Mariel and Ben's Excellent Adventures

More photos here:
http://www.new.facebook.com/album.php?aid=2262542&l=73be3&id=14833772
http://www.new.facebook.com/album.php?aid=2279643&l=cbaab&id=14833772
http://www.new.facebook.com/album.php?aid=2279654&l=38b43&id=14833772

Hi everyone,

Sorry if anyone was holding out for a closing... we have neglected that for awhile! We are back in the USA, at our house to be exact. We arrived here just a few days ago after 4 days kayaking Lake Superior's Apostle Islands with Mariel's dad. Before that (and before the long plane ride that took us to Minneapolis), we spent a week in Morocco, like we mentioned in the previous entry. But first, more from Mali!

At the end of our stay, a Dutch midwifery student named Mechteld came to Nana Kenieba to do research with the midwives and women from the area. It was fun to have her around! Mariel especially enjoyed having another young woman to hang out with in our free time:

We both got our feet henna'd in Nana Kenieba. Here is Banana's wife doing my feet:

And the finished product:

Mariel met a really nice woman in Nana Kenieba named Niakalen who has a fat, healthy baby. She came to me because she was interested in helping out in future Medicine for Mali projects as a health volunteer. It was really good to meet her and her whole family, really. They are healthy, clean, smart, generous, and hardworking - a family I hope can be an example for the whole village. Here they are:

And the fat baby who I love:

We treated him for a rash and teething pains, and his mother for an ear infection. When we were leaving, she gave Mariel a lovely bamboo basket that her husband made. What a great family!

And here is a photo just for Dr. Steve DeVore.

Here I am holding the previously un-holdable Demba Dembele, the real Moussa and Kany's son. Legend has it that Demba is (or was?) terrified of white people after being spooked by Steve as a baby. Steve, you owe me $5!

After saying our goodbyes, we left Mali and went on to Casablanca, Morocco. While there, we visited a really big mosque, the Hassan II.

Then we went on to Marrakech, where we stayed in a nice hotel for one night and ate delicious Haagen Daas ice cream. The next day, we went on to Essaouira, a cool town by the beach. We found a relaxing, nice hotel to stay in and bummed around for a few days there:

It even had a Berber tent on the roof:

One day we rented a moped and went out for a spin!

After awhile, we came across a beautiful, sandy beach with cool caves on one end and camels grazing in fields nearby. We set up in the middle, nobody else in sight, and spent the day:

We spent a few more days hanging out in the medina (old town) of Essaouira:

Most Moroccan cities have these medinas, the original entire city. They have walls on the outside and windy, confusing streets inside. No cars are allowed - it's like a big public sidewalk all over. See all the photos here: http://www.new.facebook.com/album.php?aid=2279703&l=4ce50&id=14833772

After all that, we made our way back to Casablanca, then back to New York, then to Minneapolis, and then we went to the Apostle Islands for kayaking. See photos here: http://www.new.facebook.com/album.php?aid=2279708&l=55e52&id=14833772

It was a great summer all around and we had a lot of fun, and learned a ton. There was talk of "next year" all summer, so we'll have to see what happens! I hope you all enjoyed our blog and had a great summer, too.

Love,
Mariel and Ben

Hi everybody,

We have arrived back in Bamako from Nana Kenieba and are getting ready to fly out again tonight (tomorrow morning?) at 3:30am. We were able to move that ticket up, as our program finished earlier than we expected, but as we couldn't move up the one from NYC to home, we will be spending a week somewhere else before heading home. We're exploring now where the "somewhere else" will be... we are thinking a beach in Morocco or one in Europe, or maybe a city... depending on prices.

Our program went really well. We did malaria education and (free) distribution of long-lasting insecticide treated bednets in 13 villages, plus we re-treated old bednets in 5. This program was Medicine for Mali's first official work in 5 hamlets, smaller villages that are associated with villages. The people in the hamlets were really excited to be working with us. We learned a great deal about public health in general on this trip- the good and the bad, the community work and the bureaucracy.

We helped keep a baby alive with lots of cans of milk and nutrition education.

We rode our motorcycle over treacherous roads, suffering only one injury (a burn to Mariel's leg).

We educated a lot of people about malaria and what they can do to prevent it in their own villages by preventing dirty water to accumulate and keeping things clean, and we gave them some nets to help.

We learned more of the local language, engaged in lots of local customs, ate Malian food, and made new friends (Malian, American, and Dutch!).

We re-treated lots of old bednets with insecticide so that they will repel mosquitoes.

And we saw, but did not get stung by, giant scorpions.

(See more photos of us and beyond from Jill DeVore here and here)

All in all, it was a great trip! Once again, we hope to be back to see our friends and do more work.

We'll write again when we figure out where we are going and what we're doing. Until then, we love you and miss you!

-Mariel and Ben

Hi everybody,

We have good news and bad news (don't worry, not too bad).

First, the good news: we are leaving Bamako for Nana Kenieba tomorrow and we have all of our materials!

The bad news: we're not going to be spraying anyone's homes with insecticide like we came here to.

After spending the past almost 2 weeks in Bamako meeting with many district and even national health officials, we learned that all the pesticides in Mali that are suitable for public health projects (spraying houses) are, in fact, fake. Nothing is actually what it says on the bottle - chemicals are watered down, replaced with other chemicals, repackaged, relabled. We found this out when we were on the home stretch of our project, meeting with the guy who was going to come out to the villages with us and train everyone: he said that we would need 1 liter of insecticide to 9 liters of water per 10 liter tank, while the bottle said 80mL per 10 liters. After one heated discussion and lots of digging around, we found out why he had to use so much - the stuff wasn't what it said it was. Not only would it be ridiculously expensive to buy all of the insecticide we would need (it was still sold at the same high price though it was fake), it only would last 2 weeks. We also didn't think it would be good to spray mystery chemical into people's homes!

So, we pulled the plug on the spraying program. Medicine for Mali hopes to be able to do it in the near future when the Malian government figures out how to make it easier for everyone.

Since we can't spray, we want to tackle malaria in another way; insecticide-treated bednets are the best way to do this now. We are going to lead re-treatment days, where we re-treat with insecticide the nets that are already in the villages, including the ones from our last summer's program and any others that people have. We'll offer that for free. In addition, we are going to give away a couple hundred pre-treated mosquito nets. When 80% of a village has mosquito nets in their homes, there is something called a community effect whereby the insecticide in the nets actually protects everybody in the village from mosquitoes, not just those sleeping under the net. We figure this is just as good as spraying, so we will try to work toward that 80% mark at least in some of the villages if we can't do it in all of them now. We will also work with the villages' health volunteer teams to put on some village-wide meetings where we talk about malaria, mosquitoes, and the importance of bednets, spraying, and anti-malarial drugs. (We will also explain why we aren't spraying their huts.) We are excited about these projects, too, and think that they can successfully lower the burden of malaria in the kunko.

So, that is what we will be up to for the next 4 weeks. We don't plan to return to Bamako until we leave for the US again, so the blog will (hopefully) be quiet for awhile. Our stay in Bamako has been far from worthless: we learned a lot about how things work in Mali, and poor countries in general, probably, how NGOs fit into the public health scene, and Malian culture and formalities.

At a meeting with district health officials in Kati:

We've also had the chance to visit lots of interesting places like the med school and national malaria institute and, more recently, the pediatric ward of Mali's big public hospital, Gabriel Toure. It's been a few days now since we were there, but the images are still fresh in our minds.

The lower floor of the hospital was actually better than we had expected, given what people had told us. Patients who were there seemed cared for, they all had beds, and they paid only for their medications, not care or the hospital stay. On the second floor we saw the kangaroo ward, where women with very premature babies were trained to keep them warm by placing them between their breasts. The women had stretchy tube tops from Save the Children to hold the babies tight to them, and little hats for their babies. Next we saw the NICU, where there were both infants and children. There were often 3 or 4 babies in a crib and most did not look fine. In the incubator room, we saw in one uncovered incubator 6 babies, 2 of which did not appear to be alive - one was cold. The incubator itself was more like an agricultural egg-warming device and it hardly put out any heat. From the looks of it, this was the incubator for the babies who hope had been lost for. Through a window to the room next to us, we watched as another baby took its last breaths and succumbed to pneumonia. Visiting this hospital was a very hard experience for us, but we really needed to see and understand what we are working under, what we are up against. It was also inspiring - we saw many children and babies suffering because of severe malaria. Our program can save the lives of children like these in our villages, so they never end up like the kids we saw at Gabriel Toure.

In the village we've been doing some minor doctoring, too. I will leave you with some photos of that:

Ben checking a very fussy patient's ears (they were fine):

Mariel giving Augmentin to a boy with a hugely swollen groin lymph node (from cuts on his legs):

We hope everyone is doing well at home and having a great summer!

Love,
Ben and Mariel

Hi everybody,

We are writing again from Bamako, where we have been since our last blog entry. There have been some obstacles to our program and we are learning a lesson on bureaucracy in Mali. We have had many meetings in the past week with various people including the national malaria program deputy director, insecticide dealers, and the national malaria research center but we have not been able to aquire an insecticide yet. There have been many discrepencies between different groups and people on what insecticides have been approved and which have not and which ones are actually available in Mali. When we finally did find one product that most groups said was okay it was extremeley expensive.

Tomorrow we are returning to the district health people in Kati to report to them what all happened on our search and to ask for their help in speeding up this process; we are really hoping that they can help jump start this as we are all starting to get pretty frustrated.

Other than meetings and insecticide searches, we have been exploring what Bamako has to offer for fun. Last night we went to a big reggae concert at the soccer stadium starring the Cote d"Ivoire rasta man Alpha Blondy. It started at 6 and when we left at 1am it was still going strong! Alpha Blondy didnt even come on til after 11; before that they had lots of local reggae acts, which was cool. [Check out Coco Dembele.) We went with our friend Amadou and met our translator from Nana Kenieba, Baloo, there too - he is a huge reggae fan! It was a good time; definitely a very different experience from an American show. There were a lot of people getting beaten by the cops for getting too close to the stage, jumping over the fence to get closer, arguing over tickets, etc. so it lost a little of the "one love" feeling for us! There was a lot of good energy too though and everybody, I mean EVERYBODY, was dancing their hearts out.

A few days ago, we also got a tour of the medical school and national malaria research center. It was really neat to see both of those things - the med school felt a lot like home. The malaria center labs are surprisingly well equipped and looked just like the labs we have worked in. They are doing some very impressive work there on malaria, HIV, TB, filiarsis, and other tropical diseases.

So that is what we have been up to! Despite the setbacks we are trying to stay positive and learn from the experience, and we are still definitely having a good time. If all goes well the next couple days, you wont hear from us for awhile because we will be in Nana Kenieba getting down to business... heres hoping!

Love,
Mariel & Ben

Hi everybody,

We are back in Bamako again after meeting with the district's ministry of health officials in Kati earlier today. We gave them a copy of the proposal for our project and discussed some suggestions with them. They gave us the go-ahead and said that we have both local and national support, and that they are very happy to work with us on reducing malaria's burden in Mali.

Now that that is settled, we can begin our program! We do still have to get the insecticides, though. We decided to use Ficam, also called Bendiocarb, because DDT was too hard to come by and had tougher restrictions because of past bans on its use. We'll still use all of the safety equipment and do the project exactly as was planned, just with a different chemical. For the next few days, we'll be in contact with the ministry of health to get our Ficam - we don't know how long it will take, but it should be soon. We are excited to begin our work!

Hope things are going well at home, we are following the news of the floods and keeping everyone in central and especially eastern Iowa in our thoughts.

Love,
Mariel and Ben