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Friday, October 4, 2013

Family Planning with Marie Stopes

When I first got to my village a little less than two years ago, one of the first thing they told me is: “Drew, we need help on family planning.” And it was true, roughly 12% of eligible individuals used some type of family planning tool. There were a couple of reasons for this: 1) there are a lot of misconceptions about family planning in my village such as, if you start family planning you can’t stop. If you use family planning you won’t have enough people to work in the fields come rainy season. It’s too expensive. It’s dumb, etc.

Since this was clearly a problem we started trying to tackle it- by informing people about the misconceptions of family planning, of the dangers of having a family that’s too big, and of the changing stereotype that yes, a big family is good  but a smaller more well nourished and educated family is better.

Some people took the message to heart and our numbers climbed a bit. Other people didn’t hear the message and some just ignored it- such is life. Along the way though, I was luckily enough to meet someone (Adolphe) who works for Marie Stopes International- a non-governmental organization (NGO) that works exclusively with family planning. Their plan is pretty simple- they give family planning methods for a reduced fee and they go to different villages to teach people about them, and then do the procedure.

I started calling Marie Stopes (about once every 10 days) to see if they could get a team to my village and just look around to see if we qualify. Even though they kept saying, “We’ll call you back” and I never heard anything I kept calling because my nurses were getting kind of excited about it.

My new buddy, Adolphe and I started talking and I kept impressing the fact that family planning isn’t something my village does well. While we were at a training called Men As Partners together we decided that we would do a project together and that he would come to my village to talk about family planning to students- because we had done it with another volunteer a few times and it had turned out to be pretty successful.

The day finally came and I had scheduled to do everything at the school- they had actually said that they wanted me to come to the school for a while and that, even though I asked every other week when I could come and help, they still had not been able to find a date. Despite the fact that I had confirmed the date and time 24 hours before at 8AM the director called me to tell me we had to cancel. Apparently there were tensions regarding a family planning talk among the teachers so we could not go. Adolphe and I were super bummed out over this new development especially since he had come all the way from to village to make it work.

Never fear though, everything is useful in some way and I used this failed class as an opportunity to show how much help my village needs in family planning. Adolphe toured our facilities (not so shabby by village standards) and saw our numbers (very shabby) and talked to the nurses. As he was leaving he said he would make sure a family planning team came to my village because we really needed the help.

A few weeks later Adolphe came back with awesome news. It was great to see him even though we were in the middle of a mosquito net census. Even with the unfortunate timing, this project was important to my village and to me so I was able to do both projectsThe Marie Stopes team would be coming in a week. We informed all the important people including a lot of religious leaders who all were incredibly supportive of our endeavor and agreed to round up some women (and men) so we could talk to them about family planning 24 hours later.

The next day we spoke to roughly 75 women about family planning and Marie Stopes, we spoke to some  in the chief’s courtyard (thus helping to convince him that I actually do things) and some at the Imam’s courtyard. The pastor promised to mention us during his sermon too- all in all- some very good press.

When the team finally did come we didn’t get the numbers that Marie Stopes. Only 30ish women showed up. But now Marie Stopes comes and does this every month and they keep pushing our numbers higher. And, any improvement is a good thing.

While I had very little to do with the implementation of the actual family planning aspect of this- I was very excited to have laid the groundwork through my work with Marie Stopes. It allowed an NGO that already operates in Burkina Faso to do more sustainable work in my village. There may be a volunteer after me, and they may be really interested in family planning. Or, they might not. If they were not, any positive behavior changes might not continue if a volunteer created project fails. But, with Marie Stopes; they are an organization that has proven their competency and is unlikely to go anywhere.

It also serves as a lesson that staying at site all the time might not be the most beneficial way to go about a Peace Corps service. This is a common debate among people actually. Some people say that on order to be trusted by the community you need to be there and you need to be integrated. I agree with this statement. However, I also think that getting out of site from time to time is extremely helpful because it allows you to make connections that you wouldn’t have made otherwise. Peace Corps is partly about making connections. Group 1 has problem x. Group 2 has the skills and resources to solve problem x. PCV knows both groups and can put them in contact so they can solve the problem together- and create sustainable change.


Hopefully through continued collaboration, Marie Stopes and my village will be continue to create long term, sustainable change in my village long after I am gone.

Mosquito Net Census

Another month where I did not write any blogs. However, I did manage to accomplish a few things. Aside from the marathon, I led a mosquito net distribution in my village.

Every few years Burkina Faso does a mosquito net distribution campaign with the hopes of getting 1 mosquito net for every two people. To do this accurately you either need to a) have an extremely accurate census of every community or b) go door to door and physically count the number of people in each courtyard and go from there. We used option b. Since my major was going to be out of town and no one at my health center knows the village better than me, I was put in charge. Fun, right? Actually kind of.

The way I see it, I was brought to my village to work and I hadn’t done a whole lot of it, so I really enjoy any opportunity to help out. My major had already come up with a list of people who would help out which made it a lot easier so all I had to do was: divide them into teams, decide where in village they would go, make sure their materials were ready, tally up the results at the end of the day, monitor the results, transmit them to the district, take care of any problems, make sure all of the forms and maps were drawn correctly so that the district would be able to understand our plan if they were to supervise, and visit every team everyday to make sure they were doing what they were supposed to.

Since my village is a rather large place, I knew this was going to mean a lot of biking for me- which I was really looking forward to because it would be my first physical activity since the marathon a few weeks beforehand. We decided that the groups would leave at 6AM so I had to get to the CSPS at 530 to make sure all the forms were put together properly, that they were labeled properly, and that each group was supplied with a pen and some chalk. Then I would go back to house for a bit, eat some breakfast, and then grab my bike and see 6 teams in a few hours.

The registration process was very simple. Each team had a registration spreadsheet and a ticket book. Each family would get a ticket and each ticket had a number. The ticket would read the name of the head of the family, the number of nets they were getting, and where they were going to get the nets. The spreadsheet had the same information but the teams had to write down the ticket numbers and there were spaces for the supervisor to verify the teams’ work.

I really enjoyed the biking from team to team. I got to bike through the parts of my village that I don’t usually see and interact with people who might not come to the health center very often. I think the volunteers who got to help out with this during their first year are lucky because it allows their village to see them multiple times over the period of a few days. During each supervision I had a checklist to make sure everyone was there, had been trained in what we were doing, were counting people correctly, were filling out the forms correctly, and were giving people the correct information. Most teams were doing it right but a few had some small errors that I corrected. Often it was, “Great job! Keep up the good work!”

The real trouble came when you had people who were not home. Usually the census-takers would just find a neighbor and ask, who would find another neighbor and the two would discuss it before answering how many people lived in that courtyard. That had to be considered with cultural norms as well. For example, if a family had 12 people- but one was a teenage boy, they probably shouldn’t be sleeping with their 9 year old sister. So the teams were instructed to make sure nothing culturally inappropriate happened in the survey. Also, since the days were so long, there were routine mistakes that showed up- such as people writing the same ticket number down twice so one was skipped, or the names did not correspond with the ticket we had given them. I was pretty good about catching these errors as I saw them but one or two slipped by me.

The 6 days passed pretty slowly because I was kept so busy. Often I didn’t eat lunch until 1PM and then I had to be back at 3PM to tally all the numbers and to make sure we were on track. But I was really productive, the teams were happy, and the people who live in my village were happy. The district was especially happy, they started asking other CSPS’ why their forms weren’t as well done as ours- which is quite the compliment.

I was incredibly tired each day but with a sense of accomplishment which is always a good feeling- like a workout that hurts afterwards because you know you did a good job. And everyone else realized how hard I was working- especially since I was juggling a family planning project at the same time.

At the end of the campaign we turned all the papers in and were told that we would have the mosquito nets by the end of August- the height of malaria season.


Overall, it was a really good project to be involved in and to lead. I enjoyed collaborating with the teams and the CSPS staff to lay the groundwork for a successful mosquito net distribution.

The Marathon

Last year my buddy, David, and I decided that we would run the Burkina Faso marathon. After all, it’s a physically grueling race that takes a while to prepare for and in a country where Peace Corps Volunteers lack things to do- it helps pass the time. It is also a solid goal to work towards and then when you actually do it you know that you actually accomplished something. So we found a marathon plan online, and started training. In February we ran a half marathon (see blog post) and then kept right on training for our race in June.

Unlike the Boston marathon which is run in the spring, or other marathons that are not run during the hottest part of the year, the Burkina marathon is not like that. It’s run towards the end of hot season. So, it was hot.
As the preparation went on we found out that we would be joined by two other PCVs: Tim and Natalya. Plus a few Embassy workers as well. Some people had run marathons before and were well acclimated to the stresses of running 26.2 miles. Others had read a book about how marathons are about getting to the finish line and how it’s really a combination of mind, body, and spirit. David and I just decided to download a marathon training program, follow it and see how it went.

Surprisingly it went pretty well, for a time. We started well in advance and we even had time to run half of a marathon along the way which really bolstered our spirits (see related blog post). And then we got busy. Between projects, volunteer responsibilities and the like we both stopped running religiously and unfortunately, during the month of April we barely ran at all. Tip for anyone hoping to run a marathon: don’t take most of a month off. It doesn’t do anything positive for anyone.

Once May hit we realized that we probably should be running and making sure we could actually finish the marathon. My village saw me training again and started getting excited and cheering me on. Predictably May flew by and we soon got to June.

As we got closer to the date we found out that people were planning on biking with us to bring water, snacks, and keep an eye on us. In total there were about 5 bikers with us, including Christina. The day before the race Christina and I came into the city to pick up the running shirts and where I told a bunch of people that I was going to win the marathon (I was just joking but it was kind of funny to see how people reacted).

The night before we had a pasta party of sorts and talked about pre-race questions: Is it okay to walk? Should you wear a watch? Do you run with a buddy? And then we retired to a hotel and went to bed.

The race was due to start around 630 AM so we woke up at 430 in order to be picked up by a taxi on time and get to the race a little bit early (we had watched Run Fat Boy, Run recently and were scared of showing up late). We got there in plenty of time, warmed up a bit, and all of a sudden we were off. The course started easily enough, and just as last time all the Burkinabe took off very quickly. But after 2 miles they started dropping out. The PCV group started spreading out as well.

The race course took us around Ouagadougou a bit before sending us straight up the road to a village called Laye. Taking turns and stuff and seeing people was pretty cool because we knew we were going to be bored once the course straightened out.

After a few miles (6 or so) I realized that I was pulling my pants up with alarming regularity and, being in the middle of an extremely grueling activity I didn’t react very well. My shorts elastic had been ruined by the washing techniques of Burkina (handwashing) and the elastic had stretched to the point where it no longer fit. So rather than say something logical like oh let’s use a safety pin to pin my shorts together I said something along the lines of I need a new pair of shorts (I had brought 2 but the other pair was across Ouaga). So, Christina, being the amazing person that she is said she would bike back and get my other pair of shorts and I would stop and change somewhere when she met up with me again.

For a little while I was running with another volunteer who was biking but then we got separated so I ended up running without food or water and only getting 1/3 of a liter every 5 kilometers (not as much as you need when running in an almost desert).  But, I kept going and kept pressing forward. I found another running buddy who had done the marathon before and we kept each other company for a bit. Then, the volunteers who were handing out water decided to leave because the leaders had already passed. So, the further along I got, the less water there was.

Eventually it got to the point where I was walking, had extreme tingling in my extremities, had stopped sweating, and was seeing double. I collapsed by the side of the road and realized that I should probably take a rest because someone would come past me sooner or later with water and some form of snack because I thought I was severely dehydrated. As luck would have it, Christina found me not long after and gave me fluids and bananas. I felt a bit better but not enough to keep going so I got put into a minivan and driven to the finish line. All the other volunteers finished and they were very happy.

Understandably I was pretty bummed. I hadn’t finished the marathon and I hadn’t crossed the finish line. It was not a fun situation to be in. But, after we got back to Ouaga I was talking to someone who worked at the embassy who said, “I can’t believe that course- it was too long.” I replied, “by how much?” “1.1 miles”, she replied.

And I felt great. Despite collapsing by the side of the road, and throwing a tantrum over my shorts I had still managed to finish the marathon because someone had incorrectly designed the route. Only in West Africa would that happen.

In conclusion, I ran a marathon. It was hot, it wasn’t pretty, and I didn’t cross the finish line. But I made it 26.2 miles. Maybe I’ll try and run the Boston marathon one day.