11.10.2014

Disenchantment

Gorgeous Mbororo House

It's been a while - sorry for the delay. Access to internet is pretty limited and my trips to Ngaoundere are few and far between. Life has been good, for the most part. I am still completely in love with my village. It’s very adorable, quaint, and the people are extremely kind and welcoming and pretty much interested and engaged in all the work I do. Granted, there is no food other than beignets, but I've managed not to starve to death thus far! My landlord recently asked me “What long lasting mark/gift will you leave in Ngatt, which we can always look and remember you?” - that was an intense question, especially since I still have 11 months left, and after thinking about it, I think some murals will suffice as a long-lasting parting gift.

Work has been up and down, but mostly up. I had a lot of ideas for great projects, but having less than a year left makes it a bit tough to do many of them, since the ones I’m most interested in involve grants and long time spans. I’ve started 2 groups, which are held on alternative Fridays. The first group is a girls and women group where I teach various life skills such as communication, sexual reproductive health, decision making and leadership. The other group uses the Men As Partners curriculum, and it is wildly popular - my chief even shows up to it! More on those projects in a further post. I do weekly sensitizations at the pre-natal clinics in Ngatt, which involves me spending a lot of time coloring posters. I also prep sensitizations and games for the weekly vaccination clinics health in other villages. In addition to all that, I’ve been a part of a People Living with HIV/AIDS Care Group. 



Metis is Great at Development Work
I had a bit of a falling out with the village crier, to whom I was giving English lessons in return for Fulfulde lessons. He deranged me while he was drunk one afternoon (he is literally one of the handful of people who drink in Ngatt), and I called him out on his hypocrisy of translating for all my groups, which discourage alcohol and substance abuse, and yet show up roaring drunk in the market. He took that hard and then refused to advertise for my group meetings from then on. But apparently after I called him out, so did several others throughout the course of the week, and by the end of the week, he made a resolution to cut out alcohol entirely. Since then he has been extremely motivated and hardworking, and I'm hoping he has seen as much a change in himself as I have. After our brief falling out and his sabatoge of my projects, things are now better than ever between us.

My big project lately though has been planning an HIV sensitization campaign, which finished with me submitting the grant application today. I went for weeks being hopeful and excited about the project and working with my counterpart, and then suddenly I was confronted once again with the broken development system, which has once again caused me to be disenchanted with development work. While development work’s motives and goals are all admirable, I feel (or rather, I re-realize) that its goals are as obtainable as say, Boko Haram being thwarted with a mouse trap (in other words, zilch).

Maybe I’m a cynic. Okay, no, I know I’m a cynic, but I feel like when you work in development, you have to realize that your work isn’t all that groundbreaking. You have to be ready for frustration and disappointment, and usually the days you feel great about all that you are doing, or feel truly fulfilled, just barely make up for the days you feel the complete opposite. Don’t get me wrong, I like the Peace Corps and it’s a great cultural, linguistic, and life experience. I am learning valuable skills that will aid my future career and academic goals, but do I think that any of the work I’m doing will truly make a difference? No. I’m not that na├»ve. Yes, people will remember that I lived here and they will remember the things I did with them, but will they remember the day I talked about nutrition, or about the oral-fecal route, or so on and so forth? Probably not. They will instead remember me fumbling about with my Fulfulde, they will remember my red hair, they will remember my undying love for my cat, and they will remember the cakes that I baked.

While I understand that development, eradicating poverty and combating disease doesn’t happen overnight, much less over decades, I know that it will take a hell of a lot more than good-meaning and well-intentioned volunteers or development workers, well-funded NGOs, and rich development banks to make it all happen. There needs to be a grander paradigm shift, behavior change, and political and social upheaval.

Cynicism aside, development work has made strides and done great things, but for all the development work happening out there in the world, we should’ve made it a lot further than we are if the whole system was truly working. Peace Corps Cameroon prides itself in being in Cameroon for over 50 years, which yes, speaks to the relative stability of the government, but doesn’t us being here for so long (and with some volunteers being the 10th+ volunteer in their village/town) mean that something isn’t working? If the current development system worked, shouldn’t we have worked ourselves out of here already?

I’ve long studied the dysfunctional development/aid system, and it has long been one of my academic fascinations. I’ve always known the facts, and I’ve read the academic and professional critiques of the current development system. Reading about it all from my home computer in Chicago was infuriating enough, but being amidst it is something entirely different.  Despite me being on a ‘high’ from my new village, I’ve been confronted with several unnerving instances lately which have reinforced my disenchantment with development work. I’ll explain a few of them here.

The first example deals with family planning messaging. As health PCVs, we are often encouraged to promote family planning methods. Our world population growth and our increasing consumption are putting undeniable pressure on the world and its resources. Soon the world’s resources won’t meet our exponential demand, and little is being done to mitigate this problem. Many NGOs suggest that family planning in the developing world will help to prevent exponential population growth.

The problem with condom distribution and family planning in the developing world is multifold. One being that Catholicism is against birth control and family planning. Thanks to colonialism, there are many Catholics across the length of Sub-Saharan Africa, so it’s hard to convince them that the Pope is wrong, especially when he is basically giving men an excuse not to wear the pesky rubber; “Sorry babe, the Pope forbids me using a condom’ - in other words, the Catholic church is saying ‘Go forth and procreate! And spread HIV while you’re at it!’. The logic isn’t there in my opinion.

Fishermen Rolling into Mbizor
The Catholic Church isn’t the only hindrance; family planning promotion also neglects the importance of large families in most African societies. While access to family planning methods (condoms, the pill, Norplant etc.) are a problem, it’s not so much the lack of access that hinders the success of family planning methods rather than the social and economic importance of large family structures. Childlessness is a curse. Lots of children guarantee that you will be taken care of in old age, and if you have a few extra kids than you meant to, then it is merely insurance in case a few die off at a young age. Telling families to have fewer children is like telling them that they should die alone. While yes, less mouths to feed would ease the burden of food accessibility, education etc. for the family, it would also hurt the financial situation because less hands would be working the field and herding the cattle. Cultural values such as those can’t change overnight, especially if other economic, political, and societal problems have not been remedied.

Another example of the dysfunctional public health and development scene is the polio campaign I recently took part of around Ngatt. Ngatt itself has had three polio cases in the past 2 weeks, and this is in addition to the several confirmed cases in the Extreme North. Because of this, yet another polio vaccination campaign has been launched across Cameroon. Housseini and I have spent the last few days traveling to nearby villages and encampments to vaccinate and revaccinate children under 10 years old. In addition to the polio vaccines, we also gave out vitamin A supplements, and Vermox pills. The vitamin A tablets explicitly said on the bottle “Do not put the casing into the child’s mouth and under no circumstances should the child ingest the capsule”. We were supposed to open each capsule and empty the liquid into the child’s mouth, but what does Housseini do? He pops the whole capsule in every child’s mouth, even small infants, and tells them to “swallow - it’s candy“. When I confronted him about the capsules and the fact that it was not supposed to be ingested, he replied with ‘Hmm, that’s interesting. It can’t hurt that much’. Hmm, okay. We also gave out de-worming medicine. I’ve had worms enough times to know that a single pill will not de-worm you, but that is the impression we gave out.

Ride to Mbizor for Vaccinations
Other than the Vermox and Vitamin A tablets, we obviously gave the polio vaccination to all the children, since that was the goal of this campaign. What became quickly evident, however, was that in no way is there a manner to ensure that all children get vaccinated. Housseini and I rode the motorcycle to Wandjock, and on the way we passed a few paths that I’ve biked down and know there are Mbororo encampments. When I asked Housseini why we aren’t going to the encampments, he reassured me that they would be hit on the way back. Where they? Of course not. At each village we got to, children were off in the fields or with the men herding cattle, which means that we probably vaccinated 70% of the children we needed to. Additionally, there were several villages that we didn’t even try to go to because of fatigue, distance, or bad road conditions. No wonder why polio cases keep rising!

The last most recent example is my struggle getting a grant organized for my HIV testing campaign. Here in Cameroon we have specific grants set aside for HIV projects. When I began working on my grant, I asked two admin staff if I could buy 4,000 tests, and was assured I could. When I submitted my grant for review, I was quickly told that no, I couldn’t buy tests with the grant. After enough questioning, I was eventually told that the most tests I could buy is 1,000, which don’t get me wrong, is a fine number, but not the amount I needed when previous testing campaigns in Ngatt have proven that 2,500 tests are insufficient for the demand! When I demanded to know what the grant money is meant to be used for, if not for buying HIV tests, I was told it was for sexual health camps and other prevention campaigns. While prevention campaigns are all fine and good, I know that a camp might encourage a few girls to abstain or to use a condom, but the majority will continue as they would have regardless. To me, the most important aspect of HIV work is knowledge of status as a means to prevention. I think large scale testing campaigns and pre and post-counseling yields far more sustainable results that prevention sensitization. If people aren’t tested, they don’t know if they are HIV+, and don’t know if they need to actively prevent further transmission. Tests let those who don’t have HIV review their risky behavior and start on the long path to behavior change communication.  I was disheartened by the fact that PEPFAR discourages testing campaigns and would rather provide grant money to putting on camps that have little measurable benefit.

While I love the work I do in Ngatt, my Peace Corps experiences are causing me to realize firsthand the very broken aid and development system. I find myself questioning what can be done to fix the existing problems and revamp the system to be effective. I find myself wondering if development work can be effective without larger political, social and economic changes that are out of the realm of development. Is successful development dependent upon the political and social environment of the country and culture in which it takes place? While I can’t answer these questions now, I hope to someday be part of the academic community who suggest new alternatives to the broken system we have today so that perhaps someday, real strides can be made to alleviate poverty, disease, and other social woes.

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