Africa

At the halfway mark of my trip, I’m about ready to go home. But the work is getting more interesting, and I’m sure the next week will pass quickly.

Although I have worked in development for quite a few years now, I am as guilty as many inhabitants of the North, I think, of holding a simplistic view of Africa. In my mind, I see big, chaotic cities surrounded by vast swaths of land filled with villages populated by uneducated starving masses. In short; anarchy.

I was reminded today (and for the last week) that the truth is much more complex. Yes, there is an element of chaos, but there are structures in most countries that not only bring some order but are also successful in delivering a vast array of goods, services, and information. This week, I’m learning all about the health system in Senegal, which has its problems but is quite well organized. Each region has a hospital; each district has a health post; each major village has a health post. I saw a map today that showed every village in the region of Kolda, color-coded to indicate what kind of facilities each had—complex, certainly, but hardly anarchy.

The other word one always hears in reference to African countries is corruption. Of course, I can’t really tell what’s going on beneath the surface, and there is undoubtedly graft all over the place. But the people I’ve met this week—including lots of government officials—have for the most part been extremely knowledgeable and evidently deeply committed to improving the health of the people in their communities and their country.

That said, I was also reminded today that working in development, one must learn to accept a certain level of unpredictability. We have two working days here in Kolda, which is very tightly scheduled. Today, our plan was to have a brief meeting first thing in the morning with the médecin chef, the top ministry of health official for the region. From there we were to go to the local health center. Then, in the afternoon, one group would visit the hospital while another would visit local NGOs.

Well, the médecin chef wasn’t there; in fact, there was nobody at his office. So we went next door to the offices of the bit US government–funded program in five regions, where we talked to the local coordinator who was afraid to say anything at all for fear of pissing off his boss in Dakar. Then we went to the health center, where we were able to convince the midwife to talk to us, even though she was on her way out to a village, but had to cut our interview short to let her do her job. We rushed from there to the hospital, only to learn (after having been there almost an hour) that the midwives there were all gone until late in the afternoon. Late in the afternoon, one group went back to the hospital while another went back to the health center and then to visit one local NGO. We didn’t cover quite as much ground as we had planned, and we most certainly didn’t follow the plan for the day, but we did learn a lot about family planning in Kolda, which was the goal.

Tomorrow, the plan is to split in two groups again, and take off in opposite directions from the big town to visit rural health centers and health posts. I will try to maintain calm when it doesn’t go as planned, and trust that whatever we learn will be useful in some way.