Tropical disease…and training (mutually exclusive events)

I’m here in Bamako now, and since I’m on medical hold (meaning I’m not allowed to leave until approved by the PC doctor), I have a lot of time on my hands. So…I thought this would be a good time for a quick update. Especially since I am having serious insomnia at the moment.

I’ll answer the most relevant question first: what’s wrong with me? Most likely, although I can’t say for sure as the blood test could not confirm it, is that I had malaria. After several days of flu-like illness and spiking fever cycles followed by sweats, I finally called the doctor who told me I needed to come in ASAP. But, since I’m so far from BKO as it is, the soonest I would have been there would have been two days later, so I started taking the emergency malaria treatment we are supplied with before moving to post. After two fairly awful days of fever, sweats and intense fatigue, I finally made it to Bamako…but, by the time I was able to see the doctor I had already turned the corner and started to feel better. My blood work didn’t show anything concerning, so it appears that I responded to the treatment. Now, I’m still here for follow up, to make sure that it doesn’t worsen in the coming days (malaria can sometimes do that). SO that was a bit of an unexpected detour that took me rather abruptly from my village, but there wasn’t much choice in the matter. Getting malaria is somewhat scary in itself given that it can range from resembling a simple case of the flu to causing comas or severe complications, and you can’t be sure which it will be so of course, you must take all possible precautions. Even being on preventative meds like all PCVs are on, it’s still possible to get malaria, although usually it’s milder than it might be otherwise (as in my case).

Anyway, enough about my dubious ventures into tropical disease. This past weekend, I hosted the training for traditional midwives that I recently received Peace Corps funding for. It went really well–we had 16 traditional midwives, women (usually elderly women) who don’t have medical training but who are chosen by their communities to assist with deliveries when they occur at home . I found a statistic that somewhere around 2/3 of Malian women still give birth in their homes despite the availability of health services (I personally believe this occurs even more frequently in my area, where lack of money is almost always cited as the reason for not giving birth at the health center). Although we obviously can’t train the women to do everything that a school-trained, regular midwife does, and we can’t ensure that the environment in which they give birth is clean and not conducive to infection, we wanted to reinforce their knowledge of sanitary and proper delivery, how to recognize at-risk pregnancies  or complicated deliveries for referral to the health center, and how to counsel the women they work with on everything from exclusive breastfeeding to dealing with various problems during pregnancy.

The women were a lot of fun. We kept the entire training oral and discussion based as most participants were illiterate, so there was a lot of question and answer and some healthy banter about certain topics. The president and VP of the health center Board of Directors, and one of the mayor’s staffers, also attended, and I think got a good overview of some maternal/child health basics. Over the course of two days (from 8am until around 1:30 pm; the heat made it necessary to adjourn in the afternoon), we covered a lot of ground, from helping a women to recognize the signs of a possible pregnancy up through post-delivery counseling. We provided breakfast and lunch over the course of the two days, and during the last lunch I got a chance to go around and thank all of the women for coming. The training was a good opportunity, I think, to provide a link between official health structures (ie, the public health center), and the women on the ground reinforcing maternal/child health in villages where some  (or even most ) women do not make use of formal health services. The lack of service utilization is in itself a problem that we are continually trying to address, but in the meantime, if we can empower the women working on the ground with information and skills, we can perhaps minimize the risk inherent in giving birth at home in Mali, a risk so many women still take. Women are much more likely to contract infections, develop complications, and, yes, to die at home then they are in a formal health setting, where trained personnel can quickly stabilize them and refer them to an actual hospital if necessary (and we cannot forget the additional risks to the baby as well). I know of at least one woman in my village who passed away shortly after giving birth in the past year, and I know there are others. Childbirth is one of the most risky and dangerous times for women in third world countries, so anything that we can do to help train and inform the women who are entrusted to guide them through the process is a step in the right direction. In that respect, I was very happy to have a hand in organizing the training of these 16 local women.

Thank goodness the whole training wrapped up just before my not-so-thrilling initiation into tropical illness. My convalescence was unexpected but has nonetheless given me time to do things like write reports and wrap up budgets, and I’m grateful for that.  At any rate, I am feeling much better–if still a little weakened–and am excited to be in town for the new volunteer’s swear in–which, thanks to the PC 50th anniversary and the 40th anniversary of PC-Mali, is being held at the Malian president’s estate. O lala. More to come on that.