Although the better part of my February was spent in agricultural training sessions, several recent events have caused my mind to be fixated on health issues in Senegal, and the developing world in general. After two and a half weeks of trainings in appropriate agricultural techniques in Senegal I found myself waiting for a taxi back to my village, baggage piled high, at the Peace Corps training center in Thies, feeling intensely drained. But why? I’d spent my time there soaking in information on protocol and methods for being a successful volunteer. Maybe I’d just been too stressed about trying to retain it all and it was resulting in some kind of melt-down.
We jammed into a Sept-Place (seven places) taxi and began the first leg of our journey to the Peace Corps Kaolack regional house. As I shuffled some baggage around the hatch-back of the car from my seat I took notice of how much these cars look like hearses. I thought to myself that if I were dead I’d probably feel better than I did at that moment. Arriving at our destination a friend urged me to take my temperature which revealed that my discomfort was not some kind of mental breakdown but, in fact a fever. I spent the better part of the following week in a sort-of fever haze, since I’d called the Peace Corps doctor who said it was likely a virus to be waited out. As it didn’t improve he advised me to take antibiotics and I was on my feet and in my village within two days.
Although being sick here was not pleasant I’m sure it was much less difficult than giving birth in a hut in rural Senegal, as my host-aunt did on the day of my return to village. I walked into Fatu’s room and the women were doting over her, smiling, and singing. I could sense her elation as well, but there was also an intense fear palpable in the room. This was not the first child she’d given birth to, but it was the only living one. My excitement was piquing (a new cousin!) but I was anxious as well that something might happen. Pre and post-natal care for mothers and children in rural villages is usually non-existent, too expensive, or highly inadequate. A young girl died in my village a few days later and several people told me this was not rare and very much inevitable.
This attitude combined with lack of access to health care and inadequate knowledge of the causes of many health problems contribute to infant mortality (and all other health issues) in developing countries. The new baby was taken to a health post 10 K away when it was three weeks old for vaccinations. Fatu explained to me that the baby was given ‘medicine’ that was good for her ’body’. Further inquiry on my part produced no more detail on which vaccinations the baby was given. This lack of knowledge is not the fault of the mothers since the nurse likely didn’t tell her the information to begin with (or know it herself). Girls in rural villages are generally not sent to school, and without a fairly advanced understanding of biological sciences (High School level) one can’t understand germs and viruses and their connection to illness (Banerjee and Duflo 2011). In the United States we are mandated by law to go to school and learn these things.
Abhijit Banerjee and Esther Duflo point out in their book Poor Economics that many deaths and illnesses in developing nations are caused by excessive diarrhea related to water borne illnesses. Most of these illnesses may be prevented by adding a few drops of bleach to drinking water (Peace Corps volunteers are advised to do this). If this is the case we are tempted to say, “Why don’t people just bleach their water!? It’s low cost and accessible!”. But can we blame people for NOT adding an extra step to their work-filled lives when we live in a place where clean water is piped into our homes directly? Further, as mentioned, they may not truly understand the role of the bleach as this would require scientific knowledge. The water that comes into our homes in the U.S. is required to be clean by law. Just as he makes sure we understand why they are sick (bio class), Big Brother makes sure we don’t get too sick either. Even if I played hooky on my biology class, I still wouldn’t die of dehydration brought on by diarrhea caused by a dirty water source. Similarly we are required to have certain vaccinations in the U.S. and, just as my host aunt, most parents may not know exactly what the shots are for but they do understand their importance.
The differences in the quality of life and life-span are marked between developed and developing countries. I was told by a fellow volunteer that Peace Corps Volunteers live for two years less, on average, then the general population in the U.S. In the Behavioral Economic spirit of making sweeping generalizations about real life based on a flimsy statistic I will venture to say that every two years spent in a developing country takes two years off your life-meaning people born here would have zero years of life on average!
The limitations to secure public health in Senegal I point out here can really only be solved through policy change, which is out of my control as a non-citizen (and for my own good). Despite my neutered political status in this country I do have the ability to play a small-scale educational role in improvements to public health. I’m involved in a project being designed by health volunteers to train community educators in common causes of illnesses and prevention of these on a village level. The broader population of the village has the opportunity to received subsided pricing on the building materials for latrine construction. In order to receive this pricing they must attend several trainings, led by the community educator, in health and hygiene as well as the importance of using and maintaining their latrines. As Esther Deflo calls them, ‘low hanging fruit’ for improving public health will be promoted like hand washing and burying human defecation.
A project like this is born out of the hope that we can (at least try to) help prevent devastating occurrences like the death of a child in our village and keep new babies healthy so they have a chance for proper development. A week after her birth the new baby in my compound had a traditional baptism ceremony was named Mariama. I was so excited for it I biked all morning to get there and even agreed to wear a pink, puffy belly shirt with a matching wrap skirt (not pictured here).