In The Gambia, I worked with the MRC, the Medical Research Council which is affiliated with the UK government and has been working in Gambia for over 50 years. It's now the 2nd largest employer in the country after the Gambian government. Their role is to provide clinical care and clinical research relevant to the local population. For example, the new meningitis vaccine funded and championed by the Gates Foundation as the first vaccine developed to treat a disease that affects the developing world rather than the developed world, underwent clinical trials at MRC.
As you saw from my West Africa Profile post, the country is extremely poor and health and development needs are great. However, the political situation in The Gambia is making it increasingly difficult for NGOs and other nonprofit organizations like the MRC to continue functioning. The President, Yahya Jammeh, who per his official website carries an astounding 6 titles: "His Excellency Chief Sheikh Professor Alhaji Dr," has been in power since a coup in 1994. Despite being democratically elected 3 times since then, he has been increasingly consolidating power and censoring the media and all opposition.
Apparently, anything the President decides to do can have no competition. And he decides to do a lot. He has been entering into every realm of business in the country and pushing out all competitors. He has a bakery. An NGO that grew mangoes as part of its work to sustainably support local communities had to leave when the President decided to start mango farming. Even more difficult for health-related NGOs, the President offers his own cure for HIV/AIDS. Yes, all people with HIV/AIDS can leave their cumbersome antiretroviral medications behind and go to the President's house, where he will lay his hands on them a-la Jesus and thus cure them. His "cures" are performed and presented on national television on a weekly basis. Of course, anyone with basic knowledge or education should know that if someone infected with HIV does not take their medications to keep their viral levels low and their immune system strong, they unfortunately will not have long to live (as those who were alive in the early 80s before the ARV medicines were developed will remember).
Even more difficult than trying to keep your organization's goals and activities from offending the President's next investment whim is attempting to partner with the existing political system in order to create sustainable aid projects. The hospital directors, in addition to the government Ministers, are politically appointed positions. The newest Minister of Health is a young woman in her 20s with absolutely no health-related experience. Hospital administrators are often equally inexperienced. Even so, they could be trained on the job, but political favour shifts quickly and most Ministers and Directors are fired, or sometimes jailed, within a year of their appointments, just as they begin to figure out how the systems they've been "running" were supposed to work, and just as NGOs have finally negotiated agreements for partnership and buy-in on their projects.
Monday, April 4, 2011
Saturday, April 2, 2011
The Children of West Africa
The children were one of the best, and the worst parts of the trip. Everywhere we went, especially in rural areas, groups of children would smile, point, and call out "toubab"--white person. Often they would run up to us for high-fives, and sometimes two children would take each of my hands and a whole entourage would form as groups of children walked along with us hand-in-hand.
However, I say "the worst" part as well because it was tragic to see how many of the children had sores and skin infections all over them. I saw a boy with ringworm fungus covering an entire arm. Some of the kids had scabies all over their arms and scalps. Most people bathed in the rivers--you could see them gathered there in the evenings--but I saw one or two children so caked with dust and dirt that it must have been months since they had had access to any spare water to wash with.
Many of the children in the villages also had clear signs of malnutrition--their black hair had turned a rusty red, their bellies were big and swollen--kwashiorkor, serious protein deficiency. Here some of the kids did not have any clothes at all to wear, or they had only a T-shirt and no pants. Looking at their bulging bellies I thought about the high rates of child death in the area: in Mali 1 in 5 children die before their 5th birthdays, in Gambia 1 in 10. These rural villages were probably below the national average. I wished I had peanuts or eggs or some form of high-protein food to give to these kids. They clearly needed it.
But then there was the problem of whether or not to give things to children. Were I to give food to them, how would it influence their perception of toubabs as they grew up?
Locals of all ages saw white tourists as a source of easy money. An unfortunate tension seems to have developed between foreigners and locals. The locals view the tourists as a source of income, a free drink or meal, some sort of handout, rather than as people with the potential for friendship and cultural exchange. They resent that tourists have much more money than they do and yet are not as generous as they think we should be with it. Although most locals start conversations with big smiles and by welcoming tourists to their country, it was extremely rare to have a genuine conversation with a local that did not end with them somehow asking for something. Sadly this left me trying to avoid talking with locals at times, usually the part of traveling I enjoy most as a way to understand a new place and culture.
Sometimes, especially in the cities, rather than joining us out of curiosity or to play, the children would approach to ask for pens, candies, soccer balls, or simply hold out their hands and demand "cadeau" - gifts. Some of the children asking would clearly be very poor and living by begging, but others would appear relatively well-off, which made me wonder about the culture that is now engrained at a young age of asking white people for gifts. Some children need things to survive, whereas others just want toys and candy. The tourists must give children things occasionally or the ones who don't need to beg wouldn't bother asking.
Yet for many there clearly is a need for assistance. In addition to the poor hygiene and malnutrition I mentioned, most children don't have any toys to speak of. They can often be seen racing old bike tires through the dusty streets. I saw some children playing with a "car" that they had made out of an old tin can and plastic bottles that they pulled along on a string. They drop out of school at a young age because their families can't afford their uniforms or school supplies.
And, unlike with adults, the things the children ask for are often inexpensive and therefore easier for us to give away. For instance, many children wanted used plastic water bottles which they would then reuse or play with as toys. The bottles had no value to me after they were empty, so I could hand them over almost without thinking about it, and giving them to the children was a good way to recycle them. Yet it was still a "gift" given to children by foreigners.
So, should we give gifts to children when visiting poor countries, or does this engender a culture of begging, of expecting to receive something for nothing, as well as a culture where children are sent to beg for the family because they arouse more sympathy and so are able to bring in more money? What if you give them something they need, like pens for school or protein-rich food, or even toys? What to do and how to help, or at least not harm, is not so black and white.
Photo: Children in a rural Dogon village in Mali mob our hiking companions, Justin and Jeremy
However, I say "the worst" part as well because it was tragic to see how many of the children had sores and skin infections all over them. I saw a boy with ringworm fungus covering an entire arm. Some of the kids had scabies all over their arms and scalps. Most people bathed in the rivers--you could see them gathered there in the evenings--but I saw one or two children so caked with dust and dirt that it must have been months since they had had access to any spare water to wash with.
Many of the children in the villages also had clear signs of malnutrition--their black hair had turned a rusty red, their bellies were big and swollen--kwashiorkor, serious protein deficiency. Here some of the kids did not have any clothes at all to wear, or they had only a T-shirt and no pants. Looking at their bulging bellies I thought about the high rates of child death in the area: in Mali 1 in 5 children die before their 5th birthdays, in Gambia 1 in 10. These rural villages were probably below the national average. I wished I had peanuts or eggs or some form of high-protein food to give to these kids. They clearly needed it.
But then there was the problem of whether or not to give things to children. Were I to give food to them, how would it influence their perception of toubabs as they grew up?
Locals of all ages saw white tourists as a source of easy money. An unfortunate tension seems to have developed between foreigners and locals. The locals view the tourists as a source of income, a free drink or meal, some sort of handout, rather than as people with the potential for friendship and cultural exchange. They resent that tourists have much more money than they do and yet are not as generous as they think we should be with it. Although most locals start conversations with big smiles and by welcoming tourists to their country, it was extremely rare to have a genuine conversation with a local that did not end with them somehow asking for something. Sadly this left me trying to avoid talking with locals at times, usually the part of traveling I enjoy most as a way to understand a new place and culture.
Sometimes, especially in the cities, rather than joining us out of curiosity or to play, the children would approach to ask for pens, candies, soccer balls, or simply hold out their hands and demand "cadeau" - gifts. Some of the children asking would clearly be very poor and living by begging, but others would appear relatively well-off, which made me wonder about the culture that is now engrained at a young age of asking white people for gifts. Some children need things to survive, whereas others just want toys and candy. The tourists must give children things occasionally or the ones who don't need to beg wouldn't bother asking.
Yet for many there clearly is a need for assistance. In addition to the poor hygiene and malnutrition I mentioned, most children don't have any toys to speak of. They can often be seen racing old bike tires through the dusty streets. I saw some children playing with a "car" that they had made out of an old tin can and plastic bottles that they pulled along on a string. They drop out of school at a young age because their families can't afford their uniforms or school supplies.
And, unlike with adults, the things the children ask for are often inexpensive and therefore easier for us to give away. For instance, many children wanted used plastic water bottles which they would then reuse or play with as toys. The bottles had no value to me after they were empty, so I could hand them over almost without thinking about it, and giving them to the children was a good way to recycle them. Yet it was still a "gift" given to children by foreigners.
So, should we give gifts to children when visiting poor countries, or does this engender a culture of begging, of expecting to receive something for nothing, as well as a culture where children are sent to beg for the family because they arouse more sympathy and so are able to bring in more money? What if you give them something they need, like pens for school or protein-rich food, or even toys? What to do and how to help, or at least not harm, is not so black and white.
Photo: Children in a rural Dogon village in Mali mob our hiking companions, Justin and Jeremy
Friday, April 1, 2011
Border Crossing
We had to cross the border between Senegal and Gambia to get to Fajara, where we would be working at Medical Research Council (MRC) for the last week of the trip. This involved driving from Toubakouta to Karang, the border town on the Senegalese side, having our passports stamped by Senegal officials, walking across to the Gambian side (all the while being chased by money-changing hawks and young girls selling cashews), presenting our passports to Gambian officials, then taking a Gambian taxi to the north side of the Gambian River at Barra, waiting for a ferry, then crossing the river to reach the capital city of Banjul, and finally taking another taxi from Banjul to Fajara. None of these 4 taxi/ferries traveled more than 15km each.
We accomplished the first travel leg flawlessly due to a stroke of pure luck. The owner of our hotel in Toubakouta happened to be driving to Karang for some groceries when we checked out, and she offered to take us in her spacious 4-door pickup truck (with working seatbelts, the first I'd seen in 3 wks). For free. We tried to pay her and she refused. This was absolutely unheard of, and the only time we ever got something genuinely for free while in West Africa.
The Gambian border office had about 7 employees and 2 customers (us); some were wearing uniforms and some plain clothes so unclear how many were actually employed, but at least one of the plain-clothes (shorts, sandals) people present spoke to us with authority as though he were an official employee. After walking between 3 different rooms and showing our passports to all 7 employees present, someone in the final room set about a 20 minute process of stamping our passports. The stamp itself is of the fill-in-the-blank variety like you might buy for your child as a toy. It says (no joke): "Valid for a single journey to _____" where they handwrote their country name, "The Gambia," into the blank, followed by several other blanks where they handwrote an entire novel including today's date and the generous allowance of a 14 day duration of stay.
We thought we were done after this, but one of the first guys (also wearing plain-clothes) identified himself with a laminated card as part of the "President's Club Against Narcotrafficking" (or some such thing--but I think it was called "club" and it defintely looked like an elementary school library card). He stated that he was going to search our bags to make sure we weren't carrying any drugs. We said fine. He then took us to another room and began to open each pocket of our bags. He pulled out and closely examined everything. Oddly, he paid very close attention to several items that were clearly not drugs, and asked questions about them. I got the impression that he was actually just curious about us and what sorts of things we had brought from the Western world rather than looking for drugs. He leafed through my book, "The Girl Who Played With Fire," and asked if I had ever been to Sweden (the author is Swedish). He read a few lines of our Lonely Planet. He asked if my Burt's Bees chapstick was made with beeswax. He examined Geoff's inflatable neck pillow and asked whether it was for taking blood pressure.
Interestingly, according to rumours we've heard while in the Gambia, the President's new war on drug-trafficking is an elaborate scheme to detract attention from the fact that the President himself operates and profits from a vast drug-trafficking network (or perhaps just to eliminate his competition).
Finally he returned our things and sent us out to the Gambian side of the border to find our taxi to Barra (Gambian border town). We got one with just 5 adults and 1 child in a 5-seat sedan, so that was pretty lucky.
In Barra, we bought our ferry tickets and sat down to wait. 2 hours later, the ferry could still be seen sitting on the other side of the river (maybe 10km away). Apparently there are 3 ferries, but for whatever reason (you shouldn't ask too many questions about why in West Africa because even if you were to get a straight answer, it would never make sense to your worldview) just 1 was operating that day. Then we found another helpful citizen who pointed us in the direction of a small wooden boat that was going to load passengers and make the crossing "immediately" for just 10 times the cost of the ferry (I think this was actually the cost of 4 tickets, 2 for us and 2 for our new "friend" and his accomplice, but whatever as long as we got there faster). We boarded the boat and waited for it to fill. The ferry was still sitting idle on the other side of the river.
Eventually we had close to 100 people on board and our drivers motored a little ways away from the pier. There was hesitation and we sat circling close to the pier. Apparently the boat operators had decided that the boat next to us (which was still in the process of its hundreds of 50-lb bags of grain or whatnot being unloaded onto the pier) would be a better boat for the crossing, and that all 100 passengers should wait for it to finish being unloaded, and then switch to the other boat before we departed. An argument broke out between the passengers and the 2 or 3 operators.
I was picturing an angry riot. I was also picturing the boat toppling over when all 100 people tried to stand up and rush to switch boats at the same time. Around this time, the ferry began to make its way towards our side of the river. After about 30 minutes of arguing and motoring in circles 5 feet off the pier, the operators apparently also realized the potential for a full-scale riot, and/or the abandonment of all passengers in favor of the cheaper ferry now on its way to our side--unclear which, and finally set off steadily toward Banjul. Several people we met in Gambia afterwards gasped in horror at the ridiculously dangerous idea of taking a small boat rather than the ferry across...but it seemed reliable enough aside from its riot potential.
We accomplished the first travel leg flawlessly due to a stroke of pure luck. The owner of our hotel in Toubakouta happened to be driving to Karang for some groceries when we checked out, and she offered to take us in her spacious 4-door pickup truck (with working seatbelts, the first I'd seen in 3 wks). For free. We tried to pay her and she refused. This was absolutely unheard of, and the only time we ever got something genuinely for free while in West Africa.
The Gambian border office had about 7 employees and 2 customers (us); some were wearing uniforms and some plain clothes so unclear how many were actually employed, but at least one of the plain-clothes (shorts, sandals) people present spoke to us with authority as though he were an official employee. After walking between 3 different rooms and showing our passports to all 7 employees present, someone in the final room set about a 20 minute process of stamping our passports. The stamp itself is of the fill-in-the-blank variety like you might buy for your child as a toy. It says (no joke): "Valid for a single journey to _____" where they handwrote their country name, "The Gambia," into the blank, followed by several other blanks where they handwrote an entire novel including today's date and the generous allowance of a 14 day duration of stay.
We thought we were done after this, but one of the first guys (also wearing plain-clothes) identified himself with a laminated card as part of the "President's Club Against Narcotrafficking" (or some such thing--but I think it was called "club" and it defintely looked like an elementary school library card). He stated that he was going to search our bags to make sure we weren't carrying any drugs. We said fine. He then took us to another room and began to open each pocket of our bags. He pulled out and closely examined everything. Oddly, he paid very close attention to several items that were clearly not drugs, and asked questions about them. I got the impression that he was actually just curious about us and what sorts of things we had brought from the Western world rather than looking for drugs. He leafed through my book, "The Girl Who Played With Fire," and asked if I had ever been to Sweden (the author is Swedish). He read a few lines of our Lonely Planet. He asked if my Burt's Bees chapstick was made with beeswax. He examined Geoff's inflatable neck pillow and asked whether it was for taking blood pressure.
Interestingly, according to rumours we've heard while in the Gambia, the President's new war on drug-trafficking is an elaborate scheme to detract attention from the fact that the President himself operates and profits from a vast drug-trafficking network (or perhaps just to eliminate his competition).
Finally he returned our things and sent us out to the Gambian side of the border to find our taxi to Barra (Gambian border town). We got one with just 5 adults and 1 child in a 5-seat sedan, so that was pretty lucky.
In Barra, we bought our ferry tickets and sat down to wait. 2 hours later, the ferry could still be seen sitting on the other side of the river (maybe 10km away). Apparently there are 3 ferries, but for whatever reason (you shouldn't ask too many questions about why in West Africa because even if you were to get a straight answer, it would never make sense to your worldview) just 1 was operating that day. Then we found another helpful citizen who pointed us in the direction of a small wooden boat that was going to load passengers and make the crossing "immediately" for just 10 times the cost of the ferry (I think this was actually the cost of 4 tickets, 2 for us and 2 for our new "friend" and his accomplice, but whatever as long as we got there faster). We boarded the boat and waited for it to fill. The ferry was still sitting idle on the other side of the river.
Eventually we had close to 100 people on board and our drivers motored a little ways away from the pier. There was hesitation and we sat circling close to the pier. Apparently the boat operators had decided that the boat next to us (which was still in the process of its hundreds of 50-lb bags of grain or whatnot being unloaded onto the pier) would be a better boat for the crossing, and that all 100 passengers should wait for it to finish being unloaded, and then switch to the other boat before we departed. An argument broke out between the passengers and the 2 or 3 operators.
I was picturing an angry riot. I was also picturing the boat toppling over when all 100 people tried to stand up and rush to switch boats at the same time. Around this time, the ferry began to make its way towards our side of the river. After about 30 minutes of arguing and motoring in circles 5 feet off the pier, the operators apparently also realized the potential for a full-scale riot, and/or the abandonment of all passengers in favor of the cheaper ferry now on its way to our side--unclear which, and finally set off steadily toward Banjul. Several people we met in Gambia afterwards gasped in horror at the ridiculously dangerous idea of taking a small boat rather than the ferry across...but it seemed reliable enough aside from its riot potential.
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