Midwives and a Marriage

Last Saturday was my first day at the CSCOM with Mariam, a midwife that I am shadowing/interning with during my time in Bamako. In Mali, CSCOMs (Centres de Sante Communitaire) provide health care at the district level. Only very complicated, serious cases are transferred to the regional hospitals. The CSCOM where I'm interning is equipped to do c-sections and other surgeries. When I arrived on Saturday, a baby had just been born. I walked into the delivery room with Mariam just in time to see the cord cut and the newborn taken to be weighed and measured. Then we watched as the intern gave the woman stitches. Next, Mariam took me to see a girl who had been in labor for about 6 hours. They had decided that she needed a c-section because, at 15, her pelvis wasn't big enough to allow the baby to pass through safely. Mariam offered me a hairnet and told me I was welcome to watch the c-section if I wanted. I'd seen a c-section before in the U.S., but it had been a while and I was a little nervous that I would do something embarrassing like pass out from the heat/blood (it was about 90 degrees and the CSCOM isn't air conditioned), but I also really wanted to see the c-section. I was really glad I did. The interns performing the surgery let me stand right next to them so I could see everything up close and I was way too interested to be grossed out by the blood. After making the incision, the interns pulled the uterus out of the abdominal cavity, placed it on top of the sterile sheet draped over her belly, and made another incision to take the baby out. It was really cool to see. When the baby was born she wouldn't cry or breathe, so one of the interns resuscitated her by rubbing her chest and forcing air into her lungs with a plastic mask and bag. Eventually she started crying and she was moved into the CSCOM's NICU (neonatal intensive care unit), which unfortunately only has space for one baby. A few hours later Mariam and I stopped by to see her and she was doing well and breathing on her own. After giving birth vaginally, mothers and babies stay at the center for 2 hours, then they have to leave to make room for the new patients coming in. Normally CSCOMs require mothers to stay for 6 hours but the one where I'm working is under construction and so there isn't a lot of space available.
Working at the CSCOM makes me wish I was able to understand more Bambara, because none of the patients so far have spoken any French. The midwives and nurses speak to me and occasionally each other in French, but when they talk to the patients it's always in Bambara. I'd really like to be able to understand what they were saying. One thing I do understand, both in Bambara and French, that makes me kind of nervous is that when Mariam introduces me to her colleagues she introduces me as "her friend the American midwife." Mariam knows I'm a college student who's interested in going into medicine and she also knows that I have no practical experience doing anything medical beyond putting band-aids on the kids I babysit for. I've heard her introduce me like this several times and asked her why, emphasizing that I'm just a student. She laughed and said she knew that but not to worry about it. I've mentioned it to her several times, but she still introduces me as her friend the American midwife. Other than making me a little nervous with that introduction, Mariam is great. When I told people I was going to Mali, people who'd been there would always tell me that I'd love it, that Malians are some of the kindest, most welcoming people and that it was the people here who would make my experience amazing. Mariam really embodies everything I've heard about Malian hospitality. I was originally supposed to shadow another midwife (more about that later) but she wasn't able to host me. She asked around to see which of her colleagues would be working on Saturdays, which is the day when I'll be at the CSCOM most often, and Mariam volunteered to let me shadow her even though she wasn't working on Saturday. I didn't know this at the time, but she came in on Saturday because that was when I was free and spent several hours with me at the maternity, even though it was her day off and she wasn't even getting paid for it. In the late afternoon she had to head home to get her hair done for her sister's wedding, which was the next day. She apologized for having to leave early and invited me to come to the wedding. I hadn't yet seen a Malian wedding so I was excited and agreed. She wrote down the address I should give to the taxi driver and said she'd see me tomorrow. I went home and asked my sisters what kind of gift to bring to a Malian wedding. I'd visited my sister who's married and lives outside of Bamako and seen the enormous trunk she had filled with pagnes (colorful cloth worn as a skirt or sewn into shirts and dresses) that she'd received on her wedding day. My sisters told me that wedding guests typically bring 3 pagnes for the bride, so we walked to a nearby market where I bought 3 pagnes. I also got some fabric for myself which I'm giving to the tailor to make a dress, skirt, and shirt. My sister Penda loaned me a beautiful outfit made of bazzin, which is what women wear to weddings.
The next day I took a taxi to the address Mariam had given me and called her when I arrived. She showed up dressed in a beautiful bazzin dress on the back of her motorcycle. I got on, doing my best not to tear my dress, and we headed for her parents' house. In Mali, the wedding takes place at the home of the bride. Unlike in the U.S., most Malians continue to live with their parents until they get married. For instance, both my thirty-something year old brother and twenty eight year old brother still live at home and have no plans to leave until they take a wife. Sometimes, especially in rural areas, the wife will move into her husband's family compound, although this happens less in Bamako. Anyways, we arrived at her parents house, where there were probably about 100 people. The women heavily made up, dressed in bazzin, and had beautiful henna designs on their hands and feet. Half of the wedding guests were seated in the neighbor's yard, since there wasn't enough space in the street and parents' house for everyone. A giant tent was set up in the middle of the street, where men were drumming and griots were singing. As soon as I arrived, Mariam offered me lunch. The neighbors were helping with the cooking for the wedding and three enormous cauldrons were set up over three different fires to make rice, vegetables, meat and sauce, which was then distributed into plastic tubs. Each tub is shared by five or six people. Plastic teapots and basins are passed around which each person uses to pour water over their hands before eating from the communal bowl. Mariam brought me my own personal bowl and fork, even though I assured her I was more than happy to eat like everyone else, she insisted. She asked what kind of soda I liked. I assumed there was a cooler full of soda somewhere that we'd all be grabbing drinks from, so I asked what the choices were. She listed a bunch of sodas so I said I'd take a coke. Then she pulled some money out of her purse and sent one of the kids who were all running around to go buy me a coke from the store on the corner. I told her it was fine and that I really didn't want her to go out of her way, that I'd go get my own Coke later, but, again, she insisted on buying me a soft drink. Later, despite my objections, she would insist on paying for my cab ride back home.
After eating, we walked around and Mariam introduced me to various members of the family, including her daughter and her husband. Then we sat down to watch the dancing. I didn't know this at the time, but later I found out that the griots who sing typically praise one of the women present and, if you like the woman, you should get up and dance to show how much you like her. The griots also collect money, although I wasn't sure if it was for the bride or the person they were singing about. I left before the dancing was finished. I never realized before I came here how exhausting it would be to speak in French and Bambara all the time. On the weekends, I'll usually go 2 or 3 days without speaking English at all, which is great for my French, but I end up feeling like I need a good nap every few hours. One of the girls on the program read somewhere that you actually burn twice as many calories when you're forced to communicate all the time in a language you aren't used to. It also makes our English really weird, when we're talking to other Americans or trying to write assignments in English. I feel like sometimes I forget what sounds normal and what sounds awkward in English versus French, although I'm sure that my French is always somewhat awkward. Anyways, we left yesterday to go on the Grand Excursion to several different parts of Mali. We're going to be gone from our host families for 12 days, which feels like a long time. I already miss my sisters and brothers a lot and it's only our second night. And to be perfectly honest I'm not very impressed with the things we go to see on excursions. Like, they're interesting things, but none of us really came here to be shown around the new hydroelectric dam that we visited today or to tour the most expensive hotel in Selingue (which we went to see but aren't staying at). Most of us chose to study abroad in Mali to get to know Malians and spend time with Malians and learn about Mali from Malians, not get dragged to four or five "interesting" sights everyday. The real interesting sites like Dogon country and Segou are in the North, where we aren't allowed to go because of political instability. We'll probably see some cool things somewhere during this trip, but I'd still rather be with my host family. In Mali, when a member of the family travels it's polite to bring back gifts for everyone else. I'm planning to get a few small, individual gifts for my 5 sisters that I'm close with, something for my brother Alpha, a present for my sister Mami who's turning one, and then a big present for everyone else to share, because I don't know how I could possibly have enough room in my bag to get a present for every person in my house. I want to bring something back for our maids too, who I really like, but I have to ask our director if that would be culturally really weird/inappropriate/would maybe upset my host family.

Drinking Tea in Bamako

Last night my brother invited me to drink tea with him and his friends on the side of the road, Rue de l'Aeroporte. In Mali, tea-drinking is something of a national pastime. As my professor explained it, unemployment is extremely high in Mali, especially for young people, so many young men spend much of the day sitting by the side of the road drinking tea. My brother Alpha is 28 and graduated from university several years ago, but he hasn't yet been able to find a job. He tells me that he typically takes tea several times a day with his friends on the Rue de l'Aeroport.

Driving around Mali one sees many groups of young men, clustered at the side of the road with a small metal stand filled with charcoal that they use to boil tea. They drink small amounts of very strong, sometimes very sweet tea out of shot glasses. There are usually two glasses, which are shared between everyone present. However, taking tea in Mali is much more than a chance to have a quick break and get on with the day. A whole culture revolves around tea drinking and the gatherings centered around it. Walking down the street in Mali, white foreigners are met with shouts of "toubabou, toubabou," (white person, white person), from the neighborhood children, who will also occasionally yell out "bonsoir," (good evening), no matter what the time of day. Also common are invitations to take tea with the groups of men seated along the road. Our professors advised us to avoid drinking tea with men we don't know since, rarely, the tea will be brewed with kai-kai, an herb that lowers inhibitions and enhances sensations. From my professors' descriptions it sounds a lot like being drunk. One professor told us that he'd tried the drug once himself the night of an important dancing ceremony in his home village. He said after chewing some of the seeds he fell asleep almost immediately and ended up missing the ceremony. I asked my brother if he ever drank tea with kai-kai in it and he told me no. He went on to tell me that he's never even smoked a cigarette, marijuana, or ever tried alcohol. Though Muslims are technically not supposed to drink alcohol, many young people here, especially men, do drink on occasion, but not my brother. He introduced me to his friends in the "grain," the name given to a group of men that gathers to drink tea on a regular basis. I also met the "chef" of the grain, the chief of the tea circle who buys the tea and brews it. (In Bambara the verb for brewing tea literally means "to make the tea wake up.") He invited me to come back anytime to drink tea with them, even if my brother Alpha wasn't around. Lots of people here have been very helpful in trying to teach me Bambara, but I think drinking tea with Alpha and his friends was probably the best experience yet. They all really wanted to help me learn and would repeat themselves several times and then have me repeat so I would understand. I feel like I learned almost as much Bambara in one night with them as I have in my three weeks studying on my own.

The next night we went back to the tea circle. Alpha had asked me if I was afraid to ride a motorcycle and I had told him no, without really thinking about it. Around 8PM, when he told me it was time to go I went outside and saw him sitting on his moto. He told me to get on. It's hard to understand why riding a moto through Bamako is such a terrifying experience unless you've seen the way motorcycles are driven here. After riding with him I think I understand why he prays five times a day. He's going to start teaching me to drive it this weekend.

Baptisms and Sorcerers

Today I went with my sister Penda to the baptism of her sister's first child. Here in Mali Muslims don't announce the name of the newborn until the baptism, which happens seven days after the birth. According to my sister, this prevents sorcerers and people with bad intentions from being able to harm the child. Only the father and mother know the name, but they keep it a secret. Everyone dresses up for the baptism. There's a men's party in the morning, which is followed by a women's party in the afternoon. Everyone brings gifts or money. Penda dressed me in a pagne made of bazen, which I think is a very fancy special type of cotton, but I didn't really recognize all the French words she was using to describe it when I asked. Anyways, she let me wear this really beautiful white pagne with a matching top, both embroidered with gold and turquoise with matching beads. First we went to her cousin's house to get ready together, then drove across the river to her sister's house near the center of Bamako.

The street in front of her sister's house was filled with chairs and rugs, where women were sitting and chatting, listening to men playing drums. We went inside to greet relatives. The inside of the compound was full of people, probably about fifty women. After sitting briefly in the living room, we went back outside to watch the mother receive her gifts. Several female griots, storytellers who recount oral traditions in songs and recitations, starting singing and shouting out calls and responses to each other in Bambara. I asked my sister what they were saying and she told me they were counting the presents. They were singing about who had given how many of what and how much money. As the griots sang, more and more people came forward to give money to the griots, who then give it to the new mother. Apparently singing praise-songs of the gifts is a standard part of the baptism ceremony. The drummers would sometimes accompany the women as they sang. Then the maids brought out plates and plates of food for all the guests to eat. We ate communally, Malian style, with five or six people sharing a giant plate of food and eating with the right hand after washing it with the teapot and basin provided. But even if we were sharing it seemed to me like quite a lot of food to prepare. After the meal more drummers joined in, louder now, and the old women began to dance on the mats that had been laid down in the street. My sister and I left though. She explained that she wouldn't dance like that until she was an old woman.

I had two really good conversations with my sisters Penda and Fatu today. Sometimes I get frustrating because, even though I understand enough French to know what's going on around me, I feel like the language barrier prevents me and my sisters from having more serious, in-depth conversations about things. Today though, I talked for a long time with Penda about my plans for my Independent Study Project at the end of the semester. (For people who don't know, SIT Study Abroad programs end with an Independent Study Project, during which we choose to research a topic of interest to us for a month and then present our findings to the other students. SIT gives us a stipend to travel and pay for accomadations if our research takes us far away from our homestay families. I'm probably going to be living in Sanankoroba for my ISP month, but I'm not really sure yet). Anyways, it took a while and I had to use the dictionary a few times, but I finally explained to Penda what it is exactly that I'm interested in studying beyond "maternal health." We talked about birth in Mali and the U.S. and Penda told me that here having a painful birth is a good thing. She explained that the more it hurts the more you will love the child afterwards and that a painful birth is a good way to become close to your child. Then Fatou told me I need to eat more so I can be fat when I go back to the United States, and I explained to her that, in the U.S. it can be insulting to tell someone they're fat. She thought this was pretty funny since in Mali, as our professors had warned us, telling someone they're fat is a great compliment, meaning that both that you're healthy and rich enough to eat in excess. However, my other sister Kadi, who's fairly overweight, is on a diet, so it seems like actually being fat might not be desirable. Fatou and I talked about body image in the U.S. and the pressure some people feel to be skinny. I was really happy to be able to finally have more serious kinds of conversations with my sisters. Sometimes it seems like they think that because I can only say fairly simple things in French, I don't have any other thoughts. They're always really nice to me, but sometimes they explain things like I'm particularly stupid, not just unfamiliar with the language. So it was nice to finally feel like we were communicating on a more interesting level.

When I was asking Fatou about the baptism, I took the opportunity to ask more about sorcery in Mali, wanting to know what she really thought. I asked if there was a real problem with sorcerers here and she said that there was. Then I asked her what we could do to protect ourselves, and she told me that the plaque that we have above the door to the living room with arabic verses from the Koran inscribed on it will protect us from anyone who wants to come into the house to do evil. I learned more about sorcery when my older sister Kadi pointed to my foot and told me that it was bad. At first I was confused. She pointed to my toes, which were curled up under my foot, touching the floor and she told me that this is what sorcerers do. She told me that if I did it in the house someone might get sick or even die. Unfortunately, in the hours after I learned this I realized that I have a habit of curling and uncurling my toes when I'm reading or working, as many members of my family have continued to point out to me. Even my five year old sister Sallie knows not to curl up her toes on the floor, as she shows me by smacking my foot every time I unconsciously do it. The whole family, including the adults, takes it pretty seriously so I'm trying hard to pay attention and not do it, but sometimes I'm just distracted and I forget.

Tomorrow I'm going to Koulikoro for the weekend, which is a pretty rural area, so I won't have internet until Saturday afternoon. Then Saturday evening my sister's taking me out to see the clubs in downtown Bamako. I'll try to write about how it goes if I get a chance.

Aw Bismillah: Welcome to Bamako

Last Friday I arrived in Bamako, the capital of Mali and met the students and teachers of the SIT Health, Gender and Community Empowerment program for the first time. We left from Paris around noon and arrived in Bamako at 6:00PM. The flight was originally supposed to depart at 4:00PM, but it had to be rescheduled because the lights on the runway in Bamako aren't working, so all flights have to land during the day. When we arrived we were met at the airport by Modibo, the program director, Lamine, our Bambara teacher, Aida, the homestay coordinator, and Oumu, the program assistant and French teacher. They took us out for dinner at what is likely one of the most Western restaurants in the city, called Amandine, where I ate spaghetti and marinara sauce for dinner and a crepe for dessert.

The next day we had a lecture about the rules of the program and then our first Bambara class. Bambara is the name the French gave the language spoken by native Malians. However, the correct name of the language is Bamana or Bamanakan. I really like our teacher Lamine. He's a great teacher and a really cool friendly guy. The women are much more reserved around us. According to Lamine, sometimes it takes a while for women here to open up to new people. After lunch we all went downtown to the center of Bamako for our first "drop off," which is exactly what it sounds like. Our professors leave us somewhere with an assignment: it's our job to complete it and return to home or school on our own. They gave us 5,000CFA, about $10, and assigned us to go to various important sites, gather information, buy something cheap, then take a taxi or a sotroma back to the hotel on the other side of the river.

Sotromas are like busses here. They're green vans, often crammed full of people, that have certain regular routes. However, the only way to find out where a sotroma is going is to ask the driver. Next weekend we have another "drop off" that involves taking several sotromas, so I'll write more about riding on them then.

When we returned to the hotel my friend Hayley and I decided to walk around the neighborhood for a few hours. We practiced our Bamana greetings, which are very important in Malian culture. It's considered extremely rude to start speaking to someone without first going through the proscribed set of greetings, which can be a simple "good morning, how's your family," or a complex series of questions that can last up to ten minutes or more. Once you greet them, people are more than happy to talk with you for hours. We stopped and spent almost an hour talking to several men in French and learned some new Bamana phrases from them. It's harder to talk to women because they are shy and many of them don't speak any French because it's typically only upper class women who are able to go to school and learn French.

This weekend I moved into my homestay. I'm really pleased to be living with a large family with lots and lots of children. Everyone here is really nice to me and eager to help me learn Bamana. I have ten sisters: Kadi, who is 24, Penda who is 20, Lago, who is 19, Oumu, who is 17, Fatumata, who is 12, Aishata and Salli, who are both six, Adama and Haoua, who are both two and are twins, and Mami, who is ten months old. Here all of the women who share a house call each other sister or mother, depending on their age, even if they are not exactly sisters. Kadi, Penda, and Oumu are all sisters. Lago is their niece. Salli, and Mami are Kadi's daughters. Fatumata, Aishata, Adama, and Haoua are the half-sisters of Kadi, Penda, and Oumu. The mother of Fatumata, Aishata, Adama, and Haoua lives with us because Kadi, Penda, and Oumu's mother died and their father remarried. Their father's mother also lives with us. Her name is Miriam, which is the Malian name the family has given me, in her honor. A second Kadi lives with us, who is the sister of Penda's father's second wife. I barely see the mother of Fatumata, Aishata, Adama, and Haoua, because she is always at work or in her room. I spend most of my time with Penda and Oumu and playing with the kids. I keep having to remind myself when I'm playing with the babies that, in a culture where it is widely believed that, when a child dies it was probably "eaten" by a sorcerer, it isn't quite as funny to joke with the kids that I'm going to eat them, like I do with American kids

We also have four maids who live with us, Bintu, Bakoro, Fatumata, and Bama. They don't speak any French but Bintu, who is fifteen, likes to help me learn the names of things in Bambara. Now for the men.

Penda has five older brothers named Ben, Alpha, Lassi, Oumar, Sekuba. I don't really interact with them because they live in our compound but in a different house on the other side of the courtyard. I live with the women. Only the baby boys sleep in our house, although I'm not sure where the father sleeps. I have nine brothers in total, though, again, they are not all technically brothers: Ben, Alpha, Lassi, Oumar, Sekuba, who are older and I don't know their ages, a second Oumar, who is three, a third Oumar who is six months old, Papi, who is also six months old, and Modibo, who is five months old. Modibo is Lago's son. Papi is the son of the second Kadi. The youngest Oumar is the son of Penda's father's second wife and the second youngest Oumar is her nephew. I spend a lot of time playing with all the little kids here. Mami is especially cute. She was really afraid of me at first but now she comes over to sit with me when I'm in the salon, which is like the TV room. I share a room with about five of my sisters although sometimes one of them will end up sleeping in a different room. I share my bed with Penda and sometimes Oumu too. During orientation we were warned that in Malian culture part of being a good host is to make sure that a guest is never, ever alone. To want time to oneself is seen as a sign of being strange or wicked. That hasn't been a problem for me here though, I'm not someone who really likes much time alone in the first place.

Another thing we were warned about in orientation was that people here tend to be very blunt and comment on other people's character, appearance, etc. but it's not at all intended to be offensive. I experienced this myself on the night I finally met my host mother/aunt. I didn't see her at all for the first two days that I lived here, which struck me as kind of strange. According to the program directors and everyone else I've talked to, family is supposed to be very important in Mali. It seems though like the father and mother try to spend as little time at home as possible. They take the car every morning, even on weekends, and come back late at night. Even when my aunt/mother is home, she rarely comes out of her room. My host sister Penda brought me into the aunt's room to meet her and, after I gave her the gifts I brought, she asked me how long I was living here for, which seemed kind of odd to me...didn't she know? I get the impression that she's pretty removed from what goes on in the house. Later that night I was sitting with my sisters in the salon, where we watch TV and eat, when the aunt came in to get some water from the fridge. "Miriam," she yelled across the room in French, "your feet are not very pretty." I didn't know how to respond except to ask why, so I did. All she could tell me was that she didn't know why, they just weren't, which we all found pretty funny.

Even if my host parents are not very present I still get the impression that family here is very important, like I've heard. My sisters and I spend a lot of time together with the babies and children in the salon and also outside, where the maids cook all the food. As far as food goes, I'm probably lucky that my host mom is not super interested in me. One of my good friends here tells me that her host mom is always encouraging her to eat more and seems a little offended when she gets full. I can turn down food whenever I want without anyone getting offended. Or at least if they are offended they don't show it.

During our first week in Mali we spent several days in Siby, a rural area about 40km outside of the city. On Thursday night, the director told us that the American embassy had issued a warning for Americans in Mali to avoid Bamako because of the rioting going on there. Since we were supposed to return Friday we had to wake up very early so that we would pass through Bamako before the riots started. To the relief of some of the other students, we didn't see anything out of the ordinary on our drive back. (I was actually kind of disappointed, I was hoping to take some pictures). The articles about the riots I've been able to find on the internet tell a very different story from what I've been hearing here. The program director tells us that women in Bamako are rioting because their husbands, sons, and brothers have been sent away to fight the Tuareg who are rebelling in the North of Mali without enough arms or ammunition. According to the director, they're being massacred by the Tuareg, who are heavily armed with weapons from Libya. However, the only English news story I was able to find reported that a crowd of 15,000 people was demonstrating in Bamako, to encourage the President to take a stronger stance against the Tuareg rebellion. I'm hoping to find out more from my host family. My family is Malinke but her best friend (and my friend Hayley's host sister) is Tuareg. My sisters told me that many people in Bamako are not very happy with the Tuaregs who live here, but all of them have friends who are Tuareg. I asked what they think should happen and my sister Lago told me that she thinks they should stop the war and the violence but shouldn't give in to the Tuareg demand to secede from Mali. We're discussing the political situation in class tomorrow; I'll write more about it then.