Fety ny AC

December 5th was health volunteer appreciation day. Last year we threw a small party at the hospital with food, drinks, and dancing. The ACs have been so busy lately we decided to go bigger this year and visit a large park near Ambato that offers swimming, canoe rides, gazebos, and playgrounds. We brought our own food, beer, music, and had a fantastic time! It was one of my favorite days in Madagascar hanging out with my closest friends at site and their families. I think a few pictures will say more about the day than I could describe.

You know you're a PCV when
-you can eat a kilo of litchis no problem
-you are very resourceful

Recent Happenings

After the WASH festival at the beginning of November things were a bit slow at site. The ACs were incredibly busy administering more polio vaccines, distributing mosquito nets and doing follow up visits, and handing out vitamin A and deworming pills to pregnant women and children under 5 years. Due to all these events, Healthy Households has been on hold since the end of October. We resume on December 8 with a training on how to plant Moringa saplings and it's nutritional value. I invited the Ministry of Forestry to head the training and motivate the ACs to finish the program strong. Once the nutrition month is done we will administer baseline surveys again, compare data, and wrap up. Overall a quick 8 months!

On December 4, we tested the water at the three locations we hope to fix. This was quite the ordeal. Andry, the water tester arrived at 3:00pm ad we reserved a spot in the last taxi-brousse for him to return to Tana at 3:45. That didn't leave us much time, and we were literally running to each location with a bucket full of water. We passed out 12 small water bottles to people to quickly chug (to not waste new clean water) then fetched water to fill the bottles. We got back to hospital at 4:15 dripping sweat (it was close to 100 degrees). We quickly duct taped coolers shut to travel to Tana and Andry was on his way.

I went to Tana the last week of November to attend a health sector meeting. 12 PCVs representing the health sector, Peace Corps staff including the country director, and representatives from the Ministry of Health and other NGOs attended. We discussed partnerships between PCVs, MOH, and NGOs, what was working well, and what could be improved. We also discussed a new anchor activity for health PCVs that will be implemented starting with the newest group. I think this will be a positive change providing a little more structure for volunteers while still allowing time for other projects. 

I went to Thanksgiving dinner hosted by the US Ambassador along with other PCVs and Peace Corps staff, US marines, USAID members, and embassy employees. The food was delicious and it was fun to mingle with other Americans living in Madagascar. As soon as everyone sat down to eat it started pouring rain. That didn't stop us from running tent to tent getting more food, drink, and dessert. People sitting near the outside had to be careful because every so often the tent dumped a bucket of water. We were able to dodge and everyone had a good laugh. 

Lastly but most importantly, I completed a personal Peace Corps goal and one I like to consider a secondary project I've been wanting to do since I arrived at site. I made a peanut butter and jelly sandwich from scratch. It took me 4 hours but I baked English muffins, roasted and pounded peanuts, and cooked mango jam. It took all of two minutes to eat. I made sandwiches for a few Malagasy friends and they didn't quite appreciate the sandwich the same way I did. Project compete: I can go home happy. 

You know you're a PCV when

-it doesn't matter if you live in the bush with no electricity or internet access, the rumor mill is so strong that you are always caught up on the latest gossip

-you are no longer shy to dance in front of people-sometimes hundreds at a festival

bed net distribution

bed net distribution

bed net distribution

Thanksgiving 2015

Pc staff, volunteers, and the Ambassador

water testing

homemade peanut butter and jelly sandwich

Project Funded

Project update: the pumps and wells grant has been fully funded thanks to the generous contributions of family, friends and Water Charity. I'm now waiting for Peace Corps to finish processing the grant and can hopefully begin soon. The first step will be to test the water at each location to ensure the sources are not contaminated. We'll wait 10 days for the results and then can begin construction in December. We are cutting it close with rainy season on its way but my community is very motivated to start. They estimated construction to be completed within one month. I'm skeptical on that timeline but ho hitatsika eo (we'll see). I'm excited to begin soon and a huge thank you to everyone who supports this project!

WASH festival

Last April the ladies of the lake held 5 festivals educating our communities on HIV/AIDS and STDs. We felt the festivals were successful enough to hold another traveling festival about water, hygiene, ad sanitation (WASH). What we didn't anticipate was how much busier we would be at this point in service with less than 5 months remaining at site. We all had multiple other projects and the WASH festival really snuck up on us.

During the last festivals we biked to each site and almost completely around the region. This time we decided last minute to just taxi-brousse to each festival (we've biked around the region once, did we really need to do it again?), and I decided to just hold my festival and attend one other rather than participating in all four festivals.
My festival was a mess to put it lightly. It was held on a Wednesday and I found out on Monday that everyone had the wrong date thinking the festival would be on Friday. So the day before the festival I had to bike to the schools, gendarmes, and mayor's office to correct the date (and all before 8am because we distributed mosquito nets that day). Speaking of, Madagascar holds a mass mosquito net distribution every few years and this year was the biggest yet handing out 11 million nets for about 22 million people. The distribution dates for my region changed from September to the first two weeks in November crossing over the WASH festival in which we couldn't change the date. So only 6 out of 19 ACs were available to help with the festival.

The festival was scheduled to start at 2pm but started at 3pm which is to be expected. The location was different than the last festival and was not ideal. We asked health-related questions for prizes and the kids were pushing each other to be picked. There was not enough space for dances and the ACs had to use a stick to push the crowd back. The ACs each gave a talk about different WASH related topics and did demonstrations but we had to cancel the booths due to poor crowd control. The day was also hot (about 100 degrees), humid and looked like a storm was rolling in. PSI, a healthcare organization, brought a cinema-mobile and set up a movie which everyone seemed to enjoy and ended the festival around 8pm.

So things didn't go as planned but I was still proud of my ACs for giving demonstrations in front of roughly 600 people. I was much more relaxed during this festival since I'm farther along and service and I understand how important it is to just go with the flow. Maybe the festival wasn't exactly a success but that's how projects go in peace corps: some work out and some fall short. I was at least able to hold an event for the community, introduce the pumps/wells project on a large scale, and the doctor and ACs could educate on serious health issues in the community.

You know you're a PCV when:
-you've had a parasy (a parasite that buries into feet and lays eggs under the skin)
-despite no electricity you've watched more tv shows than in the states

Famadihana

Famadihana means 'turning of the bones' and is a traditional practice done in some regions of Madagascar. At my site, Famadihana is typically done in September. I unfortunately missed it this year but attended last year and forgot to write about it. How I understand Famadihana performed at my site is how Vola explained it to me. If a somebody passes away in an another area that is not the town they are from, family members wrap the body in white cloth then place the body in a tomb near the area the person died. Then come September, before the ceremony, family members retrieve the body, wrap it in new white cloth and bring the body back to the hometown. Then during the ceremony, family members dance while carrying the body over their heads in place it in a tomb. Only family members may enter the tomb during the famadihana.

The ceremony I attended last September was a festival and celebration of the deceased. Many booths were lined up on the road leading to the tomb selling snacks, street food, and alcohol. Many people were watching, drinking, and dancing. Family members participating in in the ceremony wore red. A man stood on top of the tomb pointing a shotgun at the sky. A few people made speeches then the bodies were carried into the tomb. The tombs are painted white with brightly colored accents and it is taboo to point at a tomb or take pictures of it. This was a unique cultural ceremony that I felt honored to be a part of and I think it made other community members happy to see me there paying my respects.

You know you're a PCV when:
-Time doesn't mean much. A volunteer lives close to you if she is within a three hour drive
-You understand that stuff is just stuff

Polio vaccines

October 12th started the fifth polio week in the past year. The polio campaign started because several cases were reported last year starting in October 2014 mostly in the northern regions of Madagascar. To prevent the spread of the virus, MOH, WHO, UNICEF and USAID began the polio campaign in December 2014. More cases were reported so they organized a second campaign in April 2015, then a third in August, a fourth in September, and now the fifth in October 2015. The first three campaigns targeted children 0-5 years, and the two most recent have targeted everyone under 15 years. The goal of the campaign is to reach 95% of the population within that age range.

Therefore, the ACs are going to all schools and door-to-door administering vaccines. They are also gathering census by writing the number of children on house front doors and then recording that number. I've only been on a few door-to-door campaigns with the ACs. It is tiring work walking hours in the hot sun though the fokontany calling to all kids, 'Efa nihinana?' (Literally translates to 'Have you already eaten?'). If yes we check the kid's pinky finger for a mark made by a previous AC, and if no we say we have candy for them ie the vaccine. 

This is a way to mobilize the community and it's interesting to see how differently it is done in the states. I can't imagine a current mass vaccine day at school like it is done here: gathering all the kids of one age in one classroom and administering vaccines one by one. 

You know you're a PCV when

-you're not sure when it happened but instead of counting up the months you've been in country, you're counting down the months left of service

-a common discussion question: what is the first meal you're going to eat in America

Family Vacation

My brother Chris, his wife Jenna, and her mother Marie came to Mada to visit! It took several months of planning, advancements, a last minute flight change, and many confirmations, but it all went as smooth as possible. They first arrived in Tana and we ate at a train station-converted-to-restaurant and went to the shopping on market day. We walked through the frip, past food stands, and down the main avenue stopping every so often to have a beer. Chris, Jenna, and Marie experienced a taxi-brousse to Tamatave and then another brousse and ferry ride to St. Marie, a small island off of the east coast. Although it was dicey getting to St. Marie because the morning we were supposed to leave, it was pouring rain. We gave it a shot anyway and walked in the rain with our bags hoping to flag down a tuk-tuk. The ferry ride was a bit rough, and quite a few people were sick but we still made it. St. Marie was beautiful with almost perfect weather (I thought it was a little cold since we are coming out of winter). We stayed in a cute private villa with a personal cook who made the best food I've eaten in Madagascar. It was the very end of whale season but we were lucky enough to see several. Jenna was so excited she was almost bouncing out of her seat. We snorkeled in Ile aux Nattes, an even smaller island off of St. Marie and ate Malagasy style seafood. It was beautiful.

Next we headed to Andasibe which is inland to a national park. We stayed in bungalows on the edge of the rainforest and could hear the lemurs calling in the early morning. We hiked for about 3 hours and saw 5 types of lemurs, birds, frogs, bugs, and many types of plants. In the afternoon we visited another park with crocodiles, birds, and a fossa. We also went to lemur island where the lemurs literally jump from person to person eating bananas out of your hand. There we fed three types of lemurs and at one point played keep away with one of the more aggressive kinds. This was a highlight of the trip.

Lastly, we drove to my region, and visited Ambato and my site. We wandered around Ambato and I brought them to my favorite restaurants. At my site, we toured the town and stopped at a friend's house who just had a baby the week before. She made us a 'snack' which was really first lunch. We then visited my Gasy parents who prepared fish, duck, salad, pasta salad, ratatouille, and ravitoto and pork (a very Malagasy dish) for everyone to try. They even gave Chris, Jenna, and Marie Malagasy bags. It was very sweet. In the afternoon I held an AC meeting with a training on safe drinking water and sewing bucket covers. My ACs gave handwoven baskets and wall tapestries to my family. My family didn't understand much of the meeting but watched Monica karate chop a mango as entertainment. We ended the meeting with group pictures holding the voandalana.

It was wonderful to have family visit. They were impressed with my Malagasy though they mostly heard me arguing and bargaining. They even learned a few phrases and could tell when I told someone we were friends to try and get a lower price. It felt strange to have them in my town and my little house because my two worlds were combining. I'm glad they got to see me work with my amazing Acs and it was very touching that the Acs came together to give them such unique Malagasy gifts. This trip was yet another highlight of service and I felt so proud to share my Peace Corps experience with family. 

You know you're a PCV when:
-You are especially good at telling time from the sun's location
-you become innovative with limited ingrediants



St. Marie

Whale watching

Whale watching

St. Marie

canoeing to Ile aux Nattes

Ile aux Nattes

Golden lemur in Andasibe



the market at my site

after the AC meeting

gifts from my community

 

Pumps and Wells

***I'm reposting this from a few months ago because my grant is now online through Water Charity! You can find the project description and how to donate at this link: http://watercharity.com/ambatomainty-water-project-Madagascar
Any help is greatly appreciated by myself and the community! Misaotra mialoha!

During the first three months at site I completed a diagnostic community survey. One of the questions asked people to rank the top 5 problems in the community. Broken public pumps by far was most often rated as the #1 problem the community would like to fix. Although, people wanted brand new pumps rather than fixing the existing.

One year later, I began looking into fixing the pumps. They were built by an outside NGO with no maintence plan or check ins, and nobody knows how to fix them. I then partnered with an organization with technicians to fix the pumps. As more meetings took place with community leaders, the chef doctor, and the ACs, we decided to fix the public well located at the market as well as build pulleys over that well and the public well at the hospital. The current well at the market does not have inner infrastructure and there is constant erosion making the water muddy and appear very cloudy. When looking at the logistics of the two broken pumps, we decided to dig trenches in order to control the flow of water to prevent flooding. 

As for long term maintence plans, we formed water committees at each of the four locations headed by the president of each village and the ACs. The pump technicians agreed to train local carpenters on 'what to do when' scenarios for the pumps so that when they need upkeep in the future, there will already be local community members that know what to do. 

Fixing these four public water sources will increase access to water by roughly 50% in my community. The community villages are all interconnected and the 2 pumps and 2 wells are located in high traffic areas benefitting a large portion of the  population. This is an ambitious project and I would not have agreed to it if the community wasn't as motivated as they are. There have already been frustrations with determining the budget and I know there will be more complications in the future, but the community is willing to lead the transport and storage of materials, manage the construction and water committees, and even build gardens around the wells. I have already submitted the grant and have high hopes to begin construction in November.

You know you're a PCV when

-none of your plans go as planned

-you watch a tv show and get jealous of the food the actors are eating

The public well located at the main market

Inside of the market well

This lady brought her own water to the pump to wash with. She is using the pump to dry laundry

The river people use to fetch water and wash.

 

 

CRMF Mission

For ten days I volunteered with the Caring Response Madagascar Foundation (CRMF) as a translator. CRMF is a nonprofit organization that started literacy and sanitation projects in the Tamatave area in 2004. Six years ago they began a program where doctors from the U.S. come for ten days and hold free healthcare clinics in five different areas, including one in the countryside. Ten PCVs volunteered to translate for the doctors, run triage, and help distribute medications prescribed by the doctors. 

I worked in one area per day but experienced each station throughout the week and a half. When I helped in triage I asked patients, 'Inona tena marary indrindra?' or essentially 'what is the most pressing problem?' Most often the patients said they had a headache, back pain, upset stomach, or shortness of breath. I would then fill the intake form and decide if the patient should go to pulmonary, infectious disease, internal medicine/general, pediatrics, or OB/GYN. They would consult with the doctor and then go to pharmacy to receive prescribed medications, deworming pill, vitamins, and iron. In pharmacy I explained the medication schedule and asked the patient to repeat it back to me to make sure they understood which pill to take when. The day I worked triage, I would jump back to pharmacy when they were backed up. It was interesting to see the initial intake form and then the diagnosis. Somebody that came in with a headache turned out to have very high blood pressure for example.

In pulmonary, the doctor asked me questions with vocabulary I had never used in Malagasy such as 'wheeze' or 'hold your breath.' I quickly learned these terms well and asked other volunteers when needed so that the doctor could accurately diagnose. We sent several people to the hospital to get a chest x-ray, and guessed that several others had COPD, tuberculosis, or lung cancer by asking about their symptoms, listening to their lungs, or looking at their fingernails. In internal/general medicine, we saw many people with high blood pressure or difficulty seeing. One woman couldn't see out of her left eye and I had to break the news that we couldn't treat that. Another woman was diagnosed with ovarian cancer and no funds to seek treatment. The internal medicine doctor was also a deacon of the Catholic church and so I translated a prayer and blessing for the woman. In infectious disease, I saw a man with end stage liver disease whom we sent to the hospital. One women had a tooth infection that had spread to the outside of her cheek. We were able to treat her with several months of antibiotics.

There were a lot of very difficult cases in which people did not or weren't able to seek treatment sooner resulting in such extreme cases that even the doctors had not seen before. Some questions were difficult to translate in a way that the patient understand and could give the answer we were looking for. For example, when I asked 'when did symptoms begin,' many people answered, 'efa elaela' ('already a long time ago') when it was very important to find out exactly how many months/years ago a rash or growth started. On the flipside, we were able to provide healthcare to over 800 people that may not have sought or been able to afford medications otherwise, especially in the countryside. We covered several x-rays and hospital stays in order to help the person in every way we could. 

Translating was more difficult than I thought. It was harder to speak English after translating Gasy for several hours. I found myself even translating English to English.
 
Dr: I need to find gloves
Me: We need some gloves!
Dr: and a privacy curtain
Me: Can we get a lamba! Wait you're asking other English speakers.

However, one year ago I never would have thought my language skills could progress to a level where I could participate in a mission like this. All of the PCVs worked great together in that no one was too prideful to ask what a word meant. Everyone understood that the patient's care was the most important. The CRMF mission was exhausting but so rewarding. Each member of the team was invaluable to making the clinics possible, and we helped hundreds of people and their families that may not have sought treatment otherwise. The CRMF mission helped me personally in that I'm now considering a career path I hadn't thought about before. The founder of the organization gave me wonderful advice on non-profit program coordinator positions and the logic model for grant writing. This was another very memorable part of Peace Corps service, and one of the best programs I have been a part of.

You know you're a PCV when:
-You never need to use an alarm. 7Am is sleeping in.
-You rarely feel the need to look in a mirror

This woman was 100 years old!