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.