Author: Andrew Dykens MD, MPH; Director of UIC Global Community Health Track
Photo: Anne, PCV: radio host for weekly show
We have now had some time to adjust. Spending a couple of days in Dakar and one in Kedougou on the front end was enjoyable. It gave us time, as a UIC team, to get accustomed to the heat and food. As a UIC/Peace Corps team, we were able to get acquainted and get started on our work together. We met with some amazing global health leaders as well as with the Peace Corps Senegal office, so we are inspired. Now we are looking forward to the work ahead.
We started out the day with a trip to the market to purchase veggies with which to make an American Meal for our hosts. We have done this before and it is quite an adventure: 1) Us trying to cook, first off, and 2) our hosts trying something just a bit different. We are making spaghetti with a cucumber salad and a fruit salad with yogurt for dessert. To drink: unsweetened tea with lime–definitely an oddity here, pretty much everything is sweetened.
After the trip to the market was complete we gathered our bags and headed to the “garage” (where we would find a taxi to Saraya). An interesting thing happened surrounding this event that made me think just a bit.
We found a car without too much difficulty. In our definition, you must take the descriptor “car” with a grain of salt. Nine passengers and a driver crammed into a station wagon that appears as though it could just collapse if touched in just the right way, similarly to a game of Jenga. Often these cars leak exhaust and have windshields that force one to lean a bit to the left and crane one’s neck to see the sites alongside the road — due to the cracks and tape holding it together. The exterior is composed of years of mismatched quarter panels from similar makes and models that have, in some way, met their own unfortunate fate. Though they say to “never judge a book by its cover,” you begin to wonder (as you take a look at the exterior) what lies beneath the hood. Mostly, just hoping that you don’t sweat through your clothes by the time you arrive and that, perchance, you have been fortunate to sit on the side with no direct sun, is the best that you can do. One tries her or his best to ignore the elephant in the room of “will this car actually arrive at its destination? …or will I be forced to carry my bags the last 10K.”
Well… In this case we didn’t have to wonder very long. We loaded up the car, jump started the car on the short descent out of the “garage,” turned left to head up the dirt path to the road just beyond and when shifting down to first and releasing the clutch our driver was (I suppose) not overly surprised to note that the transmission was failing. He checked under the car (I presume) to make sure the drive shaft and U joint were in there proper positions, sat back down, re-engaged the first gear and discovered again a most unfortunate and discouraging grinding sound with not the least bit of vehicular advancement.
OK. “Let’s get out.”
Better, for sure, to wait under the shade tree. Here we bargained with various drivers and within a reasonable amount of time found a driver that would leave promptly to take us to our destination. As we had purchased the seats for the entire car, we should be able to leave immediately and should not need to wait for the car to be loaded with other goods. We were somewhat comforted to know that we would soon be on our way, but the frustrations of the event were compounded ever so slightly when the driver informed us they would add another person to the car. And furthermore, they would not reimburse us for the money we had paid for that seat. Of course, that doesn’t seem fair and to know that we have an hour ahead of us in an already crowded car with windows that, in this case, didn’t roll down. Well, that was a bit difficult to absorb.
A few more minutes of haggling and we threw in the towel, accepted the additional person and, more crowded, and terribly hot and sweaty already, we were on our way.
Peace Corps Volunteers would tell you that this is a very mild illustration of the frustrations and barriers to everyday life, but, nonetheless, they apologized profusely to our team that we should have to deal with this. Of course, we reassured them that this was really no problem.
Then for the remainder of the car ride, I had a moment to think. I thought about the fact that the first driver most assuredly lost revenue from not only today’s anticipated journey, but the days that follow as he will try to fix or replace a transmission far beyond its limited factory warranty. I thought about the second driver’s loss of revenue by leaving without the routine three additional layers of merchandise strapped to the roof, and his kindness for leaving promptly in spite of this reliable income. I thought about Patrick’s (a Peace Corps Volunteer) account of the sudden and tragic loss of his 4 year old host sister, the week prior, from Malaria. I thought about the under five mortality rate in Senegal that is improving in the last twenty years. Down from 13.6% in 1990 to 6.5% in 2011. Improving but significantly worse than that in the USA of 0.7%.
When we arrived in Saraya, I left my state of reflection and looked forward to the week ahead.
The trip was without incident and we are thrilled to be back home in Saraya. Everyone was elated to see us, and I was very happy to be reunited with several friends at the Saraya health center and to have the opportunity to meet several new friends. Later in the evening, we played a game of “horse” on the basketball court. After that we were thrilled to participate in the Peace Corps radio show where Anne (the lead Peace Corps Volunteer on this project) educated the listening audience on cervical cancer in the local language of Malinke. About 30,000 people heard this show, and we had a terrific time taking part. Under her guidance we greeted the populations of several of the surrounding villages. So, indeed, we started the day vulnerable to the whims of chance and reliant on a standard transmission, itself holding on to the last vestiges of life, avoiding to the bitter end the fate that it awaits. And we ended the day as celebrities, coasting the airwaves of Senegal, broadcasting Toto remakes and Mumford and Sons to those we hope are listening to our calls for cervical cancer screening.
Before lying down to bed, I wondered… What is the mortality rate of cars in Senegal as compared to that in the US?