A summary in pictures

I've been too busy to take photos, so as usual I've only taken out my iPhone to snap a picture when I'm sitting down to eat. Here are some clips of my week so far:

 Arrival at the airport; you descend on the tarmac and a bus takes you to the actual airport building.

Hotel room

 Dinner, steak with pesto sauce, at restaurant Farid

An appetizer at La Galette bakery--similar to a thin crepe filled with tuna.

 Breakfast at Eric Kayser

Thieboudienne at a restaurant in Mamelles (I forgot the name, but it's right next to the Clinique du Mamelles)

A Mark of Prayer

I have been drinking a lot of water here, and naturally it has come at different prices. When I first arrived, I paid 1000 for a bottle. Then 500. Now 350. The tap water here is not potable, and the way the sun draws out sweat makes me feel like my skin is as porous as a sponge. I drink two liters a day, and still sometimes my throat feels dry and scratchy.

My hotel is located in a middle eastern neighborhood, so many shops sell middle eastern robes, ottomans, fez, and slippers. I was always curious about these carpets that look like they have been sewn onto long leather mats. My Senegalese friend explained that they were soft surfaces for praying. He pointed to a darker patch of skin on the top of his forehead. "You see this mark here? This is from praying on a hard floor."

I have never noticed the mark before, but now that he made me aware of it, I saw it on more and more people--a darker callous where they have repeatedly touched their head against the floor. In Senegal, it is actually a good thing to have, because it means you pray a lot. "So if someone has no mark, I guess they are not pious," I remarked.

"Or they pray on a soft surface."

Fabric

I wish I had taken a photo of the fabric stores, but I never bring my camera or anything of value when I go to the market. Pickpockets hide themselves well in the crowds, and taking a photo only shows that I have money, and vendors will try to rip me off. Granted, they will try to rip me off anyway, but flashing a camera or an iphone will just make them even more stubborn and difficult to bargain with.

Sandaga market sells everything, from cell phones and CDs, baby cribs and candy, shoes and clothing, and fabric in every color, texture, and style. There is one particularly annoying stretch that caters to tourists, where rickety wooden stalls are lined up directly next to each other. They sell carved statues, beaded necklaces, leather sandals, and mass produced paintings. Whenever a foreigner walks by, they jump up and follow, pleading, demanding, or persuading him/her to look at their goods. "Just for looking," they will say, "You don't have to buy." Or, "I give you good price because you are my friend."

Beyond the tourist section, random people will approach and begin a conversation, and unlike the shopkeepers who avoid leaving their stalls, these individuals may follow you for several blocks trying to convince you to go to their relative's or friend's store. After those experience, I always go with a Senegalese friend to avoid being ushered or mobbed by eager vendors. If I am with a Senegalese person, the people will address the person instead of me, and are more likely to leave because I am already with a local. I am really grateful to my friends who have gone to the market with me, since they have to endure the barrage of questions--"What does she want to buy?" "I have everything in my store." "Does she speak wolof?" "Does she speak French?"

Bargaining is much easier with a Senegalese friend, because they know what the price should be, and the seller knows that they know. At one stand, the seller immediately charged me double the price, and when my friend argued, he said, "okay, fine. I gave her the white people price, but since she is with you, here is the Senegalese price." As I was picking out my fabrics, he told him, "You are really stupid. Next time you bring a foreigner here, just keep quiet. I'll rip them off, and I'll give you a cut of the profits!"

I bought fabric, a type which they call "wax," from four different vendors, and now have a beautiful selection of fabrics to make clothing with, and to give as gifts to friends. Some have shiny, gold patterns printed on top, and they vary in quality. The cheaper ones are lighter, with noticeably less thread count, but are good to wear during hot summers. I did not bring enough cash with me, but I wanted to purchase some of the embroidered, bejweled, and sequined fabric--these are usually made of sheer material, and used as a shawl or a scarf to glam up an outfit. In some stores, bolts of such fabric are hung on the wall, glittering like curtains of stars.

If I have time, perhaps I will find a tailor here so I can make some pieces before going home.

Independence Day

I forgot that it was the 4th of July, since it is not celebrated here. Next weekend will be the beginning of Ramadan, which is supposedly a completely different Senegal since everyone is fasting. When I was here last time, I was walking around the city one day (instead of being in the hospital) when the call to prayer sounded--perhaps around 3:00 pm. The government official that I had been trying to speak with excused himself, grabbed a carpet that was rolled up in the corner, and headed outside. When I followed, I saw hundreds of people, mostly men, with carpets tucked under their arms--like ornate yoga mats. There were areas in front of the mosque where people lay down their carpets in rows and sat on their knees, heads bowed. My interpreter had forgotten his carpet, so he had to ask someone if he could share theirs. Still thinking along the lines of yoga, I had asked whether he would have enough space with two people on one mat, but clearly you don't need as much room to pray.

Today we interviewed the parents of the 14 year old girl who had passed away. She had been very religious as well, and spent a good portion of her time praying. Her mother let us listen to some prayers that she had sung and recorded on her cell phone while she had been alive. It was a hard interview to do, and I feel like this time, more than last time, there is such a heavy pressure to make changes. When agreeing to do the film, they had said that even though their daughter passed away, they considered it a good thing to continue fighting against the thing that killed her. They agreed to participate in the film because they want to improve access to health care in Senegal, which is our goal too. Sometimes--many times actually--I'm afraid that the work will not have any result. I think improvements have already been made since our presence here last fall, but I wonder to what extent. Our project is on palliative care, but palliative care is not enough. There is a balance however, on what we are able to demand from the government. If we demand too much, they do not listen at all. By demanding too little however, I feel like we let down all of the patients, and even the doctors, that we interviewed.

How can one improve cancer care with so little resources? Palliative care is easy--it is cheap, and the training to administer symptom relief is not so complicated. Oncology however, presents far more challenges. While it is a palliative care report, I hope that it will help raise awareness, not only for the desperate need for cancer treatment in Senegal, but also in developing nations as a whole. So little attention is given to non-communicable disease, despite the fact that the world's most deadly killer is not war, or famine, or HIV/AIDS--it's cancer. Of the foreign aid that is directed towards health in Africa, less than 3% goes towards non-communicable disease. Cancer in adults is tragic, but cancer in children is just obscene.

Senegal needs palliative care, but it also needs chemotherapy, radiotherapy, and other forms of curative treatment. I've been trying to schedule meetings with government officials to discuss our findings and recommendations, which has proved to be more difficult than I imagined. Our topic is not controversial, yet I think there is still trepidation when a human rights NGO "needs to talk." One simply hung up on me as soon as I said who I was. I've been trying to emphasize that we are not trying to villainize them, rather we want to collaborate on how to improve access to care--by suggesting what models to follow, how to allocate resources, and policy adjustments that make it easier for patients and hospitals to obtain medication.

Perhaps we will just have to spend the days sitting outside their office--or rather in front of their car so we can't get kicked out by security--until they listen to what we have to say. And even then, maybe our words will just fall on deaf ears. I hope it won't come to that.  

The Green Rabbit

I found the taxi sisters!

Last time I was in Senegal, I heard about a company called "taxi sisters," with only female taxi drivers. Their cars are well maintained, and it is a solution for women travelling alone who are worried about their safety, or simply want to avoid having someone hitting on them for the entire ride. When I asked the male taxi drivers waiting outside my hotel about them, they had told me that the company was not in existence. LIARS.

While walking to the hospital today, my cameraman made a comment, "oh, you don't see those taxis that often. They're called taxi sisters." And there they were--two bright yellow cars, slightly smaller than normal taxis, but relatively new looking. I ran over and took both of their phone numbers. Next time I have to travel alone at night, especially to somewhere unfamiliar, I will call them.

Today I met a really cute kid at the oncology ward. I was sitting in the room by myself, waiting for one of the health care workers, and he kept peering in. I waved at him a few times, then finally he entered and extended his hand, which I took and said formally, "enchanté." He's about 3 years old, and smiles all the time. I could not speak to him since I do not speak any of Senegal's native languages, but he has a box of crayons so I borrowed one to draw a picture for him. I drew a rabbit on a piece of paper, and then a flower, and gave it to him so he could draw something else. Instead, he took a green crayon, and painstakingly colored the rabbit in, making sure not to color anywhere outside of the lines.

We did some preliminary filming today, and I ate a lot of bread. Tomorrow we will work with an interpreter.