Campaigns, Neem, Stage

July 26^th

Today was a rather unusual morning at the CSPS. I got there at 7:30, as usual, and Sali wasn't there but I decided to go ahead and start without her so things would be ready to go when she arrived. Normally we have 20-25 women waiting for CPNs or birth control, but today we only had 6! I think it must have been the rain last night – it had been so long since the last rain that people had stopped working in their fields, and with the sudden ability to start planting again most people must have decided to come another day. I handed out the numbered cards anyway – people have a tendency to keep showing up until about 8:30, and started weighing and taking blood pressures. Two women had come in a month before their next scheduled exam, so I gave them the anti-malaria and anti-parasitic drugs that they were due to receive, and asked them to wait for Sali so that she could give them their tetanus vaccine injection. The 6^th woman said she was ill, and I tried to figure out if she meant ill as in pregnant, ill as in aborting, or ill as in having malaria, mainly so I could determine if it was necessary to give her a maternity carnet and weigh her. I asked the major to question her further, and after he just said that she would wait for Sali, so I figured the carnet could wait as well.

Then we sat. Sali showed up for half a minute, but left again and didn't return. I was surprised at how frustrated I felt – I logically knew she probably had a reason for being at the CSPS but doing something besides her regular routine. But I also felt annoyed that we'd been sitting for over an hour waiting for her when these 6 consultations would easily take less than an hour, allowing her to go back to whatever she was doing and allowing the women to get back to their families and their fields. She came a bit before 9am and we were pretty much finished by 9:45, even with a surprise walk-in who requested a Jadell birth control implant which typically takes a little bit of time. I asked where she had been all morning and she said she had arrived at 5:30 to clean out the PAM (world food program) room, since they're coming to inspect the food distribution tomorrow. It made me somehow feel better, and guilty about being frustrated, to know that she'd been working and not just refusing to come to work, but then I wondered why having a reason should make me feel so differently when I logically knew the whole time that she probably had a reason for not coming on time. I also was surprised she hadn't asked me to help, but I guess between cleaning spider webs and sitting listening to the women I'd prefer to sit.

So instead of leaving early after we finished I ended up sitting and talking to my major, which went surprisingly well. Recently I've tried to avoid being around him too much because he irrationally annoys me, but one on one he's a lot easier to handle. I think when he's around a group he has to entertain and joke a lot, and I tend to feel like the butt of his jokes, or as though he's using his joking to criticize something I've been doing or not doing. I'm probably overly sensitive about it, I just don't like the constant implication that I'm not working, or that I have so much time on my hands that I won't mind doing his work for him. We talked about batteries (I'm thinking of buying a small one so I can have a lamp, not just my lantern), and I asked him about housing people on the Tour de Burkina fundraiser bike tour and who in the community I needed to officially inform about the arrival of a dozen nasaras.

We had just started talking about the possibility of me doing a sensibilization on baby-weighing days when people from the schisto campaign started returning. I swear, the poor ASVs have been doing campaigns almost continuously since I got back – first it was polio, then it was lymphatic filarisis, now it's schistomiosis, and while we were talking the major said that another polio is starting on Friday! While I'm typically of the mindset that vaccinations are a crucial part of public health, and getting vaccinated more than the minimum doesn't hurt, it seems bizarre to re-vaccinate the exact same population a month after the last campaign. People are in the fields and take their children with them, meaning that we have to go field to field and somehow try and make sure we're getting the people in that village (and not the neighboring village, or the percent coverage numbers get messed up), as well as attempt to determine what house they belong to so we can write down the number of children vaccinated on the side of each concession. The ASVs do get paid to do these campaigns, but I'm sure they must be kind of sick of them at this point – I'm tired of them and I haven't even been going out with a team since the polio campaign when I first got back, just collecting papers and adding up totals. So I promised that, for this next campaign, if the major helps me find flour (or buys it in Seguenega for me) I'd make snacks for everyone on Friday morning (I'm thinking of giving tortilla chips another try, and possibly the lemon cookie recipe in the cookbook).

I've been talking to Emily and I think I'd like to do a demonstration at baby weighing on how to make neem cream and use it in conjunction with other measures to prevent malaria, but I realized that to actually get the majority of women I'd need to do it every week for a month or two. This isn't a big deal, and I really mind paying to make small batches to demonstrate every week, but I was also debating trying to use neem cream as an IGA (income generating activity), possibly for someone like Colette or Koka or one of the other women who is an ASV and/or CoGES member and is already invested and active in the health of the community and familiar with the CSPS. I didn't think it would be very nice of me to do a demonstration every week and then expect someone to try and sell the same product the next day in the marche. But I realized that perhaps if I teach someone to make it and ask them to help me do my sensibilization and use the opportunity to sell neem cream (the batch we demonstrated with the week before, since it has to set at least overnight), it would be a way to pay for the materials for the next week, earn some money for these women who work very hard and often without pay at the CSPS, and offer a product to women that they may not have the time or motivation to make on their own.

Now, to present the idea to my staff and the 5 women I suspect might be interested in doing this.

I'd ideally like to get started right away, but with yet another campaign starting I think I'll have to wait. Plus next week I'll be gone nearly the whole week. I'm working stage the 3^rd and 4^th, but because of MSC for super stage, Sylvie can only meet with Anna and I to go over the first aid material on the 1^st. So I'll take the bus in on the 1^st, be in Ouaga/Saponey until the morning of the 5^th, and return to site on the 6^th by way of Nongfaire, Alicia's village. She didn't say why exactly, but she invited a handful of us to come visit and I'd love to finally meet her family and see where she lives. Thus, neem cream will have to wait for a little, but with any luck the campaigns will be over for a little bit and we can focus our energies on other things. The major did say that everyone is really tired of doing campaigns, especially polio, but that a child in Mali (or maybe a child in Burkina who recently came from Mali) had been diagnosed with polio in the past week, so the North region is doing an extra polio campaign in response to make absolute sure that everyone is covered and the disease can't possibly spread. It makes sense, I just wonder how people in the village think of it. Do campaigns lose a bit of their effectiveness when they become routine, when seeing vaccinations come to your house is no longer an interesting and unusual occurrence worthy of curiosity and attention? Do mothers lose their faith in the usefulness of a vaccine or medication if it's being given to her child on a monthly basis to prevent a disease she hasn't seen a case of in years, possibly her whole life?