Saturday, November 3, 2007

Toto, I've a feeling we're not in Kansas anymore!

As I am sitting on the terrace, ice coffee in hand, watching the cats play in the garden, some music in the background, pondering my life, it almost feels like I am in a very familiar place (New York, Berlin, Santa Fe, …), and not very much like I am in Bamako, Mali! But if I sit here long enough, I think about things that I have experienced in the last five months that have been decidedly un-familiar and that could have taken place only here, and never in New York …

Fridays we have Mutton for Lunch
Who needs a planner? I know it’s Friday when I hear sheep bleating in front of our gate. Our neighbors to the right are Tamashek (Tuareq), and they like their roast mutton! (Even Malé, the original carnivore, remarks about the Tamashek that they eat a lot meat. So you can just imagine…) Every Friday morning somebody tethers a frightened sheep to the tree in front of the house, where it bleats for a couple of hours. Around 10am or so the animal is silenced with a swift cut to its throat, and with remarkable speed is skinned, gutted, and chopped up to fit the cooking pots. I have learned to not leave the house during that time – I will just wait for an hour or so, rather than witness the procedure. Something about watching an animal bleed to death, still kicking its legs, so early in the morning … Later that day the neighbors to our left (regular old Bambara) start roasting the mutton’s head. (I know that they do when the stench of burning fur wafts into the house). Every once in a while the Tamashek send over an animal part as a gift (leg, shoulder, ribs…). (They probably feel sorry for Malé because his wife does not cook him a sheep every Friday.) As soon as they leave I re-gift the leg/shoulder/ribs to my neighbors on the left. I don’t have the utensils to cut something like that into smaller pieces, but they do. Later that day they send us a pot of whatever sauce/stew they cooked up. I’ll eat the sauce, and Malé eats the meat. All around it’s a perfect arrangement!

Bathroom Story #1
Shortly after we moved into this house both sink faucets in both bathrooms broke, after having leaked, dripped, and jammed for about a week. They broke because they were the cheapest possible faucets, entirely out of plastic with a thin coating of metal (or silver-colored substance anyway), made in China. (They cost $3 in the hardware store, so that gives you a reference.) We called the manager of the property, and he came over later that day. We urged him to replace the faucets with something that was of better quality so that they actually would last. (Maybe something top-of-the-line, like for $5!) The faucets that he had put in the next day were so poorly made that they must have been Chinese “rejects” from the 90’s, before they started exporting everything to Africa. They both broke two days later, hours apart. (It was actually quite impressive, the way they both broke in the same manner, just hours apart. Maybe I misjudged the manufacturer, and I was actually witnessing an ingenious example of engineered consumerism … ) We decided that it would save us a lot of grief to forgo getting the property manager involved, and instead just pay for the material of our choice. We splurged on two Italian faucets, and I am happy to report that they are still working nicely …

A Love Story (Malian Version)
Malé has a friend whom he calls “le grand ton-ton” (the big uncle). He is really nice, and for ten years he has been married to an equally nice woman. They are both health care providers and –although originally from Timbuktu- live here in Bamako. They have never conceived any children, which causes the couple and their families much distress. His family, especially, has been putting pressure on the Ton-Ton for years to take a second wife, something that his current wife does not want. Apparently they really love each other a lot, and up until now they had been able to keep his family at bay. Recently we had been to their house for dinner, and found out that after many months of unemployment the Ton-Ton just was hired to work for the state, providing health care services to employees of one of Mali’s gold mines. He was very happy about that, and prepared to report for work later that week. Unfortunately he would have to live there as well, since it is about 6 hours away, and would only be able to come home every couple of weeks.

Afterwards Malé told me that while he is happy that his friend found work, he is also worried about the Ton-Ton and his wife: once the Ton-Ton lives so far from his wife, he will surely succumb to the family’s pressure and let them select a second wife for him (one that is fertile!). He will agree to it because he, too, wants to have children, and he does not want to leave his current wife. His current wife will be heart-broken about the second wife, but she will not leave him. Instead she will try to be the better wife, and shower him with food and other tokens of affection. She loves him too much to leave him, Malé predicts, and even if she wanted to leave him she would hardly find the courage. A woman who has not conceived will not easily find another husband. Here, where marriage and procreation are a woman’s most important accomplishments, this woman will feel shamed and betrayed, and yet hold onto her husband and her marriage. (But what if he is the one who is infertile, I interject. Would she get to take a second husband? I just had to ask …)

I feel sad for my sister, and –again- I am filled with gratitude that my life is so different. I cannot imagine thinking or feeling that way, and having so little control over my life. (And if you are wondering: because Malé already has 4 kids he has fulfilled his quota, and I am off the hook!)

The BYOB Hospital
A while ago Malé’s nephew Hamédou ended up in Bamako’s biggest hospital with a really badly shattered leg. Luckily Malé’s sister-in-law works there, so thanks to her connections the boy’s leg was operated on and reset right away. Hamédou’s mother and aunt took turns staying there with him. We were lucky that Hamédou had a bed and that he had been treated, but aside from that it was a BYOB-type of hospital: the family had to feed him, wash him, dress him, change the bedding… Whoever was not staying in the hospital was at home cooking meals and washing clothes. The room contained about 6 beds, and most beds were shared among patients. Additional patients were lying on mats on the floor, as were family members and visitors. In one bed was a young man who had been in a motorcycle accident and broken his thigh bone. His leg was swollen, but so far it had not been set. Instead, the doctors had attached a cast on his foot, and a rope with a rock on it. I was not really sure what the purpose was: the weight was to pull at the leg and prevent something or do something. I admit that I am not a doctor, but surely the real objective was to set the bone and put it in a cast! One week, two weeks, and then three weeks went by, and the young man was just sitting on his edge of a bed he was sharing with a very old man. Several times Malé went looking for a doctor to advocate for this young man, and to find out why he had not been treated. He never found a doctor. (Meanwhile I wanted to write an exposé a là Geraldo Rivera, publishing all the scandalous and outrageous conditions at this hospital!) Finally one day after more than three weeks we arrived and he finally had a cast on. They had to re-break the bone to set it properly. Duh!

One time we arrived and found everybody in the court: patients and family members, with their beds, mats, cooking utensils, clothes, everything. It turned out that that day they were spraying the hospital rooms against mosquitoes, and so the rooms had to be vacated from early morning until 4pm that day. A couple of patients died while being moved. There were no stretchers or wheelchairs to move them, just family members to carry them.

One day a man arrived with his badly wounded friend. He and his friend were “vagabonds” (homeless? Alcoholics? mentally ill? Criminals? Hobos? The term could describe all of that…), and his friend’s leg was crushed by a moving train. He stayed with his friend in the hospital, and tried to get a doctor to see him, but to no avail. The entire time his friend was suffering and bleeding and begging for help. We were told that after four days the “vagabond” suffocated his injured friend with a piece of clothing and left the hospital. Now the police was looking for the man in all the known “vagabond” places. I was appalled, and had so many questions: did he kill his friend to end his suffering? Was the man really suffocated, or did he bleed to death and somebody concocted the story to shift the blame? Is the hospital being questioned about leaving somebody untreated for all that time? But the questions were really just rhetorical, I already knew some of the answers, and I would never get the others ...

[During this time a young French medical student was staying with us. He signed up to complete a 6 week internship at the other big public hospital, and he would come home every day depressed and angry and outraged and discouraged and disgusted at the conditions at the hospital, and the behaviors that he was witnessing. While he understood that part of the problem was a simple lack of funding and access to resources, he also identified other aspects of the problem that could not be explained by that. For instance, as we know, the simple act of washing ones hands between examining patients prevents infections and saves lives. He was assigned to senior staff and shadowed them every day for 8 hours, and he never saw them wash their hands. (Not before their shift, not during, not after.) All 12 patients that he was assigned to follow died within three weeks from –according to him- preventable and treatable causes. Even though there was not enough staff, he hardly was assigned any work and was bored for most of the day. He would see his colleagues take naps throughout the day, and was encouraged to do so as well. He barely was able to finish his assignment; he could not wait to get out of there. He felt overwhelmed by the enormity of the problems, and completely powerless to change anything.]

After 4 weeks Hamédou was finally released from the hospital. Once I saw his leg without a cast or bandage I realized that we were lucky that he was alive, and that he had not lost his leg. He has two huge Frankenstein-like scars, which run the entire length of his lower leg. Apparently the bone was shattered and protruding in several places. Who knows what would have been had his family not had the connections and the money to ensure his treatment….

After all this …
You read all of this and you wonder why I am staying here? You just heard about skinned sheep and dying patients and dripping faucets and you have to be curious about my life here … Well, I like it here: at night we eat on the roof top, and I hear the muezzin call for prayer, and I see shooting stars, and I have a mango tree in the yard, and the food tastes good, and I meet very nice people, and I love going out at night and listening and dancing to Malian music, and I love how the cow herds stop all the traffic when they cross the street, and how the Niger river is wide and untamed and has just three bridges, and I like how peaceful it is here, and I like how men will show their respect by placing their hand over their heart while greeting somebody, and I like learning things about the people and languages and cultures, and I like going to places and feeling like I have stepped inside a movie, except that the set is real and the people are no actors, and I like the possibilities and all the potential that I see everywhere I look, the transformation that is in the making, but most of all I am here because Malé is the most amazing man that I have ever met, and makes me so happy I could burst! And so I am here, shaping and making my new life with Male and his kids and my three cats, and a skinned sheep or two will not even break my stride….!