Phase One (mostly) Complete

Just about two months ago it was confirmed that Peace Corps Togo would be the independent evaluator for the Global Fund funded mosquito net distribution that occurred last October in all regions of Togo (excluding one piece of the Maritime region).  Togo received roughly 70million dollars from the Global Fund to complete last year's bed net distribution and 20million dollars more has been promised if the first phase of the distribution goes well.  To determine if the distribution went well, and to give the organizations and the government who distributed the nets an idea of how close they came to reaching their goals, an independent evaluator is needed (A.K.A. us).

With funding from the WHO, UNICEF, and Plan Togo, two other volunteers and I were chosen to lead the study.   Our task was to perform a nation-wide survey of households to determine bed net usage, how many more nets are needed to achieve the goal of universal coverage, and of course the effectiveness of the bed net distribution itself.  To do this we have organized six trainings for Peace Corps volunteers and their Togolese counterparts to educate about the importance of the collection of good data and the protocol for performing the survey.  With five regional trainings (one for each region) and training for the trainers we will have trained over 220 people in everything from why this survey needs to be done, to what is bias, to how to ask a question.  The majority of these trainings occurred this Monday, except Savanes which is a week later, and the Training of Trainers which was a week earlier, all of which seem to have gone pretty well. 

I am glad Monday is over. Leading up to these trainings we have been working tirelessly booking hotels, writing manuals, negotiating budgets, creating computer programs, mapping villages to be surveyed, and so much more.  There were days that I would come into the office around 6:30am and not leave ‘til midnight, only to show up again the next morning at six.  I spent three straight days staring at a map on the med-unit wall, because it was the only map available that had on it (nearly) all the villages I needed.  It has been a tiring couple of months and it is nice to have a good portion of our work over with.

After these regional trainings, volunteers and their counterparts will go out to their assigned villages and perform a survey of household in those communities.  Once the surveys are completed volunteers will send us their data and we will compile our report analyzing the results.  Until we begin to get data back from the volunteers we have a little break where we will get to think about our report in a more relaxed setting, and I will finally get to return to my own bed and will no longer be sharing a cot the size of a twin bed with another volunteer or eating street food every night of the week.

For now we must wait to see if our survey goes well. I’m hoping for some good data and lots of bed net use!

A Machine that Does Your Laundry

Wow, a laundry machine, who would have thunk it?  I believe I have said that after hand washing my clothes for over a year I will never complain about doing the laundry again back home in the States.  Yesterday confirmed that.

A couple of weeks ago one of our Peace Corps Togo organizations Gender and Development (GAD) had an auction to raise money to support gender related projects and one of our medical staff donated five loads of laundry in her laundry machine, and I won.  I redeemed by first load yesterday morning. It was awesome.

I stuck my clothes into the machine, added a little soap, and pushed a button.  A couple hours later I moved my clothes to the dryer and BAM! my clothes were clean.  No blistered fingers, cracked skin, or aching back necessary.  I lounged around read my book and napped.

And can I talk further about that amazing out of the dryer feel?  That warmth that is so dry it is cozy? I was sweating as I folded my clothes, but I wanted to wrap myself in my freshly laundered clothes and I don’t know, just cuddle with them.  It was great.  If I had the plumbing hook up I might have gone right then and there and bought myself a laundry machine and dryer.

Heaven. 

A Year Down With Many Changes

Yesterday marked the one year anniversary of my arrival here in Togo.  Since my arrival here much has changed and I want to share some of the changes that have occurred between when I first got here and now.

Eighty degrees is cold.  When I first arrived the heat killed me.  The first few nights we spent in Lomé I hardly slept because I was too hot.  As a native Northerner I never thought I could ever get used to the heat.  Of course I still get hot, but the other day I was feeling distinctively cold and when I looked at my thermometer it was a whopping 82 degrees.

I feel naked wearing anything that exposes my knees.  Like a typical young American, back in the States during the summer I wore shorts and skirts that fell above my knees.  I rarely had a second thought about having my knees exposed in an everyday casual setting, but here I never wear anything that doesn’t fall below my knee.  I have one dress that is below my knee, but as a result of slit positioning, if it is windy they skirt will slightly rise to or above my knee and I am constantly pulling my dress down.  Even with my fellow Americans, wearing shorts feels bizarre. Being anywhere in public and having my knees exposed I feel like I am walking around in my underwear.

If it’s not spicy it’s not food.  I ate some spicy things and had no problem tolerating them when I was back home, but my more typical daily cuisine usually didn’t include hot peppers (“piment”).  Now, even when I am cooking for myself, nearly all my food must be spicy.  I add piment to everything.  As ubiquitous as salt normally is to bring out flavor in a dish, for me, piment is in everything.

Waking up at 7am is sleeping in.  I have never been a morning person; I much prefer spending most of my waking hours at night.  At the beginning of my time here it was much the same; I needed an alarm clock to get up for my morning lessons and meetings, but now anything much later than 5:30am is sleeping late.  Part of this is that my neighbors somehow manage to wake up just before the sun begins to rise around 4:30am and they make a fair amount of noise or play music early in the morning.  Everything here seems to get going earlier than back home.  Businesses open around 7:30am instead of 9am and having an early morning meeting is not out of normal.  In some ways I hope the habit of waking up early continues when I return home so that heading to work at 9am doesn’t feel so much like torture.

This is by no means an exhaustive list of how things have changed since I have been here but they are some of the most apparent.  I still have a year here and plenty of time to settle even more into my Togo life ways.  I am interested to see what the next year has in store.

C’est Mon Choix

As a result of a number of contributing factors, teen pregnancy is a significant issue here in Togo.  Many young people feel pressure from peers to engage in sexual activity, rumors run rampant about the dynamics of sex and love, girls get bribed into having sex for gifts, teens often receive no education about their developing bodies, and there is little awareness about contraceptive options available.  

Partly for these reasons, as part of my rounds talking about family planning, I of course found myself talking to students about not having children until they have finished their studies and were ready to support a family.  I found that talking to students is a bit different than talking to adults.  With such a mix of ages and maturity levels, getting students to participate can be a challenge and talking of sex can set the group into nervous giggles.

This time around I was with a team of Red Cross workers.  We began by explaining why waiting to have children is important for them as students, followed by a brief discussion about using contraception if they do choose to have sex.  At this point the school director who had been lurking in the doorway cut in. He spoke of abstinence and that it was the only method of family planning the students were to use.  Later when we were saying our thanks and goodbyes in his office, the director brought up once again—to the Red Cross director of their HIV/AIDS program—that he should not be talking condom use with students, only abstinence.  He “knew his students, and if you open the door just a little there will be a flood of sexual activity.”

The school director is not alone in his thinking about teaching “abstinence-only” to students.  In the U.S. there have been a number of pushes to implement this type of sex-ed in public schools; even withdrawing funding from school who choose to teach about condom use and other contraception.  Distributed by PSI, the slogan “L’Abstinence, C’est Mon Choix” (Abstinence, That’s My Choice) can be found on billboards and T-shirts all over Togo.  And these believers in abstinence are right, the only surefire way of avoiding teen pregnancy and the spread of STIs is by having teens abstain from sexual activity, but abstinence-only is also misguided in its belief that talking about sex and contraception will cause teens to start having sex.

I for one—someone who started getting a sex-ed, including contraction, in middle school—can attest that, upon hearing that things such as condoms could keep me from getting pregnant or a nasty STI, I did not run off to have sex.  Assuming that contraceptives are the key towards teens starting their sex lives is very naive, and over-estimates the amount of thinking that goes into some teenagers’ sex lives.  Yes, we very much want to think that the number one concern of a newly sexually active young person is their health and babies, but in reality when that moment strikes, if they have never been educated to think about protecting themselves, they won’t.

The reality is that teenagers often mature sexually before they do mentally.  Unfortunately teenage sex is not a decision purely driven by a logical assessment of the possible consequences of their behavior, no matter how many times someone tells them, just say no.   There are of course many youth who do abstain from sexual activity, but it isn’t because they have never discussed sex or contraception.

Youth should be taught to value their bodies and wait to have sex until they are mature enough to evaluate the consequences, but a balance needs to be struck.  Even if we close our eyes and pretend it doesn’t exist or hope desperately that it will just go away, time has shown us that teen sex happens.  In Togo teen pregnancy is a large contributor to girls not finishing school and apprenticeships.  It is not because someone didn’t tell them not to have sex that they became pregnant, it is because they were never told to use contraception. We need to show these youths, who—besides our pressure for abstinence—still choose to have sex, how to protect themselves and avoid having to suffer from the very real consequences of unprotected sex.

Grab the Cooking Pot Too!

It rained this morning, no, it poured.  Usually the rain seems to calm everything down as everyone runs to seek shelter, but not my compound, not today.

Our pump is broken and we have been living without water for just about a week.  Some of my Peace Corps friends may give me a, “boohoo, you poor thing.” As they live without running water everyday, but being used to running water and being unprepared to not have running water can be somewhat more of a hassle.  Now I am not completely unprepared; my water situation has been notoriously finicky and after a few times of wanting to cook or take a shower and having no water I have started keeping a large plastic trash can filled with water.  But that water store is not meant to last for weeks at a time and my water supply is becoming perilously low.   Do not worry that when my water runs out it perilously means death—there is another pump a few hundred meters away—it just means a little more lugging of water.

Other than our privately owned pump we do not have any other super conveniently close water source.  So when it rained we all jumped into a flurry of action.  Unlike my host family who had cisterns to collect rainwater our compound is hopelessly pump-bound, but that didn’t stop us from making the most of heavy rains.

At the inside corners of the U that is our building, where the roof comes together, there is an amazing spigot of water when it rains and we all took advantage of it.  Grabbing our buckets, bowls, and as my neighbor shouted, “Grab the cooking pot too!” we filled up as much as we could with water.  I hastily washed some dishes and did some laundry so that I could run out and collect more water.  Only the littlest ones sat back dry and laughing as everyone else dashed around filling one container then the next.  I managed to finish with three large buckets of water after doing a load of laundry and my stack of dishes.  I am so glad for that rain.  Though I’m still hoping my pump will be fixed soon, it is a relief to know that I have a few more days’ worth of water.  

Everybody Was Kung-Fu Fighting

There is a young girl about the age of three in my compound.  She lives with her two grandmothers and a teenage relative.  As you may or may not know about me I am not a big kid person.  We get along fine, but I tire quickly and really could do without.  This little girl though is quite adorable.  She directs all visitors—even those not here to see me—to my door, and shouts my name and runs over to pet me every time I catch her eye.  For all this cuteness, though, she is one of the most annoying and temper-tantrum prone children I have ever dealt with.

Within seconds her laughter turns to rage if things don’t go her way.  If it is meal time and her grandmother comes over to collect her she quickly throws herself against the wall beating her little fists and screaming.  Sometimes she screams and cries for hours on end.  If you’ve talked to me on the phone you’ve probably heard her, she is by no means quiet.  I feel for the women who care for her, who must be at least well into their seventies.

A few weeks ago when I returned home from traveling she seemed worse than ever.  I heard louder and more frequent tantrums; I hadn’t thought she could or would get worse.  For near a week I went about my evenings thinking this little girl had amplified her screaming, until I ventured over to share a snack of fruit and a woman emerged from the house leading a boy of about ten years.  The boy, Kossi, and his mother had been living in the house for the past week, I had never seen them, but boy had I heard them. It had been the young boy’s screams I had contributed my little girl. 

Upon seeing Kossi I felt a profound sadness and sympathy for his mother; he was visibly mentally handicapped.  While a handicapped child anywhere can be a great hardship for a parent, here there is nothing for these children.  Unlike in the U.S. there are absolutely no resources for families with handicapped children.  With no counselors or teachers specializing in mental disabilities and no state funded support, families are left to fend for themselves.  Without a halfway house or a way to earn money, as they get older and their families can no longer care for them, many of these mentally handicapped individuals are left on their own; becoming a town fou, living in rags, and begging around town.

As an outsider and childless I cannot imagine the strain this boy’s mother is under.  I don’t even take care of him and I have already grown weary of my 4:45am wake-up call as Kossi pounds on our metal gate screaming to be let out of the compound.  I flinch as he hits the other children or naively steals things from their hands, leaving them in tears.  I got annoyed at a little girl’s relatively normal tantrums and his were so much worse.  To feel that desperation that you cannot take care of you little boy forever and that he will never be able to take care of himself, I can hardly imagine.

The other day as I sat on my porch and Kossi played in the courtyard, he picked up a stick and began to practice his Kung-Fu.  It was such a normal and endearing thing for an ten year old boy to be doing I had to smile and when I looked over I saw Kossi’s mother leaning in the doorway eyes content on her son and a soft smile on her lips.  I was wrong when I said there was nothing here in Togo for the mentally handicapped, through it all there is still the patience and love of their families.  For all the screaming, hardships, and such uncertain future, you could still see how much Kossi’s mother loved him.  We can all hope that as things develop more options, support, and resources will become available to families such as his, but for now there is always his mother’s embrace and of course a little Kung-Fu fighting.

Talking Trash

This morning my homologue told me he slept much better last night than he had all week. Yesterday marked the last day of a three day training we gave for seventy community leaders on the importance of community waste management and public waste bins. After all the planning and worries that it wouldn’t go smoothly it was relaxing to finally have it over with, but there is still much more to do.

The three days of training were only the first phase in a project to install public waste bins in Vogan.  With the help of the mayor and the director of Hygiene and Sanitation for the prefecture of Vo we sought to educate the community leaders (including all Chefs du Quartiers among others) on why public waste bins are important and how they, as community leaders, can help make this project a success.  The appreciation for the project was evident in the participation we received at the trainings, and of course everyone wanted a bin in their quartier.

Felicity and Delphine with an example bin.

As of now we are installing sixteen public waste bins around the city in locations that are most frequented, such as the marché and public areas of assembly.  We have had a local welder make the bins and we hope to get them all installed later this month. With the availability of public waste bins we hope to encourage people to place their trash in the bins rather than tossing it on the street. 

Installing the bins is, however, not the hardest part of this project; it is going to be getting people to actually use the bins. Simply having public bins and a trash collection program in place doesn’t make people use them.  It is habit for nearly everyone to toss their empty water containers and plastic bags on the ground and simply toss household trash into a pile next to the house.  Hopefully the community will recognize the importance of a clean city and the bins will catch on and people won’t simply toss their trash at their feet. 

To achieve this behavior change we trained community leaders, are having radio public service announcements, and are even working with the mayor to institute fines to those found littering.  With the community’s participation I hope that we can make Vogan a cleaner city and that after we have set the example for the first few bins that the community will take the initiative to make them multiply.

Without the help of many of my Togolese partners, and the community itself, I would not be able to make this project be a success, because as I so tackily said is my speech at the training, “It is not the waste bins that will create the change, but the people of the community.”