Midwives

Though it hasn't even been one week in Jakarta, it feels like it's been two! I went to work the day after I arrived and met my translator, Ibu Isti along with some of my co-workers. Isti is a bidan, or midwife, who works her family's private clinic. She's also a former member of Indonesia's national women's basketball team member, and translator extraordinaire. Isti went to medical school but decided to become a midwife instead.

Midwifery in Indonesia is really widespread, and in fact there are too many midwives. Previously, the midwifery schools had better standards, but they've popped up everywhere making it very easy, and pretty inexpensive to get a certificate/degree. Midwifery jobs are pretty easy to come by, and midwives can either work independently as village midwives, work at government-run clinics and hospitals, or work privately in their own, or others', clinics. Access to medical care is different in Jakarta, but in the rural areas, many women still give birth at home with traditional birth attendants (women with no formal education) and consequently the maternal mortality rate (MMR) is still very high for Asian countries. More and more, women are using midwives, private clinics or government-run clinics, but the numbers are still dismally low. In January of this year, the government created an free insurance scheme called jampersal that makes it free for women to go to both public and private facilities to give birth. Once the facility claims the birth, they government reimburses them. The problem is that many women still don't know about this free service and so they aren't using it. I hope that we can educate women about it and encourage them to go to facilities instead of staying at home.

Not surprising, the cost of giving birth is much lower than in the US. But the prices vary depending on if you stay at home with a TBA or with a midwife, if you go to a public facility or to a private facility. The cost can range from 250,000 rupiah (RP) to 1,000,000 RP (approximately $27 to $120). One of the problems with jampersal is that the government will only reimburse 350,000 RP so the private clinics that normally earn 750,000 for one birth are having a difficult time and are trying to discourage the use of jampersal in their clinics.

Isti and I are working on a survey to ask women about their perceptions of giving birth in a facility. We are going to investigate the different reasons (cost, transportation, cultural values, etc) that influence women's decisions. Few surveys have been conducted about women's perceptions of health care, but we found a few that helped us to create the survey.

We're now in the final stages of creating the survey and we'll meet to discuss the content and to decide which districts we're going to visit to deliver the survey. The MCHIP project works in three districts in Indonesia: Bireun in Aceh, Kutai Timor in Kalimantan and Serang in Java. The map below isn't very detailed, but Bireun is just east of Banda Aceh, Kutai Timor is north of Samarinda and Serang is due West of Jakarta near the dot for Merak.

Hopefully we'll know our destinations and schedule today or tomorrow and can plan our interview schedule. Isti has worked as a translator with three other midwife volunteers here and I'm really looking forward to working with her and learning from her.

Welcome to America.....er, Jakarta

As the jetlag has finally worn off and I have feeling in my lower limbs again, it's time to welcome you all to America, er Jakarta, Indonesia. The introduction says it all, I think, but suffice it to say that things aren't that different from a big city in the US here - Probably more NY or LA, as opposed to DC or Philadelphia. I arrived pretty late on Wednesday night and got through customs, immigration and baggage claim with no problem. I exchanged some money and headed to the taxi stand where instead of getting the nice black Mercedes to take me to me to town, I essentially wound up in the back of someone's minivan praying the entire 50 minute drive that I was going to arrive at my destination, not at a brothel. Talking to the taxi driver and coordinator was my first sign that I was in a foreign land. I'm pretty sure I slipped into negotiating in Bambara when he told me the price was 280,000 Rupiah (about $30, but it sounded like WAY more in my head). So we set off to Kemang, the neighborhood/district of Jakarta where I'm staying. This big city - of which only a fraction I actually saw - introduced me to brand new cars (including the bright green Mazda 2!), Harley Davidson, Starbucks galore, and huge shopping malls touting Burberry, Gucci and the likes. The whole time I'm thinking, "Okay, did I really get off the plane in Jakarta?" Once we arrived in Kemang, essentially the foreigner area of Jakarta, it really turned into little-America. KFC, McDonalds and Pizza Hut, and then some other random foreign restaurants like an Irish Pub, German Beer Garden and endless Dim Sum choices. Trying to take it all in, we eventually arrived at my abode and I couldn't have been happier. All I really needed was a horizontal sleeping surface and water to feel human again.

By way of where I'm staying - the Chief of Party (Director of the project, for those of you not familiar with "aid-speak") for the MCHIP Project, Anne, has graciously offered her guest room for my stay. Her family is sweet and her pool looks inviting, though the weather hasn't been too awesome yet.

All in all, my arrival was exactly what I would have expected a 12:00 AM after a 29 hour trip - interesting. I'm looking forward to exploring a bit more of the city and starting on work. More to come!

Traveling Alone in SE Asia

"Yeah, traveling alone can be like that - sometimes amazing, sometimes uninspiring." Spoken by a great friend who I'm sure, like many of us, has traveled on his own. This isn't my first time traveling alone, but it is - so far - my lonliest and most uninspiring. I'm in Thailand for the moment and I can't think of a place I'd rather not be. Nothing about the country has excited or thrilled me to the point of wanting to stay. I counter in my head, well, it'd be different if I were with someone else, but I don't think it would be. I think I chose the wrong places to visit, I think I wasn't positive of what I wanted to see while here, and in the end, it has been uninspiring and almost regretful. Another friend told me, "Skip Thailand, go to Laos instead." I had barely even heard of Laos, but I had heard all of these amazing things about Thailand. Next time, I'm going to Laos.

I wanted friends and/or family to come along, and several people were interested in coming, but the timing just didn't work out. I'm one of the only people I know that had a little bit of money and more time on their hands than she knows what to do with. I couldn't miss the opportunity to take this trip now, not knowing what the future might bring. My plans of going home to the States and working and starting a family in the next couple of years will certainly thwart any month-long vacation to some secluded corner of the world. Plus, with the international economic situation, who knows what the situation of my bank account will be. It really is the perfect time for me to be here - except, I'm alone.

So, how do I get out of this alone funk? How do I 'make the best of it' without reminding myself how much cooler Southeast Asia would be with a friend from DC or Mali or my Mom or sister? I have a lot of hope for Cambodia considering I based my entire trip around going there, and I know it will be better than Thailand has been. Seeing the amazing ruins of Angkor Wat and then immersing myself in dark history that has fallen upon Cambodia during the Khmer Rouge years - though a bit depressing - is interesting to me. I'm also going to the beach in Cambodia. We're not talking white sands and crystal clear waters, but we're talking about a place that not many tourists go to - a definite plus.

I'll write more about my travels in Cambodia and Vietnam and hope that things will change. In the end though, I think I'm just so used to life/culture in Africa that this is a completely wild experience for me. Maybe I should have traveled to a new region of Africa, like southern Africa. Next time, I probably will.

Talk to My Hand

So, in teaching Baba English, I've started teaching him some common phrases. But while walking around in Dakar, I remembered back to the day when we used to say "Pshaw" or "Talk to the hand." So, I taught him "talk to the hand" which he transformed into "talk to my hand" with a dictatorial accent. Hilarious. Enjoy.

Dakar - The Paris of Africa

Dakar is the Paris of Africa. I’m not kidding. People are dressed to the 9’s, very fashionable. Skinny jeans and tight shiny tshirts that cling to only one shoulder. Designer bags and sunglasses add to the shine. It doesn’t matter that most of the stuff is knock off – it still has those shining double CCs or GA or Gucci plastered on it. Name brands, that’s all people really care about. The buildings are tall and constructed primarily out of cement, not mud. The roads are all paved and clean – the city actually hires people to sweep. The sewers are covered and there’s no chance of accidentally falling in. The ocean sits adjacent to the city offering a splendid breeze to take away the sting of the hot Senegalese sun. There are over and underpasses. There is a 4 lane highway. Simply put, there is money. Things cost the same price, if not more, in Dakar than they do in America (at least the last time I was there). A kilo of bananas, the equivalent of $1.25. 2 lbs of bananas in the States, last time I bought them, was about $1. But that’s just one example. We were told by the people we stayed with, friends of Baba’s, that a normal apartment in Dakar costs 600,000 CFA per month – that’s about $1,200! That’s ridiculous. Seeing that a nice apartment in Bamako is between 100 and 200,000 CFA, 600 is just outrageous to me. There are so few motorcycles in Dakar – everyone drives a car. I’m not talking about the cars from 1957 that have been rebuilt 39 times in Mali. I’m talking about brand spanking new SUVs, BMWs and Mercedes. I saw an Infiniti dealer in Dakar for God’s sake. Really?

But my main question is, where does all this money come from? It was Baba’s first time going to Dakar and he was blown away. I mean blown away. He kept saying how the only thing lacking in Dakar are stop lights and a metro and as soon as it has those two things, it’ll be on par with Paris. He kept saying how Abdoulaye Wade, president of Senegal, really knows how to work and that our own president, Amadou Toumani Toure (ATT), is zero a la base, meaning that he doesn’t do anything. Baba went so far to say that if a bunch of Malians went to Dakar and saw how developed and how built up it was, they would revolt against ATT. It was pretty amazing to hear him talking about it. But, on the other hand, those are his political views. If you look at Senegal as a whole, it’s in a pretty sad state. Even 15 km outside of Dakar, the roads are unpaved and there’s no development. Every penny that President Wade found has gone into the development of Dakar. Last year, when I was in Dakar, there had just been this big conference called ODI. Basically, this group of Islamic countries got together for a conference and Senegal took tons of loans – I don’t know the amounts, but in the millions and possibly billions – and interest free to help the development of Senegal. But as I said, it’s all gone to Dakar, not to the rest of the country that could really use it. It’s disappointing for me.

All of this is to create a background for an entry I want to write about the visa process and immigrating to the US. The two days that Baba and I were at the Embassy were very interesting and odd. I’ll write more about this soon.

Baba's Coming to America!

Baba's US visa!

I’ve just completed my 4th trip to Dakar, this time on my own terms - and with Baba in tow. We spent about 10 days there and had a great time. The main purpose was to go and have our interview for the immigrant visa to go to the US. I was so nervous about it, but in the end it turned out wonderfully! We arrived at the Embassy at 7 AM only to be told that the photos we brought were the incorrect dimensions, and therefore we would have to go find a photo shop open to take new photos. At 7 AM nothing was open and the first place didn’t open until 8. I was discouraged. 7 AM and problems already? Despite having a perfect set of documents to hand over to the Embassy officials, I felt that the photo issue was a foreboding warning.

We arrived back at the Embassy around 8:30 and were finally allowed to enter. Unlike the US Embassy in Bamako, I wasn’t harassed about why I wanted to enter my own Embassy, but things went rather smoothly. Then came the waiting. After three and a half hours of sitting and waiting they finally called Baba’s name. This was it: he was going to be interviewed and we were going to get our visa (insh’allah). He was asked to swear to the accuracy of the documents that we gave them and then the questions started. “Where did you meet Sara?” “How long has she lived in Mali?” “What are your plans when you go to America?” “What are Sara’s plans?” “Where are you living?” “Does Sara have any siblings? If so, where do they live?” “Have you met members of Sara’s family yet?” The questions were amazingly simple, especially compared to the questions that other Africans seeking their visas were being asked. While I could hear all of the questions being asked of Baba, we couldn’t see each other – which was probably for the best. Each time he would get an answer just a little bit wrong (ie, saying that I moved to Mali in August 2006 instead of July), I would cringe and I was sure that that was the end of our visa searching. After about 10 minutes of me cringing, I heard the interviewer say, “Okay, come back on Tuesday on 2.” Come back on Tuesday at 2? What does that even mean? So I immediately shot up from my chair and went to the window asking, “Tuesday? 2? What does it all mean? Do we find out Tuesday if we got it or?!?!” I was like a frantic animal, it was pretty embarrassing. She looked at me, very sympathetically and said, “You’ve passed the interview, don’t worry.” The proverbial 100 lbs were lifted off of my shoulders. We passed? Are you serious? I wasn’t sure I believe it all. We spent $800 on the visa alone and waited for almost 4 hours and we passed. Baba and I just looked at each other and smiled.

Once we excited the Embassy, I was practically jumping up and down with excitement and Baba was just as smooth and cool as ever. I kept asking him, “Are you excited? Are you excited?” “Yes, Fatoumata, I’m very excited!” was his response. I didn’t quite believe him at first, but I know that he’s stoked. I called my Mom and Sister and said, “Baba’s coming to America!” They’re excitement was awesome too.

I tried teaching Baba the art of the jumping photo - not too shabby! Visa in hand, it would have been better infront of the Embassy, but this is a start!

So, in a few months, we’ll be in North Carolina – now it’s for sure!

Last Day in PC!!!

31 Months
124 Weeks
868 Days
124 Malaria Prophylaxis Pills
2 Trips Home
84 Pills Treating Amoebas
~800 meals consisting of rice
Uncountable amount of mosquito repellent used
~500 Days of sleeping under the stars
3 Different Homes
7 West African Countries
300 hours spent traveling to Bamako and back
$6,975 – the amount of money I’ve earned in the last 31 months
Uncountable number of people I will remember and times I will cherish

These are just a few things I’m reflecting upon my last week and last day in the Peace Corps. Today, Friday, March 27, 2009 marks the end of an era in my life. I’m done with Peace Corps. That’s a pretty striking statement for me, considering this has been my life for the last 2.5 years. I feel extremely accomplished and satisfied with my time here, though much of it has had its ups and downs. I honestly can’t imagine where I’d be or what I’d be doing today if I hadn’t been in Mali. My friends and other volunteers have been asking me, “So! How do you feel?” On Sunday, after a 9 hour, sweltering hot bus ride my answer was, “My back hurts…” I had no idea what they were asking me. “No, how do you feel about being done?” “Oh, that…” I replied. It’s a little strange for me being done because normally when you Close of Service (COS), you fly out to America at the end of the week. I’m flying out, but not to America, and I’ll be back and forth in Mali until the end of June. So, I feel great, but I haven’t had to do the preparations for leaving my family and friends and I haven’t cried yet about leaving, which will happen. I’ve also had so much else to think about – Baba and I are flying to Dakar on Saturday to start our immigration visa process! Please keep your fingers crossed and have good thoughts for us all next week. When I know anything, you will too!

The good news and results that have been part of my COS week are keeping me pretty happy. I did language tests in both French and Bambara – though I was pretty sure my Bambara was about as good as yours – and I scored Advanced High in French and Intermediate High in Bambara. Just keep in mind I’ve never really been taught Bambara, it’s all been picked up by talking to people and spending time with them. Where else would learning some random African language have been so important? So, those two scores were very much to my liking. I also don’t have tuberculosis, which is a pretty positive thing! I also look very much forward to this afternoon when Baba comes to pick me up. Now that I’m officially no longer a PCV, I get to hop on his moto (with my helmet!) and speed off to some unknown destination. Alright, it’s not that exotic, but it’s making me feel pretty damn good.

Well, I just wanted to share a rather positive week with all you at home who have been so supportive throughout my time here. I promise I’m coming back soon! I sent out an email asking anyone about traveling awhile back, and I just want everyone to know that on April 28th, I leave Paris, France for India, Thailand, Cambodia and Vietnam, and I can’t wait! It’s going to be an amazing trip. You’re all still invited if something were to change, like law school ended 2 months early. I know, probably not, but… I look forward to talking and seeing you in June!