Pictures!

With Lisa at a group dinner


With Sarah this time. Not sure how Jacob ended up looking like a giant in this picture...


Ready to make lettuce wraps


Finished product...beautiful AND delicious!


Before our fabulous anniversary lunch in Kombo


Happy :-)


Julia went on a picture-taking spree with my camera at Blue Kitchen after the first day of the HIV workshop. Fern, Erica and Lindsey.


Jo and Devin


Jo and the other Devin


Us


Whitney and Brendan


Lucia and Sarah

Female Genital Mutilation/Cutting Workshop (DISCLAIMER - this is a rather graphic post, so squeamish people should probably skip this one)

Last week I attended a very interesting workshop on Female Genital Mutilation/Cutting (FGM/C), put on by a local NGO focused on fighting FGM/C through educating and sensitizing health professionals. It was very informative, so I thought I would pass on some of what I learned for those of you who might not be familiar with the practice (last chance...STOP HERE if you don't want to read more about this practice):

What is FGM/C exactly? Also sometimes called Female Circumcision, Female Genital Mutilation/Cutting "comprises all procedures that involve partial or total removal of the external female genitalia, or injury to the female genital organs for non-medical reasons." The main types of FGM/C are three progressive levels of severity, the mildest being more or less the equivalent of male circumcision (Type 1) and the most severe involving significant removal of the genitalia and suturing (Type 3). Types 1 and 2 are practiced here in the Gambia - Type 3 is not practiced, but on occasion, the flesh can fuse during the healing process in a Type 2 procedure in a way that makes it resemble a Type 3 procedure when fully healed. The painful procedures are generally performed by an elderly women, often a traditional birth attendant, with generally non-sterile cutting instruments like razor blades, knives, and pieces of glass. After the procedure is complete, the wounds are generally dabbed with local materials like ash or cow dung to stop the bleeding. FGM/C is generally done as part of a cultural rite of passage. The age at which girls are cut varies by tribe and region, but it is generally done before puberty, and sometimes as young as newborns. I think that's more than graphic enough for now, so if you're interested in more detail on what these procedures entail, visit this link: http://www.who.int/mediacentre/factsheets/fs241/en/.

Where is it practiced? FGM/C is a common practice throughout western, eastern, and north-eastern regions of Africa in some countries in Asia and the Middle East, and among certain immigrant communities in North America and Europe. The WHO estimates that 100 to 140 million girls and women worldwide are currently living with the consequences of FGM/C. In the Gambia, current data shows that 78% of adult women have undergone this practice.

What are the health implications? In addition to inflicting long-term mental and emotional trauma, even the milder forms of FGM/C have very serious implications for a girl or woman's physical health. Immediate physical health complications can include: 1) contracting tetanus, hepatitis, HIV, etc, from the cutting instrument, especially if multiple girls are being cut in a single ceremony; 2) developing an infection in the wound; 3) shock, hemorrhage, anemia; 4) injuries sustained if the child struggles; and 5) urine retention to swelling or fear of pain when passing urine.

Long term physical consequences can include: 1) obstetric fistula, a serious and highly stigmatized medical condition - see http://en.wikipedia.org/wiki/Obstetric_fistula); 2) an increased risk of childbirth complications and infant mortality; 3) recurrent bladder and urinary tract infections, which can lead to infertility in severe cases; and 4) sexual dysfunction.

For women with suturing or severe scarring (Type 3 or Type 2 that healed with significant fusion), the health concerns are even more significant. The immediate health risks are often played out multiple times in a woman's life when she is "reopened," either through cutting or tearing to allow for sex and childbirth. These fresh wounds during sex and childbirth are not only exceedingly painful, but they also significantly increase the risk of contracting or transmitting HIV and other blood-borne diseases. Additionally, women with this condition have a significantly increased risk of obstructed labor and/or the need for a c-section, which is a serious danger to the life of both the mother and the baby in any context, but particularly in one where emergency obstetric care may not be readily accessible. These women are also prone to infections throughout their lives if urine and menstrual blood cannot exit the body properly.

So why do people do it? FGM/C is extremely deeply ingrained culturally as an crucial for: initiation into womanhood; social acceptance into the community; controlling women's sexual urges to reduce pre-marital sex, promiscuity, and unfaithfulness; a women's ability to get a husband (which, since virginity is highly valued, is closely linked to the previous point); and reaching and maintaining a clean and pure state, both physically and spiritually.

Is it a Muslim thing? Most Gambians think it is, so at the workshop, we spent a significant chunk of time discussing the relationship between FGM/C and Islam. Here were the highlights of the NGO's argument that FGM/C is not, in fact, a muslim "thing": (1) Most people here are not aware of it, but FGM/C in Africa actually pre-dates the arrival of Islam in Africa...historians believe it originated in Egypt and the Nile valley at the time of the Pharaohs; (2) FGM/C is not widely practiced in other deeply Muslim countries, such as Morocco, Saudi Arabia - including the holy city of Mecca!; (3) Most Gambians look to religious scholars in Senegal for spiritual guidance, and the prevalence of FGM/C among adult women is only 28% there, compared with 78% in The Gambia; (4) The prevalence is nearly 100% in Egypt and they have a significant Christian minority, and Jews in Ethiopia practice it as well, so it is not only Muslims who participate in FGM/C; and (5) In recent years numerous Muslim groups and leaders have issued statements and religious decrees or fatwas declaring FGM/C (particularly in its more severe forms) to be contrary to Islam, and some have gone as far as to recommend banning the practice.

For example, Dr.Muhammad Lutfi al-Sabbagh, Professor of Islamic studies at King Saud University in Riyadh stated: “Since all these risks are involved in female circumcision, it cannot be legitimate under Islamic law, particularly since nothing that recommends it is definitely established as said by the Prophet {Peace Be Upon Him}. It is, however, established that he has said: "Do not harm yourself or others". This hadith is one of the basic principles of this True Religion. The conclusion to be reached is that female circumcision is neither required nor is it an obligation nor a sunna. This is the view taken by a great number of scholars in the absence of any hadith that may be authentically attributed to the Prophet {Peace Be Upon Him}.”

If you're interested in learning more about the relationship between FGM/C and Islam, here are a few sites with some more information: http://www.iccservices.org.uk/news_and_events/updates/female_genital_mutilation.htm, http://www.minaret.org/fgm-pamphlet.htm, and http://www.religioustolerance.org/fem_cirm.htm.

Rodents

As some of you may be aware, we have been battling with an ongoing mouse/rat problem. I say "mouse/rat" because our current theory is that we have both. They live in our ceiling and frequently come down to eat anything and everything they can find, regardless of whether it even vaguely resembles food. In addition getting into a wide range of food, to-date, they have chewed/eaten the following surprising non-food items:

-Lotion
-Hand sanitizer
-Anti-fungal creme
-Countless ziplock bags (with and without anything inside)
-Plastic container
-Toothbrush
-Candles
-Two kinds of bar soap
-The edge of the silicon cover for our computer keyboard
-Canvas backpack

While destroying things is our main frustration, they also leave poop all over our house and are extremely noisy at night. We have tried two different kinds of traps with several different kinds of bait and glue traps, none of which have been successful. We don't want to poison them because then they will die up in our ceiling and smell (and Gambians tell us it isn't particularly effective long-term). We reinforced all our doors and windows with a metal mesh that the mice/rats can't chew through the way they chew through plastic mosquito netting and duct tape patches. Unfortunately, they still can get into our ceiling easily from outside from a variety of entry points around the roof, and from there, they can easily jump down into our house (the rice bags don't seal tightly against the walls). Our next strategy is to try to convince Peace Corps that our rodent situation is a hazard to our health, and therefore they should replace our rice bag ceiling with a tightly sealed wooden ceiling to prevent our critter friends from getting down from the ceiling into our house. We'll see how this works. Stay posted for further developments. Oh Africa...

Driving Rules in The Gambia

Read these rules. Learn these rules. Love these rules.

1. If I am bigger than you, I have right of way. Always.
2. Rule #1 takes precedence over every other rule.
3. I will drive where I want, when I want, even if it involves driving the wrong way on a road or cutting across all traffic.
   
4. I will honk my horn loudly and repeatedly to say either a) hello or b) get out of my way. It is often hard to distinguish between these two purposes.
5. Never forget rule #1.
   

I hope these rules will be helpful if you ever are driving or walking in The Gambia.

Working hard....or maybe too hard?

As Sarah mentioned I have gradually shifted to do more IT work. I am sure you all aware that while I am definitely comfortable with computers, troubleshooting and solving all problems is not a skill I have developed significantly. I turned to Daniel for some suggestions and have spent all day browsing some websites and downloading information that might be useful so I will have access to it at site. In Kombo I have a reasonably fast connection. At site I have a 56k connection or occasionally something a bit faster.

Anyways, it is now closing time so as everyone was leaving someone said to me that it is important that I do not finish all my work at once and that I need to leave some for tomorrow. If I finish all my work in one day I am telling my employer that I do not have enough work and I don't really need to be here at all. Thus threatening my job security. I have previously heard that it is unwise to demonstrate talent at something you don't want to do and the logic behind that makes sense to me. However, I have never thought that being productive decreases your job security. Interesting conversation and potentially an important component in perceived differences in work ethic.

More on Islam (written Sept 14)

I had another interesting conversation with a colleague yesterday and I wanted to share a few of the highlights:

My colleague brought up the Florida pastor threatening to burn the Koran in commemoration of 9/11. I quickly started talking about how every country has its crazy people and emphasized that the insensitive and irrational actions of one man should not by any means be taken to represent the general attitude of our country. My colleague said he understood that, and that in fact the imam at his mosque had actually said something very similar regarding the issue. Very good to hear! My colleague also said that a very large majority of Muslims in the world do not support violent actions by extremists, and he hopes that Americans understand that. I said that some do, but not all.

A little while later, the conversation moved on to polygamy, which is the norm here, and I believe in most Muslim countries. He explained that Allah says that women should be taken care of by men, and that is one of his gifts to women. I asked why, exactly women need taking care of, and he said that Allah decreed it, so we don't question it. A more satisfying answer would have been that women also are supposed to have a lot of children, which means they are busy with child-rearing and therefore generally don't have time to work outside the home, which means they need a husband to support them financially. That certainly is how things work here. So women need husbands, and he rightly pointed out that there are more women than men in the population (not a huge number more, but there are more), so it follows that in order for men to carry out their duty of taking care of women, some of them need to have more than one wife. Interesting perspective.

From there, my colleague went on to ask me why it is illegal in the US to have more than one wife (something that is genuinely shocking to many Gambians). I said that the only reason that Gambians are allowed to have more than one wife is because the Koran says so. As I was saying that, however, I started to wonder...why am I considering monogamy the assumed starting point that must be modified for anything different to be acceptable? I would assume that it's because the US was founded by Christians, most of whom believe in monogamy, but the US today is not nearly as homogeneously Christian as it was in the late 1700s, and yet the law still stands. My colleague, aware that there are Muslims in America, asked why the US Government has laws about an issue on which different religions differ so radically. Shouldn't it be something that people can make their own decision about based on their religious beliefs? Hmmm...good question. Back to the ever-controversial debate about the separation of church and state...

We've been slacking

Sorry everyone for the dearth of posts lately (yes, I just said "dearth" - I haven't completely forgotten how to speak English yet)...we've been busy and have had minimal access to internet. Here is a brief update of what we've been up to:

Jacob has been working with a new internet cafe in Soma, helping them make their business more efficient and profitable. He also has been learning new computer skills (such as reformatting and networking computers) and using them to maintenance various computers in the area.' He went down to Kombo a couple weeks ago to participate in the swearing-in of a new batch of education volunteers.

I have been continuing to work at the Public Health Office at the local major health center, helping them improve their information systems and data analysis. I also have been helping Lisa with a relatively extensive research project focused on HIV stigma.

We are still waiting to the funds for our water project to come through from Washington, but we hope to be laying pipes within a month. The community has a bank account set up ready to receive the funds and they have already started collecting money for a maintenance fund and paying the monthly bills once the taps are installed.

Last month we both went down to Kombo for "reconnect," a several-day training for our whole group where we had a chance to catch up and share our experiences. It was fun and great to see everyone.

The Muslim holiday of Ramadan was early August through early September. It wasn't overly exciting, honestly...not a whole lot to say except that during Ramadan all Muslim adults (with the exception of breastfeeding and menstruating women, sick people and travellers) fast during daylight hours, which means no food and no water, even when they're out working in the fields in the sun. We gave fasting a try, but only refrained from food, not water. A month is a long time, so we're quite happy it's over.

We came down to Kombo on Monday for several reasons: 1) The Project Proposal Committee, which we were involved in establishing and on which we are active members, is having a meeting; 2) The Gender and Development Committee, on which I am our regional representative, is having a meeting; 3) The HIV Task Force, on which I am a member, is holding a workshop and planning meetings for an upcoming HIV Education Bike Tour; 4) I am helping Lisa compile data for her HIV research project; 5) Jacob is enlisting an IT volunteer to help him write an inventory tracking program for the internet cafe he is working with (in addition to offering internet services, printing, copying, typing, and CD/DVD burning, the cafe also sells movies, mobile phones and accessories, phone credit and sim cards, flash drives, etc); and 6) We are celebrating our two year anniversary :-) Like I said, we've been keeping busy!

I hope everyone is doing well at home and enjoying the beginning of fall. We miss you all a ton, so please please drop us an email if you have a minute...we would love to hear from you!

Oh and even though I haven't been writing much lately, I haven't been slacking quite as much with taking pictures, so here are a bunch:


This is for Daniel. Speaker set-up at a local graduation. In addition to precariousness of the tower, note the proximity to the ceiling fan. A few seconds after I took this picture the fan hit the top speaker. Luckily it did not fall, but still a bit scary.


Asobe (sort of) at a dinner during reconnect.


During a recent rain shower, I got caught on the opposite side of the compound from our mat and the National Geographic magazine I was reading. Luckily the camera was on my side of the compound, so I was able to capture little Ntanding immersed in the magazine.


Once the rain slowed down a bit, she decided to go play/bathe in it.


How could you not love this girl???


Some of the public health team I work with.


Isatou with her motorbike. Lovely as always.


Chocolate cake, hot out of the bread oven...heavenly!!


Birthday girl posting with her fishcakes and chocolate cake


So I finally broke down and cut my hair. It's much cooler and easier to wash now. Huge thanks to Leah for doing an awesome job cutting it :-)


Jacob with Ntanding and Bintu at the celebration of the end of Ramadan (Korite)


Saanka and Umie on Korite


Bintu all gussied up for Korite


Hawa and Bintu. I made this black and white because it was too blasted out to see their faces any other way.