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July 28, 2006
Conflicts at the Clinic
I guess one thing that I have discovered from spending time in Mali is that development really cannot happen overnight. No matter how much you plan, or how much money you have, something is bound to go wrong, and you just have to be able to adapt to it. There is also so much diplomacy involved, and if you step on the wrong people's toes even once, a project can be finished. For example, last week, Dr. Malick Kone, the director of GAIA in Mali, arranged to have an HIV expert from Point G Hospital, Issa Kone, come to the clinic every Thursday to write prescriptions for people's HIV meds and to provide free HIV transportation to and from the clinic. However, Dr. Daou, the director of the Sikoro clinic, was really offended when Issa Kone showed up on Thursday because he felt like Malick was trying to supercede him, so he ordered Issa to leave the clinic although there were dozen of patients waiting for medication. Even though we have now entered into negotiations with other doctors and it looks like the program will still happen after all, I am just so frustrated because so many of the arguments here are so pointless, especially because they are driven by people's egos. Daou called me into his office after his argument with Malick Kone and Ramatoulaye and started explaining the situation to me in French, and I listened to him, but I was just thinking, "Why are you telling me this? Why aren't you speaking with Malick? Why do you have to make everything so difficult?" Despite anyone's good intentions, it seems there is always an obstacle.
Yet despite the administrative struggles at the clinic, the staff is incredible, particularly the sages-femmes (midwives). This week, I had the opportunity to watch them in action when I spent the night at the clinic with my friend Victoria, a graduate student from BU who has been helping the sages-femmes all summer. We arrived around 10pm and were shown to our quarters for the night - a small narrow mattress on top of a barren concrete floor. After a pretty sleepless night, Vic and I were feeling pretty disappointed because there had yet to be a birth, but around 7:50am, we noticed a woman hobbling towards the Salle de L'Accouchement (Birthing Room) Vic and I hurried after her, and the sage-feems quickly mounted her onto the cot. When I entered the birthing room, I was shocked at the lack of medical equipment - the room consisted only of the cot the woman was placed on and a table with a scale and some medical instruments on it. I have to admit that I was nervous - how, I thought to myself, are the sages femmes going to pull this off? However, I would soon learn that the sages femmes had just all that they needed - they began talking to the woman in soothing tones and she pushed without more than a whimper. Within 20 minutes, there was finally noise in the room - but it was coming from a beautiful, newborn baby girl. This was the first birth I had ever witnessed, and it was very quick and very clean. I think that the Malians have the right idea about childbirth - women don't come to the clinic until it's necessary, and labor isn't the long, drawn-out process it is the United States.
The Balanie de L'Espoir is tomorrow in Sikoro. Today's rehearsal went very well, and I think that it should go off pretty well. What makes me the happiest is that some of the peer educators are really enthusiastic - one of them in particular, Francis, has come to the clinic every morning without fail since training to help us out - so I'm hoping that if we can set up the proper infrastructure, the program should be able to continue throughout the year. Obviously, monitoring progress will be difficult as I will be back at Brown, but another Brown student, Caitlin, is staying in Mali until January, so I'm hoping that if she works with Ramatoulaye and keeps me in the loop, I will be able to monitor the program and do the things necessary to keep it going.
Posted by Madeline DiLorenzo at July 28, 2006 09:48 PM
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