7.21.2015

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.
Fisherman

View from Fish Market


Lobe Falls

Lobe Falls
Sole and Shrimp on the Beach

Our Hotel

7.04.2015

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

        6.22.2015

        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. 

        5.08.2015

        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.


        4.07.2015

        Combating Malaria in Ngatt

        Malaria Education Session in Ngaoumere

        Yesterday evening, the winds picked up, the sky darkened, dust swirled around to imitate a small, weak tornado, and then suddenly – I heard it: the pinging on my tin roof. It was the first sign that the rainy season is approaching. It has been unbearably dry, hot, and dusty lately as the end of dry season rears its ugly head. Food is scarce, and water is scarcer. What water I do manage to find to bathe, drink and clean with is the color of my bright red hair from all the dirt that falls into the few wells which have a scant amount of water remaining. People stay at home, choosing to nap in the heat of the day rather than be enervated by the blistering sun. The hospital is quiet except for a handful of cases every day from waterborne diseases, such as typhoid.

        Most people in Ngatt are anxiously awaiting the start of rainy seasons in April. They know that with rainy season come mangoes, oranges, and avocados; it is a time to start sowing crops, which means an increase in income; it’s also a time when the heat lessens and everyone can go about their life again. What they don’t often realize, however, is that while the rain, their work outdoors, and increased plant growth means the end of some of the burdens of dry season, a new enemy arrives: malaria.

        Malaria is a serious public health problem throughout Cameroon. Many Americans are often shocked when they hear that most of us PCVs get malaria at least once, if not several times, during our service. It’s known as a deadly public health menace all around the world, but here in Cameroon, it is business as usual when you have malaria. Unfortunately over the years Cameroonians have been so accustomed to having malaria that it long ago lost its shock value. Not to mention, many Cameroonians still have false information about malaria.
        Grassroots Soccer

        Locals joke with me about why I educate them on malaria when it’s considered a ‘normal’ burden of life for them. What they don’t seem to understand, however, is that while they might be able to go about life as normal when they have malaria, there are certain groups who are more vulnerable, such as young children, pregnant women, and people with HIV/AIDS, for whom malaria can spell death. And while many Cameroonians feel like malaria isn’t too big of a deal, they don’t comprehend just how much they spend on malaria treatment per year, which they’d be able to save if only they slept under a mosquito net.

        People in Ngatt know of malaria, or as it is called in Fulfulde pabbooje. They are used to having it annually, and they thankfully know that when it’s bad enough, they need to seek immediate medical care. However, many people hold false ideas about malaria, such as it is caused by water, or it is caused by mangoes – both of which are easily believable for them since malaria cases skyrocket at the start of rainy season, which brings both lots of mangoes along with the abundance of rain. Most people know that the best method of prevention is a mosquito net, and many of the Fulbe do indeed use their mosquito net that was given to them by the Global Fund a few years ago. The Gbaya, however, prefer to use theirs to fish with or use it to catch those delectable termites.

        The Cameroonian government recently released a tiered payment system for malaria treatment. 
        Treatment and testing for children under 5 is free, while pregnant women pay 4,000cfa ($8), and all others pay 8,000cfa ($16). This price includes testing, medicine, a quinine perfusion if necessary, as well as hospitalization costs in the case of severe, cerebral malaria. Between February 2014 and February 2015 we had a total of 38 positive cases of malaria in pregnant women at our health center, which represented 5% of overall 666 positive malaria cases last year. These 38 pregnant women paid 152,000cfa ($300) for their treatment. It’s absurd that these 38 women caught malaria in the first place, given that all pregnant women who go to their pre-natal consultations receive a free mosquito net as well as a prophylaxis medication. The challenge to eradicating malaria during pregnancy is a problem of behavior change communication, which means working endlessly to convince someone to change their daily habits.  It is exhausting and takes time.
        Certificate Ceremony after Grassroots Soccer

        While pregnant women spent nearly $300, all other adults from age 6+ spent a whopping 2,896,000cfa ($5,700). Positive malaria cases for people aged 6+ nearly equaled the number of positive cases of children 5 and under. While we have a large under 12 population in Ngatt, it’s absurd that the number of cases under 5 equal all those over the age of 5. What this suggests is that parents take malaria seriously in their children when all treatment and testing is free, but once they have to start spending the $16 for treatment, they stop taking their loved ones to the hospital, choosing instead to go to traditional doctors or directly buy less effective medicines from vendors in our local market.

        Over the next month, I’m doing a series of malaria activities in my community, namely a grassroots soccer malaria curriculum and presenting on malaria in Ngatt’s weekly market in an effort to increase education ahead of the arrival of rainy season. These last few weeks I finished two “Grassroots Soccer – Malaria” curriculums with the primary school and another with neighborhood kids. All the kids knew of malaria and have had it at one point, but they had varying opinions on what causes malaria and how to prevent malaria. The kids at the primary school knew a little bit about malaria, but the whopping majority of kids in my GRS activity in my neighborhood proved to know next to nothing about the transmission of malaria. After a few activities, the kids had a much better understanding of malaria, but still failed to take malaria seriously.

        What a Stank Face from this Sassy Girl
        It’s a sad reality that malaria is so deadly, but yet so commonplace and ‘normal’ in Cameroon. Peace Corps Volunteers and community health workers face the tough challenge of convincing people to change their behaviors by using mosquito nets, seeking treatment, and actively trying to avoid malaria rather than accepting it when it comes. It’s most definitely discouraging work that sees little progress in the short time we are in our villages, but I think we all hold out hope that with enough education, slowly but surely people will start taking their health into their own hands for the sake of themselves, their family, and their community.

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