre au Mali, et une grande partie du revenu familial vient de membres de famille en France et en Europe qui envoient jusqu’à 40% de leur salaire pour contribuer à leur survie.
Quelle que soit le sort des maliens qui quittent le pays pour des pays plus lucratifs, il semble que la pauvreté est immuable dans ce pays.
Il va sans dire que nous avons maintenant été baptisées maliennes:
Maude R. = Mariam Diakité
Vanessa L-M. = Samaka Koné
Laurence L-B. = Binta Koulibali
Christine N. = Nana Sidibé
Leyla D’A. K. = Aminata Koulibali
Jenny W.= Salimata Koné
Karelle D.= Aramatha Djarra
Vanessa R.= Oumou Keita
Où que l’on aille, l’emploi du nom malien aide à bâtir des ponts transculturels et à faciliter la connaissance. Imaginez l’effort requis pour un malien de prononcer un nom tel que “Christine” (qui d’ailleurs incite un peu la moquerie, puisque la majorité des maliens trouvent que de se nommer d’après Jésus Christ est arrogant, sans compter que le pays est à plus de 75% musulman) alors que “Nana” est facile et approuvée.
Le système de castes est encore très vivant au Mali, et même si l’esclavage n’existe plus officiellement, il en demeure des exemples dans les interactions entre clans (par exemples, une Kanté serait “propriétaire” d’une Keita) et l’esclavage est encore présent dans le nord du pays, chez les Touareg.
La famille d’où l’on vient suggère parfois la profession, bien qu’avec les temps modernes les jeunes prennent plus de liberté et choisissent une carrière selon leur instruction (mais souvent avec le coup de pouce de la famille). Kayes est la région la plus pauvre au Mali, et une grande partie du revenu familial vient de membres de famille en France et en Europe qui envoient jusqu’à 40% de leur salaire pour contribuer à leur survie.
Quelle que soit le sort des maliens qui quittent le pays pour des pays plus lucratifs, il semble que la pauvreté est immuable dans ce pays.
Monday, July 20, 2009
Cooking diaries - Crème Brûlée & Paella
True to character, my need to cook surfaced all of two days after our arrival in Kayes. We have access to a gas oven, which I thought would be a dream, except that it proved exceptionally difficult to do (more later). I decided my challenge would be to make paella for dinner and crème brûlée for dessert. Let’s run through the issues at hand in Kayes:
-forget fresh dairy. Milk is powdered and cream dosent exist unless you milk a goat and churn it yourself. Considering the elevated risk of brucelloses (a harmful bacteria), I thought it best not to chance it. So we made concentrated milk.
-if you want chicken, you have to go to the chicken market and pick out a chicken. They then kill it and clean off the Feather for you. However, the birds here just don’t have the same kind of meat on them as at home. A chicken breast is about the size of a St-Hubert chicken finger.
Leyla and I went to the chicken seller for the meat tthe night of our meal, and watching the beheading (and subsequent last dash of the headless bird - this is NOT an urban legend) was enough to remind me of why I was a vegetarian for so long. On the other hand, there is something very powerful that occurs when you connect with your food in a most basic way; it reminds us that there is a very real cost to our gluttony and to acknowledge the loss of life associated. It was both humbling and touching: it goes without saying that despite our being 12, we only had 2 chickens killed.
If only everyone’s appetite were limited by their tolerance for bloodshed.
-the final obstacle to our cooking fiesta lay within the cookware (or lack thereof). All dishes are made in large enamel tubs here (so obviously my little ramequins from home weren’t sitting on the shelves. We therefore needed to use a metal bowl too deep in an improvised bain-marie.
Necessity is the mother of invention, after all, so that night was highly creative.
The girls and I got working as soon as we got in. The crème brûlée needed to be ice cold, so we started early. The eggs here for some reason have fragile yolks, so instead of wiski 12 yolks, we wound up with 12 whole eggs, and we could look forward to a very firm crème brûlée. Leyla nearly lost her eyebrows when she tried to light the stove, as we had not figured out whether to light the top or bottom burner. Needless to say, mystery solved now! J
The oven cooked unevenly and the surface of the flan was scorched despite all our efforts and the dessert was tossed into the freezer to cool down for a few hours. Freezers here are about 2-3 degrees lower than our fridges, so you can imagine that the fridge would have been quite ineffective.
We moved on to the paella.
Leyla and Laurence prepped the onions and garlic and began sauteing them, and I got started on the chicken.
Thus began the madness...
Our dear butcher had not gutted the chickens, just cleaned the OUTER part. Aside from the fact that they were still warm for their former lives, I squirmed when I reached for the bird’s head and my fingers groped something grainy and gritty.
I forgot about the stomach. Ew. One thousand Ews.
It was, however a magnificent opportunity to engage in an impromptu dissection, and that is exactly what we did, taking turns and facing our fears. Jenny had the time of her life facing her fear of blood and guts (especially with having the pull the ribcage apart to access the intestines!) and after an hour or so, the chickens were deconstructed, meat removed, cleaned and the remains discarded with great pomp and ceremony.
The paella was made in the oven and came out quite well, despite the fact that I found it lacked its usual kick, most probably because we didn’t have the usual shrimp, mussels and sausage to top it with; it would make sense, wouldn‘t it? The girls liked it, however, and we made homemade flatbread and salsa to balance out the flavors.
For dessert, we sprinkled the crème brûlée with granulated sugar, lit the broiler and hoped for the best. The broiler flame however, was too far from the immensly tall bowl to caramelize and so the sugar half melted and the pudding came out piping hot.
But hey, let’s face it, we made CRÈME BRÛLÉE in AFRICA.
So all things taken into perspective, it was a success, and either way, we were happy to eat something other than goat and couscous.
-forget fresh dairy. Milk is powdered and cream dosent exist unless you milk a goat and churn it yourself. Considering the elevated risk of brucelloses (a harmful bacteria), I thought it best not to chance it. So we made concentrated milk.
-if you want chicken, you have to go to the chicken market and pick out a chicken. They then kill it and clean off the Feather for you. However, the birds here just don’t have the same kind of meat on them as at home. A chicken breast is about the size of a St-Hubert chicken finger.
Leyla and I went to the chicken seller for the meat tthe night of our meal, and watching the beheading (and subsequent last dash of the headless bird - this is NOT an urban legend) was enough to remind me of why I was a vegetarian for so long. On the other hand, there is something very powerful that occurs when you connect with your food in a most basic way; it reminds us that there is a very real cost to our gluttony and to acknowledge the loss of life associated. It was both humbling and touching: it goes without saying that despite our being 12, we only had 2 chickens killed.
If only everyone’s appetite were limited by their tolerance for bloodshed.
-the final obstacle to our cooking fiesta lay within the cookware (or lack thereof). All dishes are made in large enamel tubs here (so obviously my little ramequins from home weren’t sitting on the shelves. We therefore needed to use a metal bowl too deep in an improvised bain-marie.
Necessity is the mother of invention, after all, so that night was highly creative.
The girls and I got working as soon as we got in. The crème brûlée needed to be ice cold, so we started early. The eggs here for some reason have fragile yolks, so instead of wiski 12 yolks, we wound up with 12 whole eggs, and we could look forward to a very firm crème brûlée. Leyla nearly lost her eyebrows when she tried to light the stove, as we had not figured out whether to light the top or bottom burner. Needless to say, mystery solved now! J
The oven cooked unevenly and the surface of the flan was scorched despite all our efforts and the dessert was tossed into the freezer to cool down for a few hours. Freezers here are about 2-3 degrees lower than our fridges, so you can imagine that the fridge would have been quite ineffective.
We moved on to the paella.
Leyla and Laurence prepped the onions and garlic and began sauteing them, and I got started on the chicken.
Thus began the madness...
Our dear butcher had not gutted the chickens, just cleaned the OUTER part. Aside from the fact that they were still warm for their former lives, I squirmed when I reached for the bird’s head and my fingers groped something grainy and gritty.
I forgot about the stomach. Ew. One thousand Ews.
It was, however a magnificent opportunity to engage in an impromptu dissection, and that is exactly what we did, taking turns and facing our fears. Jenny had the time of her life facing her fear of blood and guts (especially with having the pull the ribcage apart to access the intestines!) and after an hour or so, the chickens were deconstructed, meat removed, cleaned and the remains discarded with great pomp and ceremony.
The paella was made in the oven and came out quite well, despite the fact that I found it lacked its usual kick, most probably because we didn’t have the usual shrimp, mussels and sausage to top it with; it would make sense, wouldn‘t it? The girls liked it, however, and we made homemade flatbread and salsa to balance out the flavors.
For dessert, we sprinkled the crème brûlée with granulated sugar, lit the broiler and hoped for the best. The broiler flame however, was too far from the immensly tall bowl to caramelize and so the sugar half melted and the pudding came out piping hot.
But hey, let’s face it, we made CRÈME BRÛLÉE in AFRICA.
So all things taken into perspective, it was a success, and either way, we were happy to eat something other than goat and couscous.
Sunday, July 19, 2009
Premiers jours à Kayes
Nos deux premiers jours à Kayes avaient pour but de nous orienter dans le système de santé régional et local. Karim (auquel je réfèrerai souvent comme Dr. Diakité, puisqu’il est MD de formation) nous accompagna afin que nous puissions rencontrer le directeur régional de la santé (un peu comme de le directeur du ASSS de Montréal) et plusieurs professionnels au niveau administratif.
Nous avons fait la connaissance de Dr. Lucie Lemieux, anciennement Directrice de Santé Publique de la Région de l’Outaouais, qui collabore avec le système de santé ici à Kayes. Elle nous a aidés à identifier les grandes problématiques de santé et les obstacles à leur résolution.
Les plus grands défis sont au niveau de la santé des femmes et des enfants, car le taux de mortalité infantile et maternelle est très élevé et demeure une priorité du gouvernement.
Les causes de décès principales chez les femmes sont:
-L’hémorragie lors de l’accouchement
-L’éclampsie
-L’infection post-partum
Les enfants, par contre, succombent à:
-la malnutrition
-le paludisme (la malaria)
-les infections respiratoires
Ces décès sont tous évitables si les mesures sanitaires et l’accès à une saine alimentation peuvent être améliorés. L’accès aux soins est un énorme défi également, et la responsabilité repose autant sur les épaules des utilisateurs que du système de santé. Plusieurs patients meurent à chaque année parce qu’ils refusent de consulter (pour des raisons culturels ou personnels), consultent trop tard ou n’ont pas l’argent pour payer les frais des soins. Souvent la consultation est gratuite mais le matériel employé dans les soins doit être acheté avant de pouvoir administrer les soins. Plus fréquemment qu’on ne voudrait, une femme meurt suite à une crise d’éclampsie parce que après ses premiers symptômes, elle a attendu de demander d’aller à l’hôpital, puis a dû attendre la décision de son mari ou de sa famille par rapport aux frais. Si la famille accepte de payer les frais et trouve l’argent requis, ils doivent ensuite se rendre à l’hôpital, qui peut être jusqu’à 6 heures de route. Le temps d’y arriver, elle est déjà dans un coma profond et meurt, ainsi que son enfant peu après.
Le coût d’assistance à un accouchement est de 1000CFA, c’est à dire 2$. Pour vous le mettre en perspective, c’est le coût de 4 litres d’essence, et tout le monde à des motos, mais peu de gens dépensent les sous pour l’accouchement.
Suite à notre rencontre avec les dirigeants du cercle de Kayes, Dr. Diakité nous offrit une présentation du système de santé malien et nous distribua notre horaire. Nous ferons des rotations en maternité, pédiatrie, dermato, CSRef (CLSC) et CSComm (brousse). Ceci devrait nous offrir une expérience globale et nous exposer aux mêmes défis auxquels le personnel régulier doit faire face quotidiennement.
Après le dîner, nous eurent la chance de faire une belle sieste et de nous accoutumer à nos quatre autres collègues. Relativement jeunes et admises en médecine directement du cégep, elles ont néanmoins un très bon sens de l’autocritique et il nous fait énormément de bien de partager nos perspectives et de comprendre le processus mental médical, qui est très différent du processus infirmier.
Une note sur la cuisine malienne.
Ceux qui me connaissent personnellement savent à quel point la cuisine (et par conséquence le contrôle de la pièce de la maison concernée) est importante pour moi. Le fait de reléguer la préparation des repas est un processus de détachement qui m’a pris deux mois de préparation mentale CONSCIENTE. Je suis donc arrivée à Kayes prête à accepter que je ne pourrais pas faire de cuisine. Imaginez donc le choc lorsque notre premier repas nous arrive et qu’il est très salé et gras. Un petit pétage de coche interne s’ensuit. Les autres filles s’en rendront compte lors du 7e jour du même plat. Choyées telles que nous le sommes au Québec, la diversité est toujours au menu. Ici, nous devrions évidemment reconnaître notre bonne fortune d’avoir trois repas par jour, mais il va sans dire que lorsque le repas est toujours composé d’une viande (tendre, je l’avoue, mais salée en titi!) en sauce à l’huile de palme et d’un féculent, il est assez facile d’avoir des rages de salade. Sans compter l’effet de manger du riz en grande quantité: ça constipe! Donc cette diète n’est pas géniale pour ceux et celles ayant des troubles intestinaux, des limitations au niveau du cholestérol, ou qui sont végétariens ou en forme. Je suis convaincue que d’ici deux semaines, nous allons suer l’huile de palme.
Et suer est un sport ici. Dos, mains, visage, plante des pieds et craque des fesses, nous en faisons de véritables discussions de groupe!
La température moyenne à Kayes LA NUIT est de 30-32 degrés Celcius. Elle descend à 28 lorsqu’il pleut.
Vive les petits climatiseurs dans nos chambres. Lorsqu’ils fonctionnent.
Le troisième jour, nous recevons la nouvelle qu’il fait toujours un temps de chien à Montréal avec des températures allant de 15 à 20 degrés. Apparemment, c’est chiant des deux bords de l’Atlantique. Solidarité assurée!
Lessive:
L’activité de choix ici, car nous avons peu à faire en dehors de nos heures de stage. Nous prenons deux heures à laver nos petits sous-vêtements avec une brosse à ongles, et nous jasons de tout et de rien.
Vraiment de tout et de rien.
Le reste du temps est passé à discuter de notre adaptation gastro-intestinale, qui se fait vite pour certaines et moins vite pour d’autres, de ce qu’il nous manque de chez nous, et de la chaleur qu’il fait.
KAYES
Kayes est une ville d’environ 10 000 habitants, et la première chose qui saute aux yeux est la pauvreté abjecte. À l’opposé de la capitale Bamako, il n’y a pas de “beau” quartier, ni de nouveaux quartiers où les édifices sont en béton et les fenêtres ont de la vitre. Tout le monde vit dans des vieilles maisons à un étage ou des cases rudimentaires en bois. Ils dorment à terre ou à cinq sur des mince matelas de mousse ou des tapis de plastique tissé. Toute la ville ressemble à un immense dépotoir ou un bidonville des plus délabrés. Et c’est la norme. Peut-être est-ce la raison pour laquelle il n’y a pas de violence ici. Il n’y a rien à envier, à l’exception près des voitures de certains et des ONG. Mais encore, personne ne se plaint, ni cherche à faire du mal à autrui.
La politesse et les salutations sont attendus de tous, et une fois la langue locale, le bambara, maîtrisée, il nous sera facile de traverser ce pont interculturel pour compléter notre immersion.
Malheureusement, le bambara s’avère un défi de taille, car la grammaire est assez complexe et ce n’est pas la seule langue du Mali. En fait, le Mali inclut OFFICIELLEMENT 10 langues et 10 millions de personnes. Cela remet en perspective nos petites disputes entre anglophones et francophones au Québec.
J’écrirai davantage dès que possible.
Nous avons fait la connaissance de Dr. Lucie Lemieux, anciennement Directrice de Santé Publique de la Région de l’Outaouais, qui collabore avec le système de santé ici à Kayes. Elle nous a aidés à identifier les grandes problématiques de santé et les obstacles à leur résolution.
Les plus grands défis sont au niveau de la santé des femmes et des enfants, car le taux de mortalité infantile et maternelle est très élevé et demeure une priorité du gouvernement.
Les causes de décès principales chez les femmes sont:
-L’hémorragie lors de l’accouchement
-L’éclampsie
-L’infection post-partum
Les enfants, par contre, succombent à:
-la malnutrition
-le paludisme (la malaria)
-les infections respiratoires
Ces décès sont tous évitables si les mesures sanitaires et l’accès à une saine alimentation peuvent être améliorés. L’accès aux soins est un énorme défi également, et la responsabilité repose autant sur les épaules des utilisateurs que du système de santé. Plusieurs patients meurent à chaque année parce qu’ils refusent de consulter (pour des raisons culturels ou personnels), consultent trop tard ou n’ont pas l’argent pour payer les frais des soins. Souvent la consultation est gratuite mais le matériel employé dans les soins doit être acheté avant de pouvoir administrer les soins. Plus fréquemment qu’on ne voudrait, une femme meurt suite à une crise d’éclampsie parce que après ses premiers symptômes, elle a attendu de demander d’aller à l’hôpital, puis a dû attendre la décision de son mari ou de sa famille par rapport aux frais. Si la famille accepte de payer les frais et trouve l’argent requis, ils doivent ensuite se rendre à l’hôpital, qui peut être jusqu’à 6 heures de route. Le temps d’y arriver, elle est déjà dans un coma profond et meurt, ainsi que son enfant peu après.
Le coût d’assistance à un accouchement est de 1000CFA, c’est à dire 2$. Pour vous le mettre en perspective, c’est le coût de 4 litres d’essence, et tout le monde à des motos, mais peu de gens dépensent les sous pour l’accouchement.
Suite à notre rencontre avec les dirigeants du cercle de Kayes, Dr. Diakité nous offrit une présentation du système de santé malien et nous distribua notre horaire. Nous ferons des rotations en maternité, pédiatrie, dermato, CSRef (CLSC) et CSComm (brousse). Ceci devrait nous offrir une expérience globale et nous exposer aux mêmes défis auxquels le personnel régulier doit faire face quotidiennement.
Après le dîner, nous eurent la chance de faire une belle sieste et de nous accoutumer à nos quatre autres collègues. Relativement jeunes et admises en médecine directement du cégep, elles ont néanmoins un très bon sens de l’autocritique et il nous fait énormément de bien de partager nos perspectives et de comprendre le processus mental médical, qui est très différent du processus infirmier.
Une note sur la cuisine malienne.
Ceux qui me connaissent personnellement savent à quel point la cuisine (et par conséquence le contrôle de la pièce de la maison concernée) est importante pour moi. Le fait de reléguer la préparation des repas est un processus de détachement qui m’a pris deux mois de préparation mentale CONSCIENTE. Je suis donc arrivée à Kayes prête à accepter que je ne pourrais pas faire de cuisine. Imaginez donc le choc lorsque notre premier repas nous arrive et qu’il est très salé et gras. Un petit pétage de coche interne s’ensuit. Les autres filles s’en rendront compte lors du 7e jour du même plat. Choyées telles que nous le sommes au Québec, la diversité est toujours au menu. Ici, nous devrions évidemment reconnaître notre bonne fortune d’avoir trois repas par jour, mais il va sans dire que lorsque le repas est toujours composé d’une viande (tendre, je l’avoue, mais salée en titi!) en sauce à l’huile de palme et d’un féculent, il est assez facile d’avoir des rages de salade. Sans compter l’effet de manger du riz en grande quantité: ça constipe! Donc cette diète n’est pas géniale pour ceux et celles ayant des troubles intestinaux, des limitations au niveau du cholestérol, ou qui sont végétariens ou en forme. Je suis convaincue que d’ici deux semaines, nous allons suer l’huile de palme.
Et suer est un sport ici. Dos, mains, visage, plante des pieds et craque des fesses, nous en faisons de véritables discussions de groupe!
La température moyenne à Kayes LA NUIT est de 30-32 degrés Celcius. Elle descend à 28 lorsqu’il pleut.
Vive les petits climatiseurs dans nos chambres. Lorsqu’ils fonctionnent.
Le troisième jour, nous recevons la nouvelle qu’il fait toujours un temps de chien à Montréal avec des températures allant de 15 à 20 degrés. Apparemment, c’est chiant des deux bords de l’Atlantique. Solidarité assurée!
Lessive:
L’activité de choix ici, car nous avons peu à faire en dehors de nos heures de stage. Nous prenons deux heures à laver nos petits sous-vêtements avec une brosse à ongles, et nous jasons de tout et de rien.
Vraiment de tout et de rien.
Le reste du temps est passé à discuter de notre adaptation gastro-intestinale, qui se fait vite pour certaines et moins vite pour d’autres, de ce qu’il nous manque de chez nous, et de la chaleur qu’il fait.
KAYES
Kayes est une ville d’environ 10 000 habitants, et la première chose qui saute aux yeux est la pauvreté abjecte. À l’opposé de la capitale Bamako, il n’y a pas de “beau” quartier, ni de nouveaux quartiers où les édifices sont en béton et les fenêtres ont de la vitre. Tout le monde vit dans des vieilles maisons à un étage ou des cases rudimentaires en bois. Ils dorment à terre ou à cinq sur des mince matelas de mousse ou des tapis de plastique tissé. Toute la ville ressemble à un immense dépotoir ou un bidonville des plus délabrés. Et c’est la norme. Peut-être est-ce la raison pour laquelle il n’y a pas de violence ici. Il n’y a rien à envier, à l’exception près des voitures de certains et des ONG. Mais encore, personne ne se plaint, ni cherche à faire du mal à autrui.
La politesse et les salutations sont attendus de tous, et une fois la langue locale, le bambara, maîtrisée, il nous sera facile de traverser ce pont interculturel pour compléter notre immersion.
Malheureusement, le bambara s’avère un défi de taille, car la grammaire est assez complexe et ce n’est pas la seule langue du Mali. En fait, le Mali inclut OFFICIELLEMENT 10 langues et 10 millions de personnes. Cela remet en perspective nos petites disputes entre anglophones et francophones au Québec.
J’écrirai davantage dès que possible.
Monday, July 13, 2009
Last night in Bamako and the road to Kayes
Our last evening was in the spirit of friendship and we did our groceries at the little European grocery store, Le Azar. We bought white wine, pasta, mushrooms and cheese and ha ourselves a feast. We even got mangoes and ate them chilled in the freezer. Agnes joined us for a glass and we regaled her with our adventures.
4am came early, but we were ready, and after a mere two hour delay, waiting in line being courted by flies and trying to avoid getting dried fish juice (this is a frequent occurrence when it rains on the food bags they pack in the buses), we were on board. By then I had nearly had a panic attack, and I felt as though anyone would make me snap, even though this mode of transport was infinitely better than our last. We had read that the company we were travelling with had clean, new buses, with air conditioning and bathroom. If you were to COMPLETELY reverse those qualities, you would get something close to our bus. It smelled like urine on board, there WAS NO BATHROOM (which is fine for 2 hours, but 9 hours? ) and the only similarity to our buses is that it was packed. People, coolers, children and bags of all kinds made me feel like as though I was a handbag in a storage closet. My seat was damp, but thank God I was in the window seat. In that moment, tormented by flies and severely deprived of coffee with three hours of sleep in my system, I brooded under a homicidal cloud. Not targeting anyone, of course, I was just harbouring a general resentment towards anything that moved.
At last, wer’e off! Personally, I had had enough of Bamako and couldn’t wait to get to work. Along the way, the bus halted a few times so that vendors from local villages could run up to the windows and do their business, selling anything from hard-boiled eggs and peanuts to fruit, chilled water and lait caillé (a form of yogurt….I just couldn’t get past the name, or the undetermined time the dairy-filled packets had sat out in the sun). Then, two hours after departure, having drank half my water from the heat, my bladder rang and let me know it was time to void. Bladders, naturally, not accounting for environmental factors, was very insistent but was nice enough to let me tough out another two and a half hours (at least half an hour of which was spent doing the pee dance in the isle, yep Mum, I did it in public!) until we reached the half-way point and stopped for lunch.
Quite literally in a dump.
Mind you, many places, having no garbage disposal system, really do look like dumps, despite very little actual waste. A small cantina offered rice-based dishes on the fly and cold soft drinks to those who ate fast enough, but somewhere in my mind, the thought of being car-sick for another four and a half hours far outweighed being hungry. We would eat on arrival anyhow and I had peanuts on me. God bless praline peanuts, though I think I won’t ever eat them again after Africa.
We departed fifteen minutes later, and this time stopped only long enough to drop off passengers before hitting Kayes. Driving through town was like riding through sketchy parts of Harlem; after Kangaba, nothing felt friendly and we were all excessively tired by that point. We were yelled at by two different people when we got off the bus, in a language too fast and too foreign for us to understand, we were muddy, sweaty and after finally getting all our luggage, we piled into a corner and called Karim, our contact, who had told us he would meet us on arrival at the station.
Travel is such a learning experience.
Apparently, there were two bus stations in Kayes (which is funny, because there’s only one ATM) on opposite sides of the river, and he was waiting for us on the other side. He asked us to make our way there and then our connection became difficult, so all we heard was “make your way over here and I’ll wait for you”. This didn’t help our mood until a nice guy who worked at the station explained that recent rain had flooded the old bridge, and because the new one wasn’t finished yet, the government was only allowing big trucks across, and as such, only one direction at a time. He arranged for us to hop of the connecting shuttle and get a lift across town, which with waiting, misunderstandings and traffic, took 2 ½ hours. (The actual travel time was around 30 minutes). We posted a funky video on YouTube of our crossing, we’ll try to put it up soon, check every few days, it’s totally worth it!
At last, we arrived at our compound. Karim is very kind, a stern but warm public health official who was trained as an MD, and he was very welcoming and calm when we hauled ourselves off the bus like warhorses, which had a wonderfully therapeutic effect on us.
We drove through our part of Kayes to a neighborhood called Lafiabougou (translated “neighborhood of peace”) and entered a tree filled compound with concrete buildings, and at last we saw the other girls. We were ecstatic. We also met the four other girls from Université Laval who are completing their medical studies and staying at l’ACAUPED coop as well.
Somewhere between receiving directives from younger girls and being ridiculously tired and short-tempered, I began to snap. Some of the girls like to smoke now and then, the Laval girls asked us (in what seemed to be a curt manner) to find an isolated spot outside to smoke. Not the best way for them to relax. Then they immédiate jumped on the issue of internet use and told us we would have to devise a Schedule. And so on and so forth....Bah!
I couldn’t deal with it well, and then we finally ate, after 14 hours without a meal, and were had this reheated, incredibly salty stew on fried noodles, and there wasn’t enough to go around. As a general rule, when something manages to destroy my appetite, I quit. So I quietly put away my dishes and hit the sac, sniffling a bit to not yell. I wanted to, I really did.
I don’t believe it was because of the girls or the rules or the food. Leyla reassured me we would feel better the next day, and sure enough, we did. I just didn’t factor in how tired I really was.
4am came early, but we were ready, and after a mere two hour delay, waiting in line being courted by flies and trying to avoid getting dried fish juice (this is a frequent occurrence when it rains on the food bags they pack in the buses), we were on board. By then I had nearly had a panic attack, and I felt as though anyone would make me snap, even though this mode of transport was infinitely better than our last. We had read that the company we were travelling with had clean, new buses, with air conditioning and bathroom. If you were to COMPLETELY reverse those qualities, you would get something close to our bus. It smelled like urine on board, there WAS NO BATHROOM (which is fine for 2 hours, but 9 hours? ) and the only similarity to our buses is that it was packed. People, coolers, children and bags of all kinds made me feel like as though I was a handbag in a storage closet. My seat was damp, but thank God I was in the window seat. In that moment, tormented by flies and severely deprived of coffee with three hours of sleep in my system, I brooded under a homicidal cloud. Not targeting anyone, of course, I was just harbouring a general resentment towards anything that moved.
At last, wer’e off! Personally, I had had enough of Bamako and couldn’t wait to get to work. Along the way, the bus halted a few times so that vendors from local villages could run up to the windows and do their business, selling anything from hard-boiled eggs and peanuts to fruit, chilled water and lait caillé (a form of yogurt….I just couldn’t get past the name, or the undetermined time the dairy-filled packets had sat out in the sun). Then, two hours after departure, having drank half my water from the heat, my bladder rang and let me know it was time to void. Bladders, naturally, not accounting for environmental factors, was very insistent but was nice enough to let me tough out another two and a half hours (at least half an hour of which was spent doing the pee dance in the isle, yep Mum, I did it in public!) until we reached the half-way point and stopped for lunch.
Quite literally in a dump.
Mind you, many places, having no garbage disposal system, really do look like dumps, despite very little actual waste. A small cantina offered rice-based dishes on the fly and cold soft drinks to those who ate fast enough, but somewhere in my mind, the thought of being car-sick for another four and a half hours far outweighed being hungry. We would eat on arrival anyhow and I had peanuts on me. God bless praline peanuts, though I think I won’t ever eat them again after Africa.
We departed fifteen minutes later, and this time stopped only long enough to drop off passengers before hitting Kayes. Driving through town was like riding through sketchy parts of Harlem; after Kangaba, nothing felt friendly and we were all excessively tired by that point. We were yelled at by two different people when we got off the bus, in a language too fast and too foreign for us to understand, we were muddy, sweaty and after finally getting all our luggage, we piled into a corner and called Karim, our contact, who had told us he would meet us on arrival at the station.
Travel is such a learning experience.
Apparently, there were two bus stations in Kayes (which is funny, because there’s only one ATM) on opposite sides of the river, and he was waiting for us on the other side. He asked us to make our way there and then our connection became difficult, so all we heard was “make your way over here and I’ll wait for you”. This didn’t help our mood until a nice guy who worked at the station explained that recent rain had flooded the old bridge, and because the new one wasn’t finished yet, the government was only allowing big trucks across, and as such, only one direction at a time. He arranged for us to hop of the connecting shuttle and get a lift across town, which with waiting, misunderstandings and traffic, took 2 ½ hours. (The actual travel time was around 30 minutes). We posted a funky video on YouTube of our crossing, we’ll try to put it up soon, check every few days, it’s totally worth it!
At last, we arrived at our compound. Karim is very kind, a stern but warm public health official who was trained as an MD, and he was very welcoming and calm when we hauled ourselves off the bus like warhorses, which had a wonderfully therapeutic effect on us.
We drove through our part of Kayes to a neighborhood called Lafiabougou (translated “neighborhood of peace”) and entered a tree filled compound with concrete buildings, and at last we saw the other girls. We were ecstatic. We also met the four other girls from Université Laval who are completing their medical studies and staying at l’ACAUPED coop as well.
Somewhere between receiving directives from younger girls and being ridiculously tired and short-tempered, I began to snap. Some of the girls like to smoke now and then, the Laval girls asked us (in what seemed to be a curt manner) to find an isolated spot outside to smoke. Not the best way for them to relax. Then they immédiate jumped on the issue of internet use and told us we would have to devise a Schedule. And so on and so forth....Bah!
I couldn’t deal with it well, and then we finally ate, after 14 hours without a meal, and were had this reheated, incredibly salty stew on fried noodles, and there wasn’t enough to go around. As a general rule, when something manages to destroy my appetite, I quit. So I quietly put away my dishes and hit the sac, sniffling a bit to not yell. I wanted to, I really did.
I don’t believe it was because of the girls or the rules or the food. Leyla reassured me we would feel better the next day, and sure enough, we did. I just didn’t factor in how tired I really was.
Kangaba - Stearcus Accidit
On Day 5, we were intending to head to a place known as Camp Kangaba, where we would have the opportunity to learn to play traditional instruments, such as the djembé and kora, and learn bambara and local dances. So we made our way to the bush taxi terminal and asked to head to Kangaba, about 100 km south of the capital. Negotiations completed, we climbed aboard a 20-person minivan in 38 degree weather. Needless to say, this was not your average Greyhound. I guess you could say that seating all five of us across one 5 foot row of seats made us all feel really close, if not a bit sticky. Yesh.
But the ends justify the means, and we headed out finally an hour late, Maude and I gripping Vanessa for dear life as the side door (this term is used loosely: a door implies a functional lock and at least two pieces of metal, this one guaranteed nothing) slid open violently at each stop in town. You see, as she was seated closest to the door, it required her to press most of her hips against the door so we could all fit.
A small note to consider: we also had two sick girls with us. Maude had come down with a classic cold (which unfortunately, doesn’t live up to the “cold” criteria at all in this heat) and Laurence had herself a violent case of traveller’s stomach flu. So being cooped up in a hot, noisy bus, where we couldn’t see ahead, did little to soothe the girls’ symptoms. Luckily, the meds and rumble of the truck knocked out Laurence, and Maude was able to find a more comfortable position to sit in for most of the trip. Either way, it was a wonderful exercise in claustrophobia management.
Three hours of sweating and gravol chewing later, we were out of both water and energy. In heat like this, after a while, your mouth feels as though its coated in a thin film of gluey mashed potatoes, and any room temperature water you drink ceases to quench your thirst; you simply don’t feel its effects. The bus at last came to a halt, and after some awkward exchange in French-bambara, we understood we were in Kangaba. Our understanding was that the camp coordinator was expecting our call and would pick us up in the town terminal. We piled our backpacks into a heap and placed the call as the locals politely observed the five white strangers who seemed to drop out of nowhere into their quiet village.
Then two funny (or rather not so funny) things happened:
1- The man expecting our call had his phone turned off.
2- The locals had never heard of a camp Kangaba, but insisted that the place we were in was indeed Kangaba.
Leyla and Vanessa spotted some locals who seemed highly atuned to our situation and went to seek information, since the sun was setting quickly and we really felt as though we were in the boonies of the world. (I believe the wording “anus de la planète” is closer to our thoughts at that moment)
While the girls were gone, we sat on an old wooden bench kindly brought out by a phone booth owner by the name of Ladji Kébé. Side note: in Mali, phone booths are owned privately, and are a sort of shack where one can obtain phone, fax (if you’re lucky) and photocopying services. They’re scattered across the country like Tim Hortons, and are rarely hard to find. Rarer ar the ones with reliable service, however.
As we waited, exhausted, staring at the dusty road despite our best efforts to seem hospitable, the little children of the area were tentatively pointing, giggling, sometimes looking directly at us. One little girl seemed to be pondering whether or not to touch my hair, which by all accounts probably reminded her of a donkey’s mane in that moment, both in color and texture.
Ladji Kébé, as it turned out, was a very educated, open man who took great joy in reading classic French literature and philosophy. He was self taught and because of this, his interpretations of Diderot and Montesquieu offered an entirely new slant of the subject. He explained how he has been using stories by Victor Hugo and Jean de Lafontaine to teach morals and values to the village children; this fascinated me, because so few children are educated, and primary education teaches you to “know”, not necessarily to think for yourself. I promised to visit the next day to discuss philosophy and our education system. He asked me if I was a university philosophy teacher, because he thought I spoke well; I told him my husband is and taught me many things (you cannot say you have a boyfriend in Africa, it doesn’t work. You NEED to be married to be left in peace. Based on an evolution in my interactions with locals, I now also have a daughter named Simka, she’s a bit overweight - btw, that’s my CAT I’m talking about)
The girls returned soon after and explained to us what had happened. A man named Hervé, a white man, had visited Kangaba and fallen in love with their traditional dances and instruments. He purchased many and learned what he could, then set up shop ten minutes south of Bamako, in a place he named “Camp Kangaba”, which obviously has left the inhabitants of the real town infuriated and has left many travelers looking for the camp stranded.
But hey, we had the real deal, so why not stay?
We decided to decline the invitations to stay with a local family because we needed our space, but more importantly, we didn’t want to inconvenience them with two sick girls and five hungry mouths to feed (the family already included some 9 children). Thus, we made our way to the only hotel in town and settled in for the night.
Hospitality is Mali’s single most defining trait. Everywhere you go, people salute you. When you tell them where you are from, they respond “soyez les bienvenus”, ie, “you are most welcome”. Smiles are wonderful and tea is passed around with great care and generosity. You will never be turned down if you ask for directions or help. In fact, Mali is the only country where I have ever felt so safe walking (of course, never alone, but even Montreal has its dark alleys). If you visit a town, you must not refuse tea or a gift. Ever. It is an insult to them and you honor them by accepting. Nice change from touristy places where everyone’s trying to sell you their crap.
We left Laurence to rest at the hotel as she was in no condition to eat and found ourselves a little cantina in the village square. After much translation, we figured out the simple system: every portion costs 100CFAs (20¢) and you put into your plate whatever combination of items they have that day. On the menu that night: spaghetti with a very thin tomato sauce, couscous with onions, fried plantain, fried perch from the river and hard boiled eggs, a staple in Mali it seems (the eggs are hard boiled then kept in their shells until consumption: this greatly extends their shelf life and makes a handy snack on the road). We took a little of everything but abstained from the fish…somewhere along the line even my culinary cahones had limits.
Total: 800 CFAs for four girls: we ate for 1$ each.
Satisfied, we made our way back to the hotel, showered and tucked in for the night, not knowing what we were doing the next day or when we would head back to Bamako. It caused a bit of apprehension, because two days later we were expected to begin our internship in Kayes, on the other side of the country.
The following morning, Vanessa and Leyla confirmed that indeed, we would need to leave the very next morning, early. 4 AM early. There was only one bush taxi per day to get to Bamako, and it’s first come, first seated. Hundreds of people travel from villages to the capital every day, and that’s the cheapest way to get there…our odds weren’t great, and we couldn’t take a bus from Kangaba directly to Kayes, it doesn’t exist. We therefore did what you do when in Africa: we told ourselves we’d figure it out; at some point.
After breakfast and a hot cup o coffee to wash away a case of angry blues I had waking up, we set out to take a nice walk to meet the French man who lived in Kangaba who had been nice enough to explain the Camp Kangaba mess to us the night before. We never made it there, here’s why:
About 200m down the road from the hotel, a large gathering of women, all wearing their lovely boubous, sat under rich, green trees, sewing and chatting lively. An old man (looking very ragged indeed) and a tall woman in her mid forties approached us and began speaking in very good french. An hour later we were still talking, discussing womens’ issues in Mali such as education, the right to work and women’s rights over their bodies. The reality is that in Mali, with a few exceptions, women are simply too tired to do anything other than housework. With girls’ literacy rates at around 35%, they get married young and have children young, so they never really keep going. A woman’s day begins before dawn. She cooks all the meals, fixes the children’s and her husband’s clothes, cleans the house, then works in the field, cares for the children and (if she has time), takes them to be vaccinated or cared for. Then the evening meal needs to be cooked, so if there’s millet on the menu, she needs to clean, shuck and pound it before she can cook it. Most homes don’t have more electricity, so try to imagine the work this involves, all in 40°C weather. The men (not in all areas, but many) sit in their chairs in the shade and chat, have tea and wait for lunch to be served to them by the women. Visualize African lions if you like: a male that occasionally protects and leads the tribe, and the females that do everything else.
Women have no right to their body. Aside from the fact that marriage sanctifies a woman’s body to her husband so no other can touch her, her body belongs to him. You’ll always hear two visions of a marriage: the husband will assure you that rape is a grave offence and that no husband can force his wife; most women we spoke to said that no matter how they’re feeling, sex is imposed, if not they may be beaten until they can hardly move, then the husband will have his way anyhow because they give up. There’s a womens’ march in Kayes while we’ll be there; we’ll be joining it. Don’t worry, it’s not risky at all, the government encourages the march, but it’s the one day every year where women march to remind the world how much they actually do. That one day of them not working often paralyzes the harvest for a week.
We were shown by Astan, the leader, how she and others are leading workshops around Mali to teach women trade skills such as fabric dying, soap making and sewing in order for them to earn extra money between harvests. She also teaches them to manage money: this gives women power and knowledge to handle her money with care so she can use it towards medical care for herself (just a basic assistance in birth costs 1000CFAs, around 2$ and a week’s salary for a family) or her children.
She also coordinates the regional HIV/AIDS prevention-education effort, which is an enormous job because in many areas, condoms are still frowned upon and fidelity is considered prevention. One sign we saw showed two figures (one male, one female): beneath then man’s picture, a condom is shown; beneath the woman’s, the word “fidelity” is inscribed. The message feels a little lopsided, especially since often condom use must be insisted upon by women in order to assert themselves.
Astan asked us if we would be having any clothing made while in Africa. We had been considering it, and because the fabric was being dyed in front of us, we each chose our fabric and our color of choice, and the women would deliver it that evening. We set a price at 5000CFAs (10$) for two meters, and of course didn’t bargain. You don’t get any more fair trade than that.
We continued on our way with the old man as our guide (named Kanté, shown below with Maude). He had been a tile maker in Côte d’Ivoire most of his life, but was very educated and proud to show us his town. We met with various officials, including the mayor of a local
commune and we were allowed to visit the local hospital, which was to say thee least, rudimentary. It made the M*A*S*H OR look like the Mayo Clinic. A standard desk lamp with an incandescent bulb was used for lighting, there were blood stains on the floor and the room was so small there was no way to have a circulating nurse go around the room without contaminating the field. When asked about the sensitive question of complications related to female circumcision, he became uncomfortable and insisted that he’d only seen one surgical complication in 8 years. Considering labial cysts (which is a nice way of saying the skin of the woman’s excised genitalia becomes infected and abscessed) are the most common and that most excisions are performed with no sterile conditions, no follow-up and in the case of Type III, known as Infibulation (see this site for more information: INSERT SITE ) many if not most women are left with a small hole to let urine and blood through, it seems unlikely that complications are that rare. I don’t know the official numbers, but I do know the doctor we spoke with minimized them. What we do know is that 98% of women are circumcised in Types I, II and III in the Kayes region, so we knew what was coming.I never disrespect people in their values. If you tell me you believe what you’re doing is right according to your culture, I won’t argue it because it’s YOUR culture. But if you’re a medical professional who has a responsibility towards the health and well-being of his patients, you cannot argue that the practice of excision doesn’t have adverse effects on a woman’s health. Fess up and say it’s cultural. I’ll fight you on medical grounds and maybe then, we can have a discussion. On a side not, he was very nice and expressed a lot of concern in regards to womens’ health and problems in birthing and infant malnutrition. Go figure.
We left the hospital very tired but better prepared for what to expect in rural medecine.
Soon came lunch, then a quick stop to discover kola nuts, a sort of nut renown for their stimulant properties and traditionally given to elders or griots (the Malian equivalent of a bard-poet-shaman) as thanks or as a sign of respect.
Evening was quickly approaching, and we had never made it to our original destinations. I made a quick pit-stop at the telephone guy/ professor’s to say hi and exchange information. I also left him my copy of Emile Zola’s Le Ventre de Paris to read and teach with; it’s a good story to teach african youngsters dreaming of Paris. He thanked me and said he hoped one day I would return with Dave to stay with him and his family. Hopefully, we’ll stay in touch.
Just before dinner we made arrangements to head back to Bamako on the ONLY bus available, at 4 am. It’s first come first served, but the villagers and one of the merchants we very kind when we explained our urgent need to make it back to the capital and together, they arranged to guarantee us our seats, and even pick us up at the hotel so we wouldn’t have to walk the 2km to the town square for pick up. Nicely enough, they never raised their price.
Our night was brief and bumpy. I stayed awake, staring in the dark, anticipating our missing our 4 am lift. I tossed and turned, fully clothed, everything packed, braced for impact.
They knocked on our door at 3:30 AM. Apparently they were even more antsy than I was. We grabbed our things, and then it had to happen, like a landmark:
Another strap on my backpack broke.
The second buckle was gone at this point,, so in Kayes I’ll need to do some serious sewing. For now, it’ll hold with a lot of knot work.
By 8am we were back at Seguere in Bamako, thankfully passed out on our favorite dorm cots. Mr. Nou had let us in early with our two sick girls, we had arranged for our life the next morning at 4:30 AM to get us to the bus station, and we had been able to buy our tickets for Kayes where the bush taxi from Kangaba dropped us off because it was on their way. Three birds with one stone. Phew!
I’ll write more when I’m conscious enough.
Friday, July 3, 2009
Marché La Médine
Hier, nous avons eu l'occasion de visiter le Marché de Médine. Cette zone commerciale d'environ 1km carré renferme tous les arts et produits, du savon local jusqu'au jarret de boeuf. Tout se vend, s'échange, et c'est le centre social de Bamako. Nous y sommes rendus en taxi (un voyage de 10-15 min s'élève à 3$) et à notre arrivée, nous avons fait la connaissance d'une jeune femme au nom de Mariam qui s'est offerte comme guide. Tant mieux, car ce labyrinthe est non-seulement difficile à naviguer, mais il est très intimidant à première vue: tous les kioskes sont sous de larges bâches, des sacs imbibés de boue servent de murs entre les étalages. Bref, un labyrinthe sombre et inquiétant, car nous sommes les seuls blanc. Le français de Mariam est très bon; je me questionne sur son destin. Sera-t-elle mère de famille comme ses amies; ira-t-elle au-delà du minimum espéré pour une femme du Mali? Sera-t-elle vivante dans un an? Nous ne saurons jamais, mais son caractère robuste me porte à croire qu'elle s'en sortira bien. (elle est située à droite dans la photo)
Plus tard, nous rencontrons la famille de Mariam, ainsi que sa petite soeur. Lorsque nous la tenons dans nos bras, son petit coeur bat très, très fort et on croirait entendre un souffle pulmonaire. Ce qu'il faut se rappeler, c'est que cette petite (dans les bras de Vanessa, ci-bas) a 1 an déjà. Peu d'enfants survivent à l'âge adulte, et très peu ont le poids recommandé.
Le marché lui-même est divisé en sections. Tout d'abord, les vivres: d'énormes sacs de fèves, de riz, de semoule se succèdent, chaque vendeur nous saluant, parfois d'un ton de voix qui dit "venez voir ma belle marchandise", parfois qui dit tout simplement " je suis heureux de vous rencontrer, venez jaser".
Les salutations sont incontournables ici: obtenir l'approbation, ou du moins le sourire d'une famille est valorisant, et Laurence s'efforce, avec grand succès, de communiquer dans la langue locale, le bambara.
La prochaine section s'annonce devant nous: les textiles. Heureusement, car nous venons de passer les étalages de poisson. Entre les poissons à fraîcheur variable qui tombent des étals pour être essuyés par les vendeurs et les anguilles roulés et séchées, cet endroit n'est pas pour les coeurs sensibles. Et nous ne vous décrivons jamais assez les mouches, qui se jettent sur tout ce qui est viande, nous-mêmes inclus!
La sueur coule le long de nos bras, dos et jambes en longs filets qui nous rappellent de boire et d'accepter l'accueil de l'obre lorsque celui-ci se présente.
Les textiles sont d'une rare beauté au Mali, et aussi est-il vrai qu'aucun journal de voyage ne peut les décrire adéquatement. Les couleurs sont vives et désinhibées: le rouge est un bourgogne brûlant rappelant la terre argileuse du pays; le jaune varie, évoquant parfois la banane, parfois l'ocre. Je me noie dans la surcharge sensorielle du moment. Évidemment, les textiles, tout particulièrement, sont sujettes (comme tout au Mali) au marchandage. Les histoire des tissus et de leur futur emploi sont échangées entre vendeur et acheteur, jusqu'au prix désiré. Parfois, le consommateur se désiste et passe au prochain kiosque. Parfois le prix se trouve juste et les billets s'échangent.La prochaine section s'annonce devant nous: les textiles. Heureusement, car nous venons de passer les étalages de poisson. Entre les poissons à fraîcheur variable qui tombent des étals pour être essuyés par les vendeurs et les anguilles roulés et séchées, cet endroit n'est pas pour les coeurs sensibles. Et nous ne vous décrivons jamais assez les mouches, qui se jettent sur tout ce qui est viande, nous-mêmes inclus!
La sueur coule le long de nos bras, dos et jambes en longs filets qui nous rappellent de boire et d'accepter l'accueil de l'obre lorsque celui-ci se présente.
Il semble qu'il n'y ait jamais deux fois le même motif. Quel art extraordinaire.
Nous suivons notre jeune guide sous les bâches jusqu'à la section des salons de beauté. Il faut bien comprendre, la majorité des lecteurs imaginent des établissements avec un carrelage, des mirroirs et une panoplie de flacons et de fers à friser. Ici, rien de cela: tout est sous une tente délabrée, sans murs ni portes, à l'air du jour. Les seuls instruments visibles sont quelques peignes pour les tresses, car les esthéticiennes gardent précieusement avec elles leur propre attirail. On négocie le prix de tresses et de henné; une dame aînée rit de grandes dents blanches en pointant du doigt mes deux tresses blondes; je le prends de bon coeur. Les filles négocient une séance de henné, rite de beauté quotidien au Mali. Nous négocions 1000 FCFA (environ 2$ canadien) pour un tattoage à la main. Nous prenons chacune notre tour auprès de l'artiste, qui se met à la tâche avec une grande dextérité .
(c.f. le vidéo de YouTube.com : http://www.youtube.com/watch?v=dCw2jXXdTMs).
Entre temps, Leyla s'amuse avec sa caméra, faisant plaisir aux petits du marché qui viennent observer ces gens pâles et étranges sur qui le henné paraît si noir.
Nous quittons le marché peu après, un peu saturé de la foule et de chaleur. Encore une négotiation pour le taxi. 2000 FCFA pour les deux. Les tranports s'avèrent moins commodes car nous sommes cinq et peu de chauffeurs acceptent autant dans une voiture.
Nous rentrons pour une soirée paisible bien méritée et nous passons quelques heures à nettoyer notre dortoir, à écrire dans nos journaux et à regarder un film sur l'ordinateur.
Nous rentrons pour une soirée paisible bien méritée et nous passons quelques heures à nettoyer notre dortoir, à écrire dans nos journaux et à regarder un film sur l'ordinateur.
Caution: May Boil When in Mali
July 1st (late entry)
We landed at 3am and met our driver at around 4. Somehow, on the way to the inn where we’re staying, the two cars driving us got separated, pulled over by police and after having a near heart-attack, our drivers heads down a completely black, dirt road and takes right turns and left turns all over the place, as though he’s driving us into a perfect spot for a rape or a shooting. Appearing calm, we keep our eyes peeled until we spot the other cab and the inn, and all is well. It stills astounds me to witness the human mind in all of its paranoid glory.
The main thought going through my head, oddly enough, was something along the lines of “oh, for heaven’s sake, don’t try anything, I’m too tired to fight back right now and I’m SO not in the mood for your power trips.”
A note on the climate: whoever said that Mali was hot and dry is an evil bastard who should rot in hell. Or better yet, send them here. The moment our plane landed, we hopped out, expecting a cool, twenty degree or so breeze.
HA!
It was in fact more like 90% humidity and at least 25 degrees, so we broke a sweat on contact. Add to that the 6 hour flight, fatigue and general stress of traveling, we were sticky and exhausted by the time we hauled ourselves into the inn. Our room was just as warm, at least until we found the fans, then things got more comfortable. With contacts out and malaria medication taken, we flopped down on our very thin cots and called it a night.
We woke at 9 am to have breakfast, which was lovely and served upstairs under a cement veranda, surrounded by banana leaves and flowering bushes. It looked every so slightly colonial zed, but the whole inn manages to capture that je-ne-sais-quoi that reminds you that you’re halfway around the world in one of the most beautiful countries I’ve ever seen. They served a simple breakfast of bread, jam and coffee, and while the grainy texture of the jam makes me wonder if they use cane sugar for it, it’s easy to love the food here. The coffee is strong and we made sure we left not a drop behind, lazily reading our travel guides at the table while planning our day; we had many plans.
We set out around 11 to downtown Bamako in order to settle some logistical details. First, we needed local money, known as CFAs, or African Francs. So we head to the banks, ad of all of us, I got my visa card denied. Apparently, your PIN number needs to b 5 letters or numbers to be accepted beyond Europe (and no one bothered to MENTION this when I asked if there’s anything I need to take into account BEFORE leaving). So of course now I’m painfully stressed, despite the fact that the girls are kind enough to front me any cash I need. I make a gigantic mental note to Skype-phone CIBC Visa and RBC Visa when I get back to base.
Next stop is the immigration office. You see, when we ordered our tourist visas in Ottawa, the coordinator there suggested that we save money by getting a single month visa and requesting an extension upon arrival. Saving 150$ sounded like an excellent idea, so we banked on that. Our taxi driver, now paid and happy, dropped us off at Immigration and we are able to fill the appropriate papers, making our 20 day extension only 10$ CAD. Good savings!
By now, it’s 1:30 pm and we’re both hot and hungry, so we make our way to the Grand Marché, Bamako’s biggest place of business. Not for the faint of heart, the smells and sights of the market permeate you as you become part of the background. Not that five white girls with guide books and cameras don’t stick out, but we still felt quite at ease. Besides, with kids and adults waving and accosting you, it was a perfect opportunity to confront my panic issues.
Things went surprisingly well. Everywhere we went, people were kind and responded positively, with the exception of those napping in the heat and a few women who probably felt we were stepping on their turf. A few things really stand out in our mind, though. The huge number of electronic stores was surprising, considering the poverty level. Men working on fly covered, gristly meat with machettis were a great way of cutting your appetite. Fish and fruit hang side by side, a sort of odd aromatherapy in combination with the penetrating heat.
Having been followed by many, many people as the only whites in the market, we finally find our way around enough to get to a little cantina, and there, we have our very first malian meal. Everything here begins with a rice or couscous base, then topped with different stews and thick gravies, then eaten with a spoon or your right hand. And it's absolutely delicious, except that you know everything here is cooked in palm oil. For those who aren't that concerned with their cholesterol, here's the list of fats and oils in order of nocivity, from the best to the worst:
canola oil
sunflower oil
olive oil
peanut oil
soya oil (ie. non-hydrogenated soft-margarine)
butter
ghee (clairified butter)
coconut oil
palm oil
trans fats
Yummy. My arteries aren't so sure. But hey, when in Rome....or Bamako, in this case.
Apparently, I took this a bit too much to heart, and I drank about two glasses from the pitcher of local water our server plopped on our table. Now, when you're eating for 1$CAD, you can assume two things: first, the meal's authentic to its country of origin; secondly, any water they serve you is definitely not bottled.
Panic ensues at the table as two of the girls, horrified, remind me of the painful and profuse dysentary that awaits me.
I've drunken Saint-Laurence water. I,m not about to flinch, but I know they mean well and that my small intestin will soon let me know how far I can push.
Apparently, pretty far, as there,s still no reaction, despite heat, water and spices in the food.
Huzzah!
More to come later.
Thursday, July 2, 2009
Taking Off
Our last day in Paris with all the girls was a lot of fun. Sunny and hot, we decided it was the perfect time to do all those tourist things that had failed thus far. So ensued the longest walk in history. We began out stroll near the Notre-Dame de Paris cathedral, clearly one of the world's most beautiful places. (sidebar: amongst other invitations, we were asked to chase pigeons with a little boy. He was ecstatic when we obliged.) The inside of the church itself is as impressive as described in everyone's books and guides, though aside from the stained glass, I found myself shockingly unmoved by this historical site. I really hope I won't be this jaded in Bamako.
We continued along La Seine to an area known as Saint Germain des Prés, which is a little bit like a very large, sophisticated version of Montreal's Old Port. Boutiques and cafés alike line the sidewalks and there are people EVERYWHERE, though far fewer than in Montmartre. We grab sandwiches at a local pastry shop and walk around eating, as there are only three hours left until we need to leave the hostel for Charles de Gaulle Airport. We continue walking, and walking, all the way the the Jardins du Luxembourg where we sit under the beautiful royal gardens, and I take a moment to call home, since I haven't touched base since I left.
A quick remark: for a country whose exports include the world famous Vichy water and all of its derivatives, Parisian water, at least, REEKS. It tastes like musty sewer and you never feel refreshed after drinking it. Even the bottled stuff! And they tout the virtues of naturally-high magnesium water, which tastes an aweful lot like 0.5% saline solution.
Four hours pass, including half an hour ordering thai take-out (from a thai woman speaking only french) near the inn, facing crazy rush hour traffic getting to the airport, and having the commuter traint break down on us mid-way. Twice.
After midnight, Paris time. We’ve slept now perhaps a total of four hours in two days, between the heat, humidity and all of the wild energy whirling through our heads. So naturally, our final destination is the hottest town in Africa. Brilliant. Still, after a year of working our rears off to pay for it, and prepare ourselves mentally and psychologically, the time has finally come. We left an hour late because someone got held up at customs, but finally, we’re flying. Needless to say we’re all a bit pooped and yet we’re still awake, finding things to talk about and do.
There are many, many families on the plane with us, and the girls and I have been getting acquainted with the kids through conversation and coloring pages, which Maude had the brilliant idea of bringing along. As always, sometimes the best way to break barriers is music or art. Of course, a baby pukes and it’s a whole new kind of bonding, with clean-wipes being passed down the isle and rolls of toilet paper magically and generously appearing from carry-on bags.
The way mothers comfort crying children is fascinating and inspiring all at once. A child may be absolutely screaming his or her lungs out, about one or two years old, and his mother will sweep him up onto her back and deftly tie a shawl around her to form a makeshift papoose. A minute later, the child is either happy as a clam or out cold. Mom stills has all the mobility she needs to go about her day, and her child is happy and close to her. And it leaves the child to develop a degree of independence, contrasting sharply with Parisian Caucasian children.
Yesterday, in the metro, two little girls of around 4 years old came aboard with their mother, each looking very sharp in matching dresses and little purses, much like little girls like to have when playing dress-up. A minute later, one of them reaches into said purse and politely takes out….a pacifier, and sticks it in her mouth. Aside from obvious orthodontic problems later, it seems as though that little one is entirely too old for this sort of thing, especially since she is developing socially-based behavior (such as crossing her legs when seated or smoothing out the pleats in her dress).
Anyhow.
So we’re on the plane and my left-hand neighbor is a very nice teenage girl who lives in Paris but spends vacations with her father in Bamako. I’m impressed with how much European and African children are uninhibited in their interaction with others. No topic is off limit, and opinions are never kept quiet. Nice to see, though I wonder why no one ever feels flustered because of it. But then, when everyone functions the same, it’s not a problem, it’s a norm.
We continued along La Seine to an area known as Saint Germain des Prés, which is a little bit like a very large, sophisticated version of Montreal's Old Port. Boutiques and cafés alike line the sidewalks and there are people EVERYWHERE, though far fewer than in Montmartre. We grab sandwiches at a local pastry shop and walk around eating, as there are only three hours left until we need to leave the hostel for Charles de Gaulle Airport. We continue walking, and walking, all the way the the Jardins du Luxembourg where we sit under the beautiful royal gardens, and I take a moment to call home, since I haven't touched base since I left.
A quick remark: for a country whose exports include the world famous Vichy water and all of its derivatives, Parisian water, at least, REEKS. It tastes like musty sewer and you never feel refreshed after drinking it. Even the bottled stuff! And they tout the virtues of naturally-high magnesium water, which tastes an aweful lot like 0.5% saline solution.
Four hours pass, including half an hour ordering thai take-out (from a thai woman speaking only french) near the inn, facing crazy rush hour traffic getting to the airport, and having the commuter traint break down on us mid-way. Twice.
After midnight, Paris time. We’ve slept now perhaps a total of four hours in two days, between the heat, humidity and all of the wild energy whirling through our heads. So naturally, our final destination is the hottest town in Africa. Brilliant. Still, after a year of working our rears off to pay for it, and prepare ourselves mentally and psychologically, the time has finally come. We left an hour late because someone got held up at customs, but finally, we’re flying. Needless to say we’re all a bit pooped and yet we’re still awake, finding things to talk about and do.
There are many, many families on the plane with us, and the girls and I have been getting acquainted with the kids through conversation and coloring pages, which Maude had the brilliant idea of bringing along. As always, sometimes the best way to break barriers is music or art. Of course, a baby pukes and it’s a whole new kind of bonding, with clean-wipes being passed down the isle and rolls of toilet paper magically and generously appearing from carry-on bags.
The way mothers comfort crying children is fascinating and inspiring all at once. A child may be absolutely screaming his or her lungs out, about one or two years old, and his mother will sweep him up onto her back and deftly tie a shawl around her to form a makeshift papoose. A minute later, the child is either happy as a clam or out cold. Mom stills has all the mobility she needs to go about her day, and her child is happy and close to her. And it leaves the child to develop a degree of independence, contrasting sharply with Parisian Caucasian children.
Yesterday, in the metro, two little girls of around 4 years old came aboard with their mother, each looking very sharp in matching dresses and little purses, much like little girls like to have when playing dress-up. A minute later, one of them reaches into said purse and politely takes out….a pacifier, and sticks it in her mouth. Aside from obvious orthodontic problems later, it seems as though that little one is entirely too old for this sort of thing, especially since she is developing socially-based behavior (such as crossing her legs when seated or smoothing out the pleats in her dress).
Anyhow.
So we’re on the plane and my left-hand neighbor is a very nice teenage girl who lives in Paris but spends vacations with her father in Bamako. I’m impressed with how much European and African children are uninhibited in their interaction with others. No topic is off limit, and opinions are never kept quiet. Nice to see, though I wonder why no one ever feels flustered because of it. But then, when everyone functions the same, it’s not a problem, it’s a norm.
Sunday, June 28, 2009
The Smell of Paris. No! no! I mean....."perfume"
They talk about turbulence during transatlantic flights. They mention it. They fail to take into account the reaction it my induce in an easily panicked 24 year-old with claustrophobia and control issues. Of course, I was seated in the middle of the Boeing 747 jet seat row, between Laurence (hereon noted as Lolo, as she is so often) and some guy who reminds me of Charles Manson during the awkward years who didn't stop air drumming the entire duration of the flight. The cabin was shaking, I hadn't slept the night before so I was wired like a chipmunk, and I couldn't help but imagine hearing Denis Leary announcing over the PA that " um...we're going down folks, so, light'em up!" I feel safer at La Ronde. (No, Dave, this doesn't mean I'm hopping on the Goliath any time soon, it was just a metaphor in the moment :)
And we're supposed to SLEEP through this?
Either way, like Charles Lindberg, we landed just fine, got our luggage, went through customs (yay, stamps on my passport!) and then decided it would be a good idea to get to our hostel to drop off our giant backpacks.
Transport requires euros.
Euros require a working visa card to withdraw funds.
Desjardins visa cards don't seem to be recognized by the machines here.
Lolo had been assured by her bank they wood.
STREEEEEESSSSSSSSSSS!
Ok, so what we did finally, after seventeen gazillion tries, is withdraw money from my account and keep tabs on whose spending what. Still tanks.
Tomorrow we'll find a calling card and settle this. Bleh. I thought the whole point of arranging the finances before we left was to AVOID this exact situation, but to err (and get screwed by a local quebec bank) is human.
Moving on.
So we get on public transit to get to the hostel, which is great, if a little complicated because of the many modes of transit. I'm looking foreward to being in a town where are options include feet and jeep, maybe a goat.
We arrive at the hostel, dump our stuff and sign in. Rooms aren't available at this point for another 5 hours, so we decide, tired as we are, to go rest...
Yeah right. When do we ever listen to our instincts?!
We head up la butte, or the large hill that Montmartre is renown for. There are three sections of an old monastary up there, absolutely spectacular. Of course, claustrophobia kicks in nice and solid on our way up because we're being accosted rather aggressivly by African panhandlers, which makes me question somewhat how I'll fare in the Mali. I suppose the next few days will be a good exercise is learning to manage that kind of stress.
Quick note to justify the title of this entry: PEOPLE, tourists and locals alike, SMELL here.
Not sweat from hard labor and heat, but a dirty smell, like a mix between sex, decaying flesh and old urine. I know I'm sensitive, but it's overwhelming when everyone around you smells like the plague. Made me walk faster, though.
So we walk around with little more than Orangina in our system until around 2pm, then buy some fruit (fruit stalls are wonderful, inexpensive and all over the place, a bit like Côte-des-Neiges but cleaner and well, more Parisian) and we park ourselves at the hostel.
Lolo mentions she'd like to find some greenspace, a park to lounge around in. Sounds great!
We ask the guy at the front desk, he mentions le Bois de Boulogne.
Let me clarify the difference in perspective. In Paris, the word "parc" can refer to anything from a patch of grass a chihuahua can pee on all the way to Mt-Tremblant national park. SO we get there, and where we had hoped to see benches and some nice grass, there are major hiking trails and dark, creepy woods. I suppose the name BOIS de Boulogne should had sounded some hint of what to expect.
But we press on and decide to just take a nap until we decide what to do, in order to not waste our metro trip.
Insect bites.
Little dogs with big poop.
Uncontrollable sneezing and congestion due to grass allergies.
Now, at this point Lolo is out cold, happy as a clam. I can't take taps during the day, so I wind up sitting in an upright fetal position, waiting for time to pass. which of course, it doesn't, and Lolo to wake up, which of course, she does, but only when I poke her, which I still feel bad about.
We wind up trying another patch of grass, same crap happens, and the overtired nausea is beginning to overwhelm me, so at 4:30 pm local time, we haul our buts back to base and drop our stuff in our room.
We wound up grabbing a bite to eat at a local bistro, after walking around for another 40 minutes.
A word to the wise: Montmartre is a MAZE, get a map. You'll still get lost, but you'll find your way back a little faster at least.
On the menu tonight:
Steak Frites
Oeufs mayonnaise
Salade de chèvre chaud
With almost a litre of light white wine to go with it, we were happy as clams to split the various dishes, making this more of a tasting dinner than an actual supper. Not anything spectacular, but considering the whole meal cost us less than 20$ canadian each, we fared pretty well. And the french do know how to cook a steak.
After that, we waddled back, theorizing about french pet laws (the dog is king here, I saw at least two jack russells sitting calmly at bistro tables with their own plate on the ground).
Remember, a liter of wine + fatigue + jet lag + heat + no food prior = lots of philosophy.
Fear not, we wren't at all enebriated, but we certainly knew an after-dinner nap would follow.
And so it did. I woke up about two hours ago to the sound of someone's cell phone ringing. At least I thought so until I realized what was ringing was the room phone.
I pick up.
It's Dave! Calling from Montreal to say hello. Of course, in a just-abruptly-woken state, I sound slightly wry on the phone, I'm sure, but it's wonderful to get a call.
Except for my four other roommates, all of whom are more jet-lagged than me and none of whom were expecting me to get a call in what is their middle of the night.
Must get a calling card. :)
So it's now 1:15am here, and that steak from earlier is keeping me up, and I'm meeting all sorts of people in the hallway because I don't want to wake my roomies with the computer.
More news in a few days.
And we're supposed to SLEEP through this?
Either way, like Charles Lindberg, we landed just fine, got our luggage, went through customs (yay, stamps on my passport!) and then decided it would be a good idea to get to our hostel to drop off our giant backpacks.
Transport requires euros.
Euros require a working visa card to withdraw funds.
Desjardins visa cards don't seem to be recognized by the machines here.
Lolo had been assured by her bank they wood.
STREEEEEESSSSSSSSSSS!
Ok, so what we did finally, after seventeen gazillion tries, is withdraw money from my account and keep tabs on whose spending what. Still tanks.
Tomorrow we'll find a calling card and settle this. Bleh. I thought the whole point of arranging the finances before we left was to AVOID this exact situation, but to err (and get screwed by a local quebec bank) is human.
Moving on.
So we get on public transit to get to the hostel, which is great, if a little complicated because of the many modes of transit. I'm looking foreward to being in a town where are options include feet and jeep, maybe a goat.
We arrive at the hostel, dump our stuff and sign in. Rooms aren't available at this point for another 5 hours, so we decide, tired as we are, to go rest...
Yeah right. When do we ever listen to our instincts?!
We head up la butte, or the large hill that Montmartre is renown for. There are three sections of an old monastary up there, absolutely spectacular. Of course, claustrophobia kicks in nice and solid on our way up because we're being accosted rather aggressivly by African panhandlers, which makes me question somewhat how I'll fare in the Mali. I suppose the next few days will be a good exercise is learning to manage that kind of stress.
Quick note to justify the title of this entry: PEOPLE, tourists and locals alike, SMELL here.
Not sweat from hard labor and heat, but a dirty smell, like a mix between sex, decaying flesh and old urine. I know I'm sensitive, but it's overwhelming when everyone around you smells like the plague. Made me walk faster, though.
So we walk around with little more than Orangina in our system until around 2pm, then buy some fruit (fruit stalls are wonderful, inexpensive and all over the place, a bit like Côte-des-Neiges but cleaner and well, more Parisian) and we park ourselves at the hostel.
Lolo mentions she'd like to find some greenspace, a park to lounge around in. Sounds great!
We ask the guy at the front desk, he mentions le Bois de Boulogne.
Let me clarify the difference in perspective. In Paris, the word "parc" can refer to anything from a patch of grass a chihuahua can pee on all the way to Mt-Tremblant national park. SO we get there, and where we had hoped to see benches and some nice grass, there are major hiking trails and dark, creepy woods. I suppose the name BOIS de Boulogne should had sounded some hint of what to expect.
But we press on and decide to just take a nap until we decide what to do, in order to not waste our metro trip.
Insect bites.
Little dogs with big poop.
Uncontrollable sneezing and congestion due to grass allergies.
Now, at this point Lolo is out cold, happy as a clam. I can't take taps during the day, so I wind up sitting in an upright fetal position, waiting for time to pass. which of course, it doesn't, and Lolo to wake up, which of course, she does, but only when I poke her, which I still feel bad about.
We wind up trying another patch of grass, same crap happens, and the overtired nausea is beginning to overwhelm me, so at 4:30 pm local time, we haul our buts back to base and drop our stuff in our room.
We wound up grabbing a bite to eat at a local bistro, after walking around for another 40 minutes.
A word to the wise: Montmartre is a MAZE, get a map. You'll still get lost, but you'll find your way back a little faster at least.
On the menu tonight:
Steak Frites
Oeufs mayonnaise
Salade de chèvre chaud
With almost a litre of light white wine to go with it, we were happy as clams to split the various dishes, making this more of a tasting dinner than an actual supper. Not anything spectacular, but considering the whole meal cost us less than 20$ canadian each, we fared pretty well. And the french do know how to cook a steak.
After that, we waddled back, theorizing about french pet laws (the dog is king here, I saw at least two jack russells sitting calmly at bistro tables with their own plate on the ground).
Remember, a liter of wine + fatigue + jet lag + heat + no food prior = lots of philosophy.
Fear not, we wren't at all enebriated, but we certainly knew an after-dinner nap would follow.
And so it did. I woke up about two hours ago to the sound of someone's cell phone ringing. At least I thought so until I realized what was ringing was the room phone.
I pick up.
It's Dave! Calling from Montreal to say hello. Of course, in a just-abruptly-woken state, I sound slightly wry on the phone, I'm sure, but it's wonderful to get a call.
Except for my four other roommates, all of whom are more jet-lagged than me and none of whom were expecting me to get a call in what is their middle of the night.
Must get a calling card. :)
So it's now 1:15am here, and that steak from earlier is keeping me up, and I'm meeting all sorts of people in the hallway because I don't want to wake my roomies with the computer.
More news in a few days.
Sunday, June 21, 2009
One Week Left...
So here goes, testing the blog one week before departure.
My bags have already been packed, twice. Medication counted twice.
Obsessive? Absolutely.
But on with the good stuff. I'm jotting down today our estimated itinerary so you guys will know where my gang and I will be depending on the week.
June 27th - 8 pm
Take-off from Dorval Airport towards Paris, arriving at 8 am, just in time for breakfast à la parisienne. We'll be spending three days in Paris, chilin' in Montmartre until we shove off for Africa.
June 30 - 10 pm
Take-off from Charles de Gaule airport for Bamako, capital of Mali, population 6 million. We land (as do most if not all flights to Africa) at 2:30 in the morning.
July 1st - July 2
Short stay at a hotel in Bamako, where we'll get our hands on maps, organize transport around the country and most importantly, get to go swimming in a clean pool!!
July 2 - July 7
Camping, sub-saharan style, in a place called Kangaba, south of the capital. Imagine a cross between a resort and a campground. You're roughing it like mad, but you get to take language lessons and dance classes during the day. We'll try and film that last one, you guys ought to get a kick out of me and my six left feet. :)
July 7 - July 8
Single night stay in Bamako, and the next day our buts get to enjoy a 12-16 hour bus ride (the term "bus" is technical, and does not ensure speed or suspension). We arrive in Kayes, the town where we'll be living the duration of our stay, around 8pm.
July 9 - July 12
Orientation and crash course in African medecine.
July 13 - July 27
Two weeks of community medecine in an urban setting. Basically your simple version of a CLSC, plus an ER and OR.
July 27 - August 15
Two weeks of community medecine in a rural setting, an hour or so outside Kayes. We'll be following midwives and nurses. Out here, the doctors are few and far between, so it's up to us.
August 16
We trek back to Bamako via bus, another 12-16 hours.
August 16 - August 19
Debriefing in Bamako. Lots, and lots of chill time, and some time in the marketplace to get goodies to bring home.
August 19
Flight out of Bamako back to Paris
August 19 - August 21
Two day stay in Paris, and my inevitable ransacking of every gourmet grocery store I can find. I WILL bring home Branston Pickle and Herbes de Provence. Minimum. :)
August 21st, 5 pm
Flight to Montreal, arriving around 5:30 local time. Yay supper at home!
So there you have it, the whole schebang!
More to come June 28th when we've landed in Paris.
My bags have already been packed, twice. Medication counted twice.
Obsessive? Absolutely.
But on with the good stuff. I'm jotting down today our estimated itinerary so you guys will know where my gang and I will be depending on the week.
June 27th - 8 pm
Take-off from Dorval Airport towards Paris, arriving at 8 am, just in time for breakfast à la parisienne. We'll be spending three days in Paris, chilin' in Montmartre until we shove off for Africa.
June 30 - 10 pm
Take-off from Charles de Gaule airport for Bamako, capital of Mali, population 6 million. We land (as do most if not all flights to Africa) at 2:30 in the morning.
July 1st - July 2
Short stay at a hotel in Bamako, where we'll get our hands on maps, organize transport around the country and most importantly, get to go swimming in a clean pool!!
July 2 - July 7
Camping, sub-saharan style, in a place called Kangaba, south of the capital. Imagine a cross between a resort and a campground. You're roughing it like mad, but you get to take language lessons and dance classes during the day. We'll try and film that last one, you guys ought to get a kick out of me and my six left feet. :)
July 7 - July 8
Single night stay in Bamako, and the next day our buts get to enjoy a 12-16 hour bus ride (the term "bus" is technical, and does not ensure speed or suspension). We arrive in Kayes, the town where we'll be living the duration of our stay, around 8pm.
July 9 - July 12
Orientation and crash course in African medecine.
July 13 - July 27
Two weeks of community medecine in an urban setting. Basically your simple version of a CLSC, plus an ER and OR.
July 27 - August 15
Two weeks of community medecine in a rural setting, an hour or so outside Kayes. We'll be following midwives and nurses. Out here, the doctors are few and far between, so it's up to us.
August 16
We trek back to Bamako via bus, another 12-16 hours.
August 16 - August 19
Debriefing in Bamako. Lots, and lots of chill time, and some time in the marketplace to get goodies to bring home.
August 19
Flight out of Bamako back to Paris
August 19 - August 21
Two day stay in Paris, and my inevitable ransacking of every gourmet grocery store I can find. I WILL bring home Branston Pickle and Herbes de Provence. Minimum. :)
August 21st, 5 pm
Flight to Montreal, arriving around 5:30 local time. Yay supper at home!
So there you have it, the whole schebang!
More to come June 28th when we've landed in Paris.
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