By Lisa Maina
Working with Equipe Aidons les Talibés has been very interesting but there has been a recent hiatus in the management of the organization. Because of this, program development had slowed, and I haven’t been able to work with Boukom and his team in the last few weeks. However, I knew still wanted to give back to the community and was restless to find another organization to work with in the meantime. With the help of the incredible program directors here at CIEE Dakar, I was quickly placed at another volunteer post, one I am very excited about.
Being a public health major, with a particular interest in global health, I was drawn to this program in Senegal because of the chance I would have to witness the health system in action here. When the opportunity to work at a health post in suburban Dakar was presented to me, it felt like fate (sorry that’s cheesy). This post was constructed by the Red Cross and operated by Red Cross volunteers until it was offered to the local government. Now, it is operated by two government-paid clinicians, that perform the maternal and child health functions, and several volunteer clinicians, that offer first aid and pharmaceutical services. My point of contact at the post is Cheikh Faye, an impassioned, energetic volunteer that spends basically 22 out of 24 hours a day helping the people in his neighborhood.
My first day volunteering started with a 40-minute bus drive to the outskirts of Dakar in a region called Pikine. Luckily, I was travelling with a student that had been volunteering at the post for a while, so she knew exactly where to go when our bus broke down still about 20 minutes from our destination. This wasn’t my first time on public transport in Dakar, but it was definitely my longest, with loads of traffic, standing, and confusion until we were forced to take a taxi the rest of the way to the post.
When we finally arrived, we received a warm welcome from Cheikh, then we got right into the work. The other student volunteering there already knew the ropes, so she showed me around. There are 4 offices, 3 for family health and 1 for adult consultations, 1 pharmacy and 1 research lab/classroom all on the premises. Right next door to the post is a Red Cross operated primary school and across the street is a delicious restaurant that we frequently visit after long days seeing patients. My duties that first day were to learn how everything works at the clinic and pick it up as quickly as I could.
I work with Cheikh in the adult consultation room where we check in patients for the entire clinic, perform first aid duties and occasionally do mini-surgeries for kids and adults. As consultations for children 0 to 5 years of age are free, we have a lot of newborns and toddlers come into our clinic where they are weighed and sent to the family medicine offices. That is my absolute favorite part, especially last week when I got to weigh a week-old baby, oh my goodness she was so small and quiet it was incredible. Anyways, check-ins are easy enough minus the language barrier. Because we are outside of urban Dakar, many of the clients don’t speak any French and most speak only Wolof. As I have been taking Wolof classes since my arrival in Dakar, I can ask basic questions, hi, how are you, what do you want, what’s your name, and so forth. However, it’s the responses that usually pose a problem. Sometimes they have a specific card that indicates when they should be coming for visits and depending on the type of card I can figure out whether it’s a family planning visit, post-natal or adult consultation, but other times the client assumes I speak Wolof, is disappointed when I don’t, and we just wait for Cheikh to translate.
I also had to quickly learn how to clean and wrap wounds, which is simple enough but more than anything, I had to get used to seeing open wounds and blood without reacting too harshly. Though most cases have been mild, occasionally we’ll have to remove a birth control implant which involves making a deep incision into the client’s arm, squishing out the plastic implant and picking it out from the inside of the arm with some forceps. I wouldn’t say I'm rather squeamish, but that definitely shocked me watching it for the first time, especially as the procedure was done with several other patients waiting in the same room, very little anesthesia and relatively little light. In fact, conditions in the clinic are adequate for the needs of the community but insufficient compared to standards most of us are used to. When the other student first arrived at the clinic, there were no gloves for any of the clinicians in the office, meaning wound cleanings and procedures were done with bare hands. The bed is ripped up and the scale is very outdated; the tools used are limited and reused from patient to patient; and the clinic only provides antiseptic and the cleaning gauze used, so patients must buy wrapping gauze, ointments or any other necessities at the pharmacy next door.
What the clinic lacks in supplies, though, is made up for by the incredible staff that work their butts off every day to ensure the health of their neighbors. Cheikh and his colleagues are at the clinic as early as 8 am, work there until 2:30 to 3 pm, afterwards do home visits for clients that can’t make it to the clinic, then go home to their own families but are usually still on call for any emergencies. My first home visit, we went to the home of these women that are taking care of their elderly father/husband. He had fallen from a flight of stairs and has unable to walk since, but he was also experiencing severe decay of the skin on his left foot. Cheikh explained the likely cause of this necrosis as a result of the fall creating a sort of paralysis and the lack of movement decreased blood flow to his extremities. Since that first visit, Cheikh has made himself available everyday to remove the decaying skin, perform physical therapy to increase blood flow and do routine cleanings to stimulate skin regeneration. Other home visit clients include the family of a woman who unfortunately died after one of her procedures. Cheikh still visits the family members to check in on them and keep in contact as often as he can. Though I haven’t spent as much time with the other clinicians, so I am unaware of their schedules, but I know it takes a really courageous heart to do the work they do and take care of not only their neighbors, but many of these clients have become their friends, further indicating the quality of their care.
I have taken this opportunity to focus more on what I can obtain from this experience rather than analyze my impact on the community. Because I’m learning so much every day and I’m very naïve when it comes to the field of health administration, I doubt I can have much impact other than the occasional help I offer on Tuesdays, Thursdays and Fridays. I stand to gain a lot of knowledge not only on health practices, but also on the health system in Senegal, diseases in the region, maternal and child health routines, world perspectives on health, cultural aspects of medicine and so much more, all information I can use in the future to then help make an impact on the international health community.