HIV Testing in Mbakaou and The Lessons of Cameroon

Alex Leading a Education Session with His Counterpart
Cameroon teaches you a wide variety of lessons, one of which is: In Cameroon, nothing ever works, but everything works out. I was reminded of this lesson last weekend in Mbakaou where I conducted part of my HIV testing campaign alongside my wonderful clustermate, Alex. Together we were reminded of this all important Cameroonian lesson (along with other lessons, which I’ll get to) as we tried to make our testing weekend a success and as we tried desperately to search for hippos in Lake Mbakaou.

Let’s start from the beginning, shall we? Friday morning I arrived in Mbakaou, a village equidistant from Tibati as Ngatt, but much larger, after I waited for 2 hours in the rain on the side of the road trying to find a car that would take me to Tibati. I arrived in Mbakaou just as the sun was coming out and Alex warmly welcomed me to his house and his village with a big mug of mint chocolate tea (Um, YUM!).

After quickly unpacking, Alex and I discussed the game plan for the weekend. Alex apologizing repeatedly for not having set plans, but I reminded him that usually in Cameroon that works out for the best. Once we were properly caffeinated, we decided to go to the chefferie in the center of town and immediately begin the education sessions and testing. When we arrived to the chefferie we found it locked. Alex said the chief promised he’d allow us to use it that day, but when we tried to find the chief, we discovered he was in his fields with the vague return time of “sometime later today”.

Okay, change of plans. I suggested that if we don’t have the option to test Mbakaou that day, then we use the free time to hit some villages nearby, which would maximize our reach. We decide to reschedule the Mbakaou testing for Saturday, which we deemed even better since it was a market day. After rendezvousing with Alex’s counterpart and the health center nurse, we quickly rented a moto, bought gas and made our way to Gantang. See? Things didn’t work, but they still worked out!

Gantang is a small Gbaya village maybe 5 km outside Mbakaou. Everyone gathered in a circle on their plastic chairs as they listed to me discuss transmission, prevention and stigma. When I finished, Alex whipped out the wooden penis to do a condom demonstration amidst stifled giggles. When we finished, the nurse tested everyone and when the tests were completed, Alex and I joined in to assist in the post-test counseling, where only one person had an ‘uncertain’ test result. Good news!

We quickly packed our materials and made our way to Naskoul, a village 2km further down the road. Naskoul is a bit larger and a crowd of unruly young men were already gathered - prime targets for our campaign! I met the chief, introduced myself, and was then held up for a good 20 minutes as he tried relentlessly to flirt with me despite my insistence that I was ‘married‘. While I was trapped in the flirtation ambush, Alex was playing with the kids and scaring them away (thank God!), and the nurse was doing the testing.

After escaping from the flirtation ambush, I walked over to the nurse alongside Alex and we noticed he was throwing the dirty needles uncapped on the ground. Alex told him to cap the syringes before someone steps on one but the nurse said that was too great a risk to himself. How does that saying go? “Sacrifice a few for the many?”, well, in Cameroon apparently it goes something like “Sacrifice the many for me”. The nurse's willy nilly tossing of bloody needles all over the place might have been fine in his eyes, it wasn’t in our eyes. I went back over to the chief and asked for a receptacle to throw the needles in before the kids nearby decide that they’d make awesome toys. After dealing with his flirtations some more, he agreed and fetched us a bucket. The nurse left Alex's counterpart and I to pick up the uncapped syringes one by one praying to God neither I nor anyone else gets stabbed in the meantime.

40 tests later and it was time to do the education session again. I gave Alex control of the session this time so he could practice his French. When it came time to do the condom demonstration, the tipsy men roared with laughter and a few more tossed back whiskey sachets. What better environment to drink in than watching two white kids put condoms on wooden penis? I gave the female condom demonstration (which never ceases to be a spectacle) and some men asked for encore presentations - um, no.

Drinking Sachets in Naskoul
Post-test counseling was quick, with only two tests out of 40 coming back as ‘uncertain‘. The sun began dipping below the horizon as we headed to Boulintin (me with a live chicken in my arms on the moto) to alert them that we‘d test there on Sunday. Just as the sun set, Alex, his counterpart and I returned to Mbakaou famished and fatigued. Alex and I rendezvoused with the chief who returned from his field to confirm that he would unlock the chefferie for Saturday. Alex and I went to get fish, as Mbakaou sits on the edge of Lake Mbakaou, and we bought a 1.5ft long fish for $3.00. After gorging on the succulent fish and baton de manioc, throwing back a few whiskey colas, and watching a couple episodes of The Daily Show, we called it a night and rested up for the large testing event the next day. So as we saw, things didn’t quite work as we planned, but they still worked out.

Saturday was meant to be our large testing campaign since Mbakaou it is a big village, and because it was market day we anticipated even more people. After a quick breakfast of beans and eggs we made our way to the chefferie which was (astonishingly) unlocked and cleaned up (thanks, chief!). The friendly chief greeted Alex and I and thanked us for doing the testing campaign (no problem, chief!). As I set up the room for the day, Alex went to the health center to find the nurse so we could have him start taking blood. As I arranged the room and exchanged pleasantries with the chief, Alex called me in a panic: “So it looks like the nurse lied to us. They don’t have three bottles of chase buffer, they only have the ¾ of a bottle which we were using yesterday”. Chase buffer is the liquid that goes on the HIV tests along with the blood. It was the one thing which my hospital is short on, so I told Alex to tell his health center to acquire and donate to our cause - the only thing they had to contribute to this big testing campaign. They told Alex weeks prior that they had 300 tests worth, so basing everything on that figure, I brought 300 HIV tests. Turns out, the man lied and really only had about 100 tests worth. Go figure. Had we had known in advance they didn’t have enough chase buffer, I could’ve seen if I could have bought some more elsewhere, but alas, no, they chose to lie instead. That’s another lesson that Cameroon teaches you: Lie like your life depends on it so that you can put off the other party’s disappointment until a later time. Cameroonians love lying to you, endlessly. So realizing there was nothing we could do, I told Alex to bring what they had so we could at least begin and play it by ear - perhaps we’ll have a low turnout in which case we won’t even finish the chase buffer they’ve got!

Well, I was wrong. The testing was wildly popular, which in any other circumstance would be great, but when you have to turn people away because of someone else‘s error (curse you, nurse!) well, then it sucks. We tested in batches of 20 people, did our small group education talk, and then individually gave them their results and post-test counseling. When we had tested 125 people, however, the chase buffer ran out. I called pharmacies in Tibati, my health center and other people to see where (or if) we could buy more, but it appeared as if it’s only sold along with the tests, which we had plenty of. We closed up shop and Alex kept apologizing for the lack of chase buffer, which wasn’t his fault in the slightest. The man whose fault it was (the nurse) didn’t acknowledge his error or apologize for lying repeatedly to Alex and me. On top of that, he also didn’t realize the danger of all the uncapped syringes that overflowed the garbage bin (again!), which I took to calling the “bin of death“, which once again Alex’s counterpart and I were left cleaning up and disposing of. Figuring since we could no longer test in Boulintin like we intended to on Sunday, we instead planned to try our luck at finding hippos.

Sunday came and our hippo contact told us to arrive in Boulintin at 8am to meet with the fisherman who’d take us out on the lake on a canoe with a motor attached (so we could quickly escape the hippos should the need arise). Given that Douala apparently hasn’t been getting much rain, Lake Mbakaou’s water level is extremely low because all of it is being sent to the hydroelectric plant in Edea to power Douala; consequently, the hippos are easily spotted in the low water, making it the perfect time to try to catch a glimpse of them.

Lake Mbakaou
Alex and I made our way to Boulintin where we met up with Jean (the contact who knows the fisherman), who claimed he spoke with the aforementioned fisherman the night before and arranged everything. As we waited for a while in Jean's house, he insisted “He’ll be here soon!” Well, he wasn’t. After spending an hour or so listening to Jean ask me questions about Chuck Norris (please, kill me now), Alex and I decided we should just go down to the lake and wait for the fisherman there. When we arrived, the fisherman was nowhere in sight. Go figure. Another man claimed that he was out fishing, clearly unconcerned that he had an appointment with us over an hour ago and was therefore wasting our time. We waited another 45 minutes and then we started getting anxious and doubting if he was going to arrive. Jean, recognizing our not so subtle restlessness, finally took to yelling the fisherman’s name into the lake in hope he’d here. Yeah, that’s effective.

30 or so minutes later the fisherman rowed back to shore. We quickly greeted him, negotiated the price and got ready to set up and leave.
“But wait!” the fisherman cried, “I first need to go to Boulintin to fetch the motor for the boat!”
“You don‘t have it with you even though you knew since last night we were coming?” I asked.
“Oh no, no, no” he replied. What a preposterous idea: to think a Cameroonian would do such a thing as plan ahead!

So off he went on his moto and Alex and I plopped back down in the sand as I doubted if we’d see him again. In this exchange I was reminded of several other lessons that Cameroon teaches you: (1) Always, always bring a book to read, because no matter what, you will wait everywhere for a long period of time; (2) Don’t assume Cameroonians will plan ahead or ever be prepared, even if you have previously discussed whatever the event may be; and (3) Cameroonians will always waste your time (and not care in the slightest about it) because you are odd since you don’t function on African Time.

After another 20 minutes or so, Alex cast a dubious look at the darkening sky on the horizon and I cast mine at the fierce sun which seemed determined to render my sunscreen worthless. Finally Jean suggested we paddle out to the canoe that we’d take to the hippos. We piled in a small canoe and made our way to where other canoes were docked. We pulled up to one particularly submerged pirogue and I jested, “I hope that isn’t our boat” thinking in no way that it could be. But oh! Alas! It was.

Alex and I waded our way out to the boat as Jean got into the sinking boat and began scooping out the water. Alex and I looked on skeptically, mumbling “Du Courage” every once and awhile as the submerged boat began to surface and the murky water and fish who made the canoe their home were thrown out. After another half hour or so passed and our pirogue was as waterless as it was going to get, Alex and I got weary again.

“Do you have his phone number?” I asked.
“He’s not answering”, Jean replied.
That’s a great sign, right? As I asked Alex how long we should wait before we give up, we heard a moto approach.
“Is it him?” Alex and I repeatedly demanded as the moto grew closer.
“Yes, yes, it‘s him“, said Jean, “Oh….wait….maybe not….”
When the moto arrived the driver was not our shifty fisherman friend. The moto driver conversed with Jean in Gbaya for a minute and Alex and I asked what was happening.

The River that Leads from the Dam
The moto driver turned to us with a shadow of a smirk on his face and said, “Oh, his mother died, so he isn’t coming”. I was immediately skeptical as this is often an excuse used by Cameroonians to get out of things they don’t want to do (what happened to the ‘I’m ill excuse‘? Why your mother died?). And given the driver’s grin, I was even more skeptical that this statement was a fact. Dejected (this was the fourth time hippo spotting has fallen through for Alex) we got on the moto to head back to Boulintin, but instead were dropped a ways off. As we walked to Boulintin, Jean pulled up with a different moto and took us to Mbakaou.

On the way we stopped to see the Mbakaou dam and when we got off the moto a self-important guard asked for our ID cards, which I had left at Alex’s house since IDs are never checked outside of checkpoints. What did this fool think we were there to do? Blow up the dry dam? Does he really think we snuck into Cameroon somehow without having the proper documents (and anyways, who in his right mind would want to do that??). The guard quickly let up about asking for my ID but as I took out my camera the guard insisted pictures were forbidden (what, is the dam some well-kept Cameroonian secret? No!). Alex insisted that he’d taken pictures there many times before, but the guard insisted on being a pain in our ass, so instead of giving the guy any more satisfaction in harassing us, we went back home.

So back to that all important Cameroonian lesson. Clearly at this moment things were definitely not working. Intent on making things still work out in the end, and given that we were intent on seeing at least some type of wild animal, we went to a man’s house who has crocodiles. Apparently 20 years ago a fisherman caught two crocodiles and on his way to go sell them he was caught by wildlife guards who informed him he could either pay a fee and give the crocodiles to the guards (who’d probably sell the crocodiles themselves) or the fisherman could keep the two crocodiles. Paradoxically the fisherman couldn’t release them back into the wild. So the man decided to keep them, for crocodiles make wonderful pets, do they not? I’m not sure what the fee that the man was asked to pay but it was probably a lot cheaper than what this man has spent on feeding these two crocodiles for the past 20 years, because they are huge. The fisherman built them a big open pit in his yard where he allows visitors (read: PCVs) to come see them. Alex and I bought a cow heart, split it in two, and we each tossed a half to each of the crocks. As we stood and watched the crocodiles move about their little habitat, I couldn’t help but think of what a great addition these two crocodiles would make to my compound in Ngatt - any time a child would annoy me, I’d just have to dangle the annoying kid over the pit and they’d behave real fast. Sadistic? Maybe. Effective? Certainly!

So there you have it. Things don’t work here, but they always work out. The testing campaign didn’t go as planned, but we still got 125 people tested, and since I’ve returned to Ngatt, I’ve acquired another 200 tests worth of chase buffer, so we already have a new testing weekend scheduled for September. We didn’t get to see the hippos, but I got to throw a raw cow heart in an open pit to two ferocious crocodiles. So, things worked out in the end, somehow, as they always seem to do in this dysfunctional functioning country.

Crocodiles in Mbakaou


A Week(end) Getaway

Empty Beaches

As my time wraps up here in Cameroon, I keep finding myself faced with two conflicting emotions: One being that I want to spend all my time in Ngatt, enjoying quaint village life - and the other half of me wants to just say “Hell with it!” and spend my time doing whatever pleases me, wherever it pleases me. The past month or so has been me doing the latter. After I finished taking the GRE I spent a week in Makak in Spencer’s village before I returned to Ngatt for a week, only to travel back down to the Grand South again a week later. The past week and a half or so has been me spending time on the beach and once again in Makak relaxing, which I think is much deserved given all the HIV work I’ve been doing and all the stress I’m under applying for PhD programs.

A week ago I traveled the 26+ hours by bus down to Kribi, the beach town in the South region, from my village and met up with Spencer to celebrate his birthday with the feeling of sand between our toes, the sound of waves filling our ears, and the taste of pizza and cocktails lingering on our taste buds.

As always, our 3 days in Kribi were not long enough. It’s rainy season (and therefore low season), so besides a handful of European white guys and their Cameroonian wives/girlfriends, we were pretty much alone at our hotel. We saw Lobe falls again, walked up and down the beach, and Spencer even taught me how to play in the frightening-looking waves (and this time my camera wasn’t stolen!). Perhaps best of all was the food, which I needed after the lackluster food of Ngatt and Makak - we enjoyed rich pizza and cocktails every night, and feasted on fresh shrimp and sole during the days on the beach or at the fish market. While the weather was overcast, time on a beach can never really be bad. The empty beaches, cool weather (a rarity), and no sunburns made for a fun and relaxing getaway (and hopefully an enjoyable birthday for Spencer) before I continue with more HIV campaigning (this week to be held in Mbakaou with fellow PCV Alex) and finishing up other odds and ends of projects.

View from Fish Market

Lobe Falls

Lobe Falls
Sole and Shrimp on the Beach

Our Hotel


Eating in Cameroon

Market Day Beignets
I’ll be the first to tell you that nothing kills your appetite like living in Cameroon for nearly two and a half years. While the food may be ‘exotic’, fine, and maybe even good for the first few months, after the repetition of the same dishes day in and day out (multiple times a day), it gets old…fast. For about a year now, I have little appetite for anything a Cameroonian serves me, nor much for what I cook for myself given that my dishes all revolve around the one vegetable I can buy once a week in my village: onions. Nevertheless, I’m sure once I return Stateside and have fully satiated my appetite with fresh fruits and vegetables, Chipotle, sushi, Chinese, and basically whatever else I can get my filthy maw and paws on, I’m sure I’ll mutter every once a while “Man, I wish I had a warm plate of folere/gombo sec/koombie!” Oh, who am I kidding! I don’t think I’ll ever satiate my appetite for America’s variety in fresh produce!

This is a post I should’ve done probably when I got to Cameroon, but I feel it is particularly salient now that I despise nearly every Cameroonian dish (except folere…that doesn’t get old unless I get it 15 times a week) and now that I’ve tried just about every standard Cameroonian meal, both of the Grand North and the Grand South. I also want the rest of the world to recognize the food problems that us volunteers in Cameroon live with.
Folere and Couscous Dinner Chez Moi

But before I describe the typical diet of a Cameroonian, I need to explain something about Cameroonian cooking culture: its immutability. Seriously, Cameroonians never experiment and deviate from the rigid recipes they are taught. Okay, to be fair, I did know one Cameroonian who experimented, and that was my old neighbor in Lomie who opened up an American bakery with my recipes and even sold black bean and carrot brownies - but he is unique. If a girl is taught how to make folere sauce from her mother, she never deviates from this way of making it - she won’t add more peanut butter or more Maggi, she will keep everything the same every time. While there are some regional varieties of dishes, for the most part, they are all synonymous.

Speaking of Maggi, everything in Cameroon (except beignets) has ubiquitous amounts of Maggi in it. What is Maggi? It’s a little MSG cube of random spices (most of which is salt) that kind of tastes like an Asian spice, but also just kind of tastes like what it is: an MSG blob of salt. I once cooked a big pot of American-style bean chili for my landlord’s family, and while I was finishing up dumping my taco spices and hot peppers in the pot, my landlord’s wife came over and crushed 10 cubes of Maggi into the pot as I screamed “NO!!!!!”. She wouldn’t have it - no dish tastes good (apparently) without ample amounts of Maggi. The product of my labor was an Asian-Mexican-fusion chili.

Also, using a sauce for something other than eating with Cameroonian-style couscous, well, that’s a big no-no. I once was taught how to make folere sauce by my neighbor, which lead to a dispute over my not wanting to add a cup of oil and her insisting that 1 cup of oil is absolutely necessary since that’s the recipe. When I begrudgingly let her pour in 1 cup of palm oil to my displeasure, I then served the folere on top of Moroccan-style couscous, to the utter appall of my neighbor, who insisted that what I was eating was not a meal unless I eat Cameroonian-style couscous, which is a blob of corn, manioc, or rice mush and not remotely similar to its homonym.
So Much Oil (Beans for Breakfast)

Oh and speaking of oil, Cameroonians love their oil - red palm oil, regular palm oil, cotton oil, you name it, they love it so long as l’huile is in the name. Everything (and I mean everything) here is dunked, fried, or sitting in oil. Cameroonians are quite apt at taking a perfectly healthy leafy vegetable, boiling it down to a nutrition-less pulp, and then boiling it in a liter of oil, ready to serve over a plate of nutrition-less corn couscous. I never knew something so healthy could become something so inexplicably perverse. My realization that Cameroonians love oil and frying things came to a fore when at the last fete de Ramadan in Lomié my neighbor brought me a fried baguette loaf as if the un-fried variety was somehow substandard or too banal.

Now that you know the basic food culture of Cameroon, or perhaps the lack thereof, let us now turn to what we volunteers eat:

    1. Folere: The typical Grand North food, and the only Cameroon dish I like at this point. It’s made with hibiscus leaves that are cut, boiled down, and added with oil (duh), Maggie (duh), and peanut butter along with some piment peppers. Served on top of a blob of corn or rice couscous.
    2. Sauce de Feuilles de Manioc: This sauce is one I was familiar with from Sierra Leone, and it’s likely my second favorite meal in country, especially when cooked in lots of piment. This sauce is made from manioc leaves that are once cut, boiled down, and added with oil (duh), Maggie (duh), and maybe some vegetables if they are available…which they aren’t in Ngatt. Served on a blob of corn or rice couscous.
    3. Gombo and Gombo Sec: Gombo is an okra sauce. Regular gombo takes the viscous okra, cuts them up and perhaps grinds them, boils it forever and then is added to oil (duh), Maggie (duh) and perhaps some meat, and what results is a super slimy thick sauce that falls off your blob of couscous far too easily. Gombo sec (dried okra sauce) is the same thing but instead of fresh okra, dried okra is used. This is common during dry season when fresh okra isn’t available. I much prefer this variety since it is less slimy and thick, and therefore far easier to eat. My landlady also puts more piment in the dried variety, which gives it some flavor, as apposed to the bland fresh version. Served on top of a blob of corn or rice couscous.
    4. Bokko Haako: Not to be confused with Boko Haram, this sauce is made from dried and ground up baobab leaves. This green powder is sold in our market year-round in little plastic bags. It tastes unremarkable, at least the way my landlady makes it. It’s pretty  much like green, grainy water that tastes faintly like a leaf, but mainly like piment and Maggi, and, of course, served on rice or corn couscous. I liked it the first few times I tried it, but during dry season my landlord’s wife made this twice a day nearly every day, which got old…fast.

      5. Kélé-Kélé: I despise this dish. It’s probably my second to least favorite dish in Cameroon. It’s slimy and doesn’t taste like anything but perhaps drinking viscous snot, and also tastes and feels similar to when I add Metamucil or Psyllium Seed powder to a bottle of water for some fiber and leave it in there until it congeals. Yes, not pleasant at all. In Ngatt we don’t have fresh Kélé-Kélé like in Lomié, so they use dried Kélé-Kélé instead, which sits in our market week in and week out. It is probably as void of nutrients as a leafy green can get. My landlord’s wife loves making Kélé-Kélé during dry season, since it is really one of two things that are available in dry season. I’ve never seen how it is made, but I can’t imagine it is prepared in any other way than boiling cut and dried leaves in water till the sauce congeals and then adding some Maggie and lots of oil (for flavor…). Served on top of rice or corn couscous.
      Market day Beignet Options
      6. Sauce de Pistache/Arachide: This sauce, either made from peanut butter or pumpkin seed butter, is also quite tasty when not consumed every day. It’s pretty easy to make, it’s just oil, water, Maggie, piment, and then mixed with either paste from peanuts or a paste from pumpkin seeds. It’s not a thick sauce, so this one is usually served with plain rice. This is more of a Southern dish, so I hardly ever eat it in my village.
      7. Ndolé: I’m not even going to waste my breath on this one. Hands down the worst sauce in Cameroon. It consists of these big leaves that are ground and boiled down, mixed with dried fish, and God knows what else. Literally the worst.
      8. Tomato sauce: Oh, don’t go thinking this is tomato sauce as in what you add to your pasta at home (be content with those veggie or meat-stuffed sauces, you American snob!). No, this sauce is made from tomato paste, which is sold in plastic sachets in every village, and watered down and mixed with ample amounts of oil. That’s it. Mmmm tasty. Nothing like eating watered and oiled tomato paste with white rice. How appetizing!
      9. Poisson Braissé: Grilled fish is common in Cameroon, especially up here near Lake Mbakaou. This is not a meal you eat during the day. Don’t ask me why, but fish mamas don’t come out until after dark. Basically any fish can be grilled, but my favorite is carp (tilapia), which is from Lake Mbakaou and my least favorite is mackerel, which is all that Spencer has in his village. I love a good grilled tilapia perhaps once a month when I’m in a big city, since I can’t really get them in Ngatt (we have fish, but is isn’t grilled fresh, but rather is grilled and then walked around village on a plate all day). When buying grilled fish, you can order either the head, the tail, or the whole fish. It’s served in its entirety, bones, eyes and all, and you use your fingers to pick the meat off. “Red Sea” in Bertoua had the best grilled tilapia (coincidentally from Lake Mbakaou) - they were huge and she served them with lemon wedges dipping sauces which included mustard, piment, mayo, and a pesto-like sauce (condiment vert) for dipping.
      10. Bush Meat: This was more of a thing in Lomie, but it’s also consumed by the Gbaya in Ngatt, who aren’t Muslim and therefore have no restrictions of the nasty crap they can eat. Bush meat can be anything that isn’t beef, chicken, fish, or pork - so that means it ranges from antelope, to pangolin, to monkey or dog. I always avoid this, and if I wasn’t trying to, the smell itself would be enough to deter me.

        11. Beignets: How could I forget beignets, which are literally the one food sold consistently in my village day in and day out. These friend dough balls, not unlike American doughnuts just without the icing and chocolate, are sold in many varieties: there are plain flour beignets, there are corn flour beignets which my landlord’s wife makes every day and they are fantastic when piping hot, there are white bean flour beignets which taste like chicken nuggets when eaten really hot but are disgusting when eaten day-old, there are flour beignets that are served flattened rather than in a fluffy ball, there are rice beignets, there are banana corn beignets, there are manioc flour beignets…and on and on and on. Who knew there were so many different ways to eat various types of fried flour without adding icing! I’m quite partial to my landlady’s hot, fresh corn beignets and the manioc banana ones that are in Spencer’s village. In Ngatt, every market day and Friday (prayer day) dozens of young girls line up with their basins of beignets in front of them to sell to the shoppers. 10 little beignets cost about 20 US cents. I’m always amazed on market day at the number of girls who line up and all the beignets there are and the fact that my small village somehow manages to consume them all.
        Baton de manioc and Chicken in Yaounde
        12. Bouille: This is a traditionally breakfast food, or a food served frequently during Ramadan. It’s usually served alongside beignets. Bouille is a porage made from flour, rice, lime and peanut butter. It’s quite tasty and tastes like any other porridge. Other Cameroonian breakfast foods include omelets, which are eaten all day but aren’t available in my village, or rice with a sauce, or beans in lots of oil.

        While what I listed above is ‘village food’, I have to admit, we do have more variety in Yaounde and regional capitals. For example, in Yaounde we can eat shawarma, Turkish food (super expensive), Indian (closed for renovations), Chinese, pizza (again, expensive), grilled fish, Lebanese, grilled chicken (Spencer’s favorite), or hamburgers (aka nasty frozen patties), milkshakes (super expensive, again), or salads (my favorite). Eating out in regional capitals and Yaounde is quite expensive, however, if you are there for more than a day or two, which is why I usually opt to make use of the fresh vegetables and cook for myself to save money. But sometimes, even spending a ridiculous amount of money is worth it for the taste of a mediocre pizza.

        Well, there you go - that’s an idea of my typical diet when I don’t cook for myself (which consists of eggs, popcorn, oatmeal or lentils). I’ve got 3.5 months left in Cameroon before I travel to Bulgaria, Turkey, Georgia and Armenia. That means just 3.5 months left of my un-diverse un-nutritious Cameroonian diet until I can finally be reminded how good food is elsewhere - not to mention be reminded of my mom’s amazing homemade cooking, which I haven’t had for 2.5 years! My mouth is already salivating and my grocery shopping list for my mom is already quite extensive.

        Manioc Leaf Sauce Way Back When in Bokito During PST


        But What If We Don't Have Tomatoes?

        Prepping Nutrition discussion Images
        Long time, no talk! Yes, I’m still here chugging away in Cameroon. I’ve been wrapping up my projects, studying for the GRE, working on PhD applications, and trying to fit in a bit of time to relax - my hands have been full! But in case you were worried, no, I haven’t (yet) died of some mysterious illness, although it is not yet off the table. In all honesty, as my time is coming to an end here, there just isn't all that much (new) to talk about that I haven't already.

        My HIV project is still underway - 600 of my 1,000 tests have been used, and the tests have confirmed what my counterpart and I suspected: that our HIV prevalence rate in our heavily migratory fishing population area of Cameroon is 10-12%, which is 4 times the national average. The majority of large testing days in my health district are finished, but at the end of July I’m assisting a new health volunteer in carrying out a 2-day testing campaign in his village - so hopefully by the end of July, 1,000 Adamawans will know they status and seek treatment!

        As for “Phase 3” of my project - creating a support group for HIV+ people - well, that has been tried, and tried, and tried again with no success. The hard thing about Cameroon is (well, honestly, many things) the lack of will and the power of stigmatization. HIV is immensely stigmatized in and around Ngatt, especially among the Muslims. Many people have misconceptions about the origins of HIV, claiming that it’s a disease brought about by witchraft or eating too many mangoes. People are extremely worried about their status getting out in the community, which is understandable, but the fear inhibits them from even attending discrete meetings with other HIV positive community members. If people lack the trust in their fellow community members in keeping their status secret, then nobody shows up to the support group.

        The other problem is lack of will. The origins of this project came from three women in my village who came to me one day, told me their status, and begged for a testing campaign and a support group with income generating activities. I followed through with my end of the bargain (I even bought seeds to create a large support group garden to improve nutrition), yet the three women didn’t uphold their end. Even when I told them I had seeds for a group garden and all they had to do was show up to my house, they still wouldn’t do it. There’s a point in Peace Corps work where you realize you can’t force people to change, and this was my moment. Whereas my testing campaign was a success, and hundreds (and soon to be a thousand) people now know their status and are seeking treatment, the support group side of my project was a complete failure. 

        But as one door closes, another opens. I realized lately that getting people to show up to any sort of organized meeting is harder than pulling out teeth. So, I come to the conclusion that  if people aren’t going to show up to me, I’m going to show up to them and force them to listen to what I have to say. I know, it sounds like I’m torturing my community members, but I hope one day they’ll realize this pain is for their own good. 

        My new approach to spreading community health knowledge is to lead health talks at the hospital on Mondays, Wednesdays, and Fridays on a certain health topic (which rotates weekly) for the inpatients. At any given time there are usually 15-20 inpatients and their family members mingling about our hospital compound. Whilst they mingle and cook in the evenings, I educate them on (mal)nutrition, malaria, family planning, and whatever else strikes my fancy. This, thus far, has been a wild success. All the women gather around me (because the majority of our inpatients are women and children) as their pots of boiling sauce simmer in the kitchen hut. They huddle around me and my drawings, with their tops off and their boobs sagging to their knees, to listen to what I have to say.

        One week I was educating on malnutrition and a balanced diet and I discussed how at very meal they should be eating carbs/starches, vegetables and fruit. One woman raised her hand after examining my maison de nourriture (food pyramid) and she insisted, “We don’t have any of that food to eat”.  “You don’t have what food to eat?”, I asked.
        “We don’t have fruits or vegetables - only corn!”, she replied
        “What season is it right now?”, I demanded.
        “Rainy season,” she quickly replied.
        “Okay, and what can you buy in the market?” I asked. “Mangoes, avocados, bananas, folere…” She replied, and then suddenly she stopped, looked at me and laughed, “Ohh!! We do have these foods you talk about!”

        The people in my community, especially those from the small encampments en brousse, insist that they have no food and that is a fact of life. Few realize that while our selection isn’t vast, we do have some fruits and vegetables that are able to sustain us. Not to mention, starting a garden would be insanely easy if anyone had the determination. 

        My health discussions aren’t wildly interesting (at least to me), but at least I’m reaching a large group of community members, and I can only hope they are retaining half of what I say - although my translator tends to go on epic digressions which discuss completely irrelevant tidbits, so I hope my community isn’t retaining his useless rantings. 

        I've now got less than 4 months left in Cameroon, so the time I have remaining to work is dwindling down as I wrap up my projects. I'm finishing up my HIV project, attempting to get my tri-weekly health talks on solid ground so it that it might function after I'm gone, and trying to enjoy what little time left I have in Cameroon. It's not been smooth sailing recently, but time is sure flying. 


        Depistez-Vous! (HIV Campaign - Phase 2)

        Sensitization in Wandjock
         The most exhausting part of my HIV testing campaign is (thank God), done. The month of April was exhausting, stressful and angering in every imaginable way. Every week involved at least one trip en brousse to a village to educate and test for HIV. The testing days involved waking up early, taking a bumpy cramped moto to wherever our destination was, and then spending the entire day asking the same questions over and over and then either telling people they were HIV negative, or, unfortunately far too often, telling them they were HIV positive. Factor in the daily instances of ‘Cameroonian-struggle-bus-instances (which I define as things that should be simple, but which aren’t because Cameroonians make everything more complicated than it really is);  it was physically exhausting but more so emotionally exhausting.

        The opening of my campaign was in Ngatt and it involved a two day testing event at the hospital. I was significantly skeptical about whether anyone would show up, but thankfully about two hundred people did over the two days. Spencer came up from the Centre region and assisted me in educating people on methods of transmission, how to combat stigmatization, and how to properly use a condom. While the Ngatt testing date didn’t have as many people as I was hoping would show up, it was still not a bad turn out.

        Waiting for Test Results in Wandjock
        The next day Spencer and I went to Wandjock, a village alongside Lake Mbakaou. While Spencer and I both did the education sessions like in Ngatt, we were also in charge of registration and pre- and post-test counseling. Unfortunately, post-test counseling involves telling people their status, and given that my Fulfulde is stronger than Spencer’s, it was always me telling people their HIV status. The first batch of 40 or so people was all adults among which three were positive. Each time I had to tell someone they were HIV positive was worse than the previous time. After the third time, I wasn’t sure I could tell one more person their status. Thankfully, after the initial 40 or so people, there was a large bunch of kids who came to get tested who were all (thankfully) negative. While the mood was far from jubilant most of the day, the mood was lightened, if only a bit, by the children who would respond to my ‘What is your ethnic group?’ question with “Arab.” The first kid who told me he was Arab, I asked again, thinking I misheard. Nope, he legitimately thought he was Arab. Spencer and I stifled our laughs and I asked the kid ‘Oh okay, so are you Saudi or Qatari…?’ The joke was lost on the kid, but Spencer and I got a few good laughs at several kids’ expenses.

        I traveled to 8 villages throughout the month of April and tested over 500 people, with 1,000 tests left over to give for voluntary testing at the Ngatt health center for those who want to be tested on their own time. Unfortunately, we found that the HIV prevalence rate for my area was about 10-12%, which far surpasses the national average of 5%. The next step in the campaign is convincing those who are HIV+ to show up for my new HIV+ support group, but that is proving to be far tougher than my  boss and I anticipated. This week I’m attending a Working with HIV+ People conference, so my counterpart and I are hoping that’ll inspire us.

        While the testing campaign was emotionally exhausting, there were some positive stories that emerged. One day I was testing people in Mbizor, another fishing village alongside Lake Mbakaou. 20% of the people I tested that day were HIV+. Most people are quite stoic when they receive the news; for some they already knew, and for others they have a hard time accepting the fact they have HIV. One woman was shell-shocked, but asked very calmly what she needs to do. I told her the first thing is to tell her husband.
        Waiting for Results in Wandjock

        The next day in Ngatt she came to the health center with the husband, but didn’t tell him why they were there. I explained that we wanted to test both of them for HIV, and the husband agreed. When I pulled the woman aside and told her that her second test confirmed that she does in fact have HIV, tears welled up in her eyes and she explained to us that her husband told her he has another woman whom he will run away and marry if she has HIV. Given this information, I asked my boss what we should do, but he agreed that we need to tell the husband and explain to him the realities, with the wife’s permission, of course. She agreed, left the room, and we called the husband in. He was HIV negative and was obviously relieved, but was shocked his wife was positive.

        We explained for 30 minutes the realities of HIV treatment and how to prevent him from contracting HIV. We counseled him on how he can still have kids (which he wants) and told him that he shouldn’t blame or leave his wife. He agreed, but I was skeptical. We called the wife back in and he consoled her. After another discussion with the two of them together, we let them leave. The husband left and the woman followed behind him, both of them not talking. As I watched them leave, I was dubious whether he was sincere in telling us that he would stay with his wife. As he walked several steps ahead of his wife, I was convinced that my boss and I were responsible for the breakup of a marriage. But later in the day, my boss and I saw the couple sitting roadside before returning to Mbizor – they were sitting close, holding hands (already unusual for Cameroon), sharing their lunch, and laughing. The scene itself was not normal for couples in Cameroon, who usually show no signs of affection towards their significant other, but given the news they were just given, I was filled with optimism that this couple, might indeed, last.

        Fishing in Mbizor
        The next stage of my campaign will be the continuation of giving out free tests at the Ngatt health center and getting that HIV support group started. This project will lead through the end of my service which is fast approaching (!!!!!!). My time left in Cameroon is now less than 6 months, and while the past year and a half seems like it’s dragged on, I feel like my last bit of time will speed by, or at least I’m hoping it will. While I’m sure when I board the plane for my COS trip it will be bittersweet, I feel at this point, I’ve fulfilled all I wanted to in Cameroon. 

        Daily annoyances, security incidents, and struggles seem to compound on each other and build to the point that they can burn a volunteer out. I will admit that I am ready to move on and quite frankly at this point I can’t wait. I am looking forward to my life post Peace Corps but for now the adventure, and work, isn’t over quite yet.