We Don Finish Quick Quick

Exactly one year after leaving America for Cameroon to develop and test an audio program to promote exclusive breastfeeding we done finish, as it is said in Pidgin.  Yesterday we had the fourth and last listening session for our intervention group.  After a year of seeking funding, planning, and preparing in the United States and another year in Cameroon of determining existing exclusive breastfeeding knowledge, beliefs, and practices, developing the audio program, recruiting 284 pregnant women and their partners, finding voice actors, recording and editing the audio program, writing an accompanying discussion guide, arranging for food and transportation for 350 participants, hiring local assistants, and collecting data for all of the participants I feel a huge sense of relief and thanksgiving to reach this point.    Although the project isn't completely finished yet, the bulk of the project is certainly done and what is remaining does not rely on many external factors such as electricity, political stability, reliable assistants, language translation, finances, and 350 people willing to travel far distances to arrive on time and listen and discuss pertinent health matters.  

As I look back on the past two years there certainly have been obstacles, but it has always worked out, just not the way I think it will.  One of our recurrent obstacles was electricity failure on the days that the participants came to listen to an audio program segment.  I was able to record the audio program on my iPod and then played the segment on speakers operated by batteries.  Below is a picture of Gilbert holding the speakers while the participants listened to the program.  Gilbert really should be called Jack because he is a Jack-of-all-Trades at the District Medical Office.  He's a driver, logistician, photocopier, translator, and food procurer.  Each week he would arrange with "Mama Chin-Chin" and "Mama Fish-Roll" to provide food for all of the participants.  Although I only met Gilbert a few months ago, I could not have orchestrated all of the listening sessions without him.  He is an example of how God has provided in many unexpected ways this past year.

I included this picture because of the man wearing a baseball cap.  He and his wife live in Oku, about an hour away from Kumbo.  His wife came to the first listening session, but on the way back she had an accident on the motorbike and hurt her leg. Because of this and the late stages of her pregnancy she couldn't attend the remaining listening sessions, so she sent her husband.  He feverishly took notes during each listening session so he could report back to his wife.  This and his congenial attitude certainly won my respect for him.  

Since we began recruiting the women in July many of them had given birth by the time we started the listening sessions.  Having about 10-15 babies in attendance sometimes made for a noisy environment, but I was relieved and grateful with the mothers' attempts to keep them quiet (usually by breastfeeding them!) so that the others could hear.  Sometimes the babies were just as interested in what was happening as their mothers as shown below:

Nurse Margaret was another Godsend in the project.  After listening to the segment she would engage the participants in a post-listening discussion.  I also only met her a few months ago, but was very instrumental in recruiting the women and translating the pre and posttest.

Although we didn't have as many men as we anticipated, some of the ones were quite dynamic.  Seeing them there and caring for their "pikins" certainly warmed my heart.

Two times a week I attend morning devotions with the LAP staff on the compound where I live.  Each time I am always struck by how Cameroonians pray.  Since many of the workers have to travel far distances to visit rural health centers they often pray for safe travel and health and strength to carry on the work.  They inevitably end their prayers by saying, "So we can give God the glory and reason to thank Him for all that he is done."  Although the reasons for my prayers have been slightly different these past two years, the outcome certainly has been the same.

May the peace of the Lord Christ go with you wherever He may send you.  May He guide you through the wilderness, protect you through the storm.  May He bring you home rejoicing at the wonders He has shown you.  May He bring you home rejoicing once again into our door.

Celtic Prayer

It Na Be Very Different

For Christmas and News Years I decided to visit my friend Dawn, who is a Peace Corps Volunteer in the Gambia.  I returned a week ago and many of my friends here asked me what the Gambia was like.  The only thing I could tell them in Pidgin is, "It na be very different from here." My best description for them was that it is like Northern Cameroon, very flat, dry, and sandy. 

View of land from Barra, Gambia Health Clinic

I have an ongoing friendly competition with a friend about who has more African experience.  Before my trip to the Gambia she had visited more African countries then me, but I often reminded her that I had more time in Africa.  Well, I definitely am in the lead now as my trip from Cameroon to Gambia involved flying from Douala to Dakar, Senegal with a stop in Cotonou, Benin and Abidjan, Ivory Coast before taking public transportation to the Gambia.  Now, I don't consider staying in the plane on a runway in the capital city as really having visited the country, but you do get a taste of at least what the city must be like when the only other plane around is a decaying 747 resting near the runway as was the case in Cotonou or multiple United Nations planes as was the case in Abidjan.  On my way back from Dakar I sat next to a Senegalese woman who used to work in Lagos, Nigeria and now works in Abidjan.  She told me stories of how she found it odd in Nigeria that none of her colleagues ever invited her over to their house and how difficult it was to make friends because of the frantic pace of life.  She continued to tell me how the security situation in Lagos is nothing compared to the situation in Abidjan now after post-election violence and how many families are still splintered along political lines.  The whole trip was a reminder of just how vast, diverse, complex the continent really is and reminded me of the beauty, hospitality, and stability that is unique to Cameroon.    

Besides the opportunity to compare economic, cultural, geographical, and political differences between various African countries, it was also fabulous to visit Dawn and see what she is doing as a Peace Corps Volunteer.  Gambia is a very small country completely surrounded by Senegal and divided in half by a river.  Shortly after meeting her we took a ferry to the capital city, Banjul.  Below is a shot of the sun setting over Banjul.  

Dawn lives in a rural village and her main work is to assist the community health nurse.  It is difficult to grow things in the Gambia because of the climate and many people subsist on rice and fish.  One of Dawn's projects is to assist in monitoring malnourished children and distribute plumpy'nut!  As a peanut butter lover I've been a fan of plumpy'nut ever since I heard about the vitamin and mineral fortified peanut-based product in 2004.  Although I've read many journal articles about how it has positively improved the way malnourished children are treated, I have never actually seen it used in the field.  It was fascinating to accompany Dawn and her counterpart, Omar, one day to see how it is distributed to the families and if it actually helps.  We visited about 12 families that day and only one child had improved enough to stop giving him the product.  One child had died shortly we visited and another was even more malnourished because the grandmother said the product gave the child severe diarrhea.      

Dawn handing out plumpy'nut

Plumpy'nut and breastfeeding!

One of the other products Omar and Dawn distribute is BP-100, which is more like an energy bar then peanut butter.  Dawn and I did taste comparison between plumpy'nut and BP-100 and as much as I wanted to like plumpy'nut, BP-100 actually won.  And it seemed to be better accepted by the families.  

After a week in Dawn's village, I began my journey back to Cameroon.  It was more eventful then I expected as the taxi and bus drivers were on strike in Senegal over fuel subsidies and I had to take a motorbike and then hitchhike the rest of the way to Dakar in order to make my flight.  I was quite relieved when I made it back to my home in Kumbo, four days later, just in time to see this awesome sunset.