Wow! I didn’t think we were going to make it all in one piece but somehow we managed. It was one hellava ride back from my week-long field trip in Kara-même. What should have been a 7 or 8 hour journey ended up being close to 10 hours. But I’m getting ahead of myself; let’s go back to the beginning of the week…
So last week as you hopefully deduced from the title of this post, Peace Corps sent us on our mid-training field trip. The purpose of the field trip is to not only break up the “monotony” of training but to mainly let trainees see volunteers at work in their domain in other parts of the country. Unlike the business group, our health group was divided into two groups: half of us got a week-long field trip to Kara and the other half of us got only 3 days in Kara. The reason for the split was so that the first half of the health trainees who would be working with HIV/AIDS associations at post would have the opportunity to visit a real association to learn how to work with them as we did not have that opportunity in Agou. Tchao, our APCD, sent us to Kara so we could observe and learn about ONG development and management from AED-Kara, or Association Espoir pour Demain – Kara. Since my main work in Sotouboua deals with working with an AIDS association, I was one of the lucky few to go for the whole week…
AED-Kara
Founded by PC Volunteers a few years ago, AED-Kara is one of the few associations for PLWHA (people living with HIV/AIDS) being funded by a partner NGO in Boston called Hope through Health (check ‘em out online…they are awesome!). The unique partnership makes AED-Kara very different from most HIV/AIDS associations in Togo. To start off with, I use the term ONG loosely. Unlike the traditional definition of a non-governmental organization, ONGs in Togo are merely grassroots organizations that try to fulfill the needs of their communities where the government is unable to. A great majority of supposed ONGs aren’t even officially registered with the government. I would love to go into more detail about this issue but we were never presented with straight up facts about tax brackets and Togolese laws during training so that is the most that I can tell you for now. Maybe one of the older business volunteers might understand the ONG situation in Togo a little better. But back to AED-Kara, which is a registered ONG in Togo…
AED is an association of “pris en charge” (PEC). I have never been able to get a proper translation or definition of PEC but it basically means “care of people”. Therefore AED is an association that cares for people living with HIV/AIDS. AED was originally founded to solely provide psycho-social support but it has now expanded its services to 6 domains based on Paul Farmer’s (yay!!!) model for integrated care of people living with HIV/AIDS in resource-poor communities: the base composed of home visits (“visite domicille”) with 4 pillars of nutrition programs, access to drugs (against opportunistic infections), OVC support (orphans & vulnerable children), and a PMTCT program (prevention of mother to child transmission) with the roof representing psycho-social counseling and support. Since AED doesn’t get a lot of support (particularly financial) from the government, it’s partnership with Hope through Health allows it to sustain when other similar associations struggle to survive. We didn’t go into too much detail about the exact nature of the cooperation between the two organizations but it does allow AED to serve as a jaded beacon of hope for other associations. I say jaded as it’s a bit unfortunate to have US funding thanks to the help of Peace Corps volunteers. This leads to problems elsewhere since now other similar associations expect the “same” from other volunteers which will most likely never happen as I said before since AED is in a unique and rare position, a position other volunteers most likely can’t and really shouldn’t put themselves in as it leads to dependence on foreign support.
Anyways, using AED as a “model”, we spent the first 4 days at AED learning about the model of care and meeting with various members of the association. We spent the first day talking about Paul Farmer’s model and learning about how to come up with a strategic plan. On our second day at the association we learned about the various programs and we had the opportunity to shadow several health workers. I went to a session on finances to learn about AED’s financial model hoping it would be useful in helping VST with financial support. I also sat in on a few counseling sessions with infected patients. It was really heartbreaking to hear about people’s situations, although it was motivating to see how passionate all the health workers were about their work and their desire to help the patients. On our third day we spent the morning doing home visits with the “accompagneuters”. During home visits, the health workers basically visited homes of people who did have access to ARVs and made sure the people were taking their drugs properly. It was cool because they modeled their home visit program off the tuberculosis DOTS (directly observed treatment short-course chemotherapy) program, a strategy where health workers make sure patients adhere to a strict regimen of medications over a specific period of time. That afternoon, we sat around discussing the HIV/AIDS & ARV situation in Togo (more on this later). On our fourth day, before the rest of our health stâge came up to Kara, we split up into groups and discussed various strategies we could implement in our communities to develop and manage AIDS associations. Luckily we ended the day on a hopeful note as the various members of AED held a fête in our honour. After singing some songs and eating some food, several members had the courage to tell us their stories of how they became infected and how they were coping with AIDS. It was so inspiring to see members who had nothing but were optimistic enough that they could fight the disease.
HIV/AIDS & ARVs in Togo
The HIV/AIDS situation here is not only frustrating but extremely depressing as well. When I first did research on the AIDS situation last year based on data from the CIA World Fact book, the situation seemed hopeful as unlike many other countries in Africa, Togo’s HIV/AIDS prevalence rate was around 4% (compare this to countries like South Africa and Botswana where prevalence rates are between 15 % - 25 %!). This is not to say that the statistics are wrong but merely that the statistics are not representative. Statistics such as prevalence rates are great when surveys account for the true population; however if there are hundreds or thousands of people unaccounted for in the true population, which is very easy to do in a country like Togo where people live in remote areas, then it’s impossible to find a true prevalence rate. Let me describe it another way: Say there is a population of 1000 people and the prevalence rate within that population is 10%, meaning there are 100 infected people. That 10% rate is only accurate if all 1000 people got tested. If only half the people got tested, then the 10% is an inaccurate rate because there could be many more sera-positive people making the true rate much higher. But now the question is why did only half the population get tested and not the other half? It can’t just be because people live in rural areas otherwise other countries in Africa would have similar problems. The underlying reason is stigmatization against the disease & discrimination against infected people. People don’t want to be tested because they fear being shunned from the community, a valid fear in a collectivist culture. One of the biggest challenges of the PC health program in Togo is not only correcting misinformation surrounding HIV/AIDS (many people in Togo still believe that you can get HIV by sharing razors, through mosquito transmission, and through “gri-gri” or evil sorcery) but also fighting against stigma and discrimination and helping those infected to live peacefully among their Togolese brethren. The disease is largely misunderstood, particularly in the often neglected rural communities.
Now moving on to the ARV situation. As one of the poorest countries in the world, Togo obviously does not have the financial resources to purchase ARVs for all the infected people in country. A few years ago, thanks to a large donation of about $40 million dollars from the Global Fund, Togo was able to purchase ARVs from India & South Africa. Although the original price for the purchased ARVs was around $17 per month, after a carnet system was implemented, the price dropped down to about $2 per month. The carnet system involved entering a lottery for a prescription carnet which would allow you to receive ARVs at the reduced price. However last year, The Global Fund decided to cut the 2nd round of funding for Togo’s ARV program due to corruption issues (not sure where it was occurring but it was either within the Ministry of Health or else within Global Fund Togolese partner: the PNLS program, the national non-governmental program against HIV/AIDS). This now has dire consequences for all infected people in Togo as ARV treatment is a life-long commitment and it’s very dangerous for a patient to not adhere to his/her ARV regiment. The Global Fund agreed to continue donating ARV drugs to people on the carnet until a few months ago but no new people were allowed to enter the lottery for a carnet and the Global Fund would only re-start the ARV program if Togo re-applied in the next round of funding contingent upon Togo cleaning up its act. However until then, the real “losers” are the infected Togolese who now have no hope of receiving any sort of treatment…I could go into a lot more detail but I think that pretty much highlights the important parts.
Sooo, to better understand the interplay of the HIV/AIDS situation and the ARV situation, let me recount a story of a lady I met during a home visit session. There was this one lady who had lost her job selling vegetables in the market because a “rival” marché mama had spilled the beans that the lady was infected. Due to the heavy stigmatization of AIDS, people stopped going to her vegetable stand making it hard for her to earn any sort of income. No money meant she was now unable to pay rent or care for herself in any way. Even though she was one of the few women with a carnet, she was now in danger of stopping treatment since she didn’t even have the money to buy the necessary food to eat with her medication. This is the kind of stories that you will hear all over Togo. And here we are pretty much powerless to do anything. If we just donate money to the women, then we run the risk of destabilizing our roles as agents of development and instead become agents of funding; however if we don’t do anything at all, the lady is sure to die. Talk about a catch-22…
Where we as volunteers will go from here, I have no idea. Hopefully the situation will seem less bleak the more I find resources within the Sotouboua community.
Hotel Kara
Since field trip week is supposed to be a sort of mini-vacation from training (or at least that’s what it felt like), Peace Corps treated us by paying for us to stay at the amazing Hotel Kara. My how my standards have changed! In reality, Hotel Kara is probably comparable to a Howard Johnson or Budget Inn back in the US but by Togo standards, we might as well have been put up at the Ritz-Carlton (okay so maybe it was more like a really nice Hilton but you get the point). We had air-conditioned rooms, hot water, flushing toilets, maid service, televisions and A SWIMMING POOL!!! This was my first time being at a swimming pool in over 2 months and it was amazing! The hotel really is quite beautiful (check out pictures online), again by Togolese standards. Taylor, Bree & I spent all of our lunch breaks during the week laying out by the pool and taking it all in because who knew when we would be able to swim in an actual clean swimming pool again for a while! We lucked out with beautiful weather for the first three days so I even got to tan a bit (not that I need to, but like I said, I was relishing the fact that I could!). Luckily when the rest of the stâge came in on Thursday evening, they lucked out with about 2 hours of good swimming time with us. It was great to just hang out by the pool and relax as a stâge, complete with diving contests and chicken fights :) We never did find out how much rooms are but I don’t think I’ll ever be able to “afford” staying there again and even if I could, I don’t think I would want to waste the money when that money could be put to more important stuff (like real cheeseburgers from Chateaux!).
Ketao
When the rest of our health stâge came up at the end of the week we spent that Friday in Ketao, a small village about an hour east of Kara-même. The purpose of our trip was three-fold. In the morning we went directly to a guerisseur-traditional or traditional healer to learn about traditional medicine and its impact on the Togolese health system. It was interesting to hear about traditional healing and how the tradition was passed along from generation to generation. The healer we visited was a Peace Corps certified healer and he showed us a list of ailments he was certified to treat as well as showing us some of the natural medicines he used. He also explained how he understood the gravity of the AIDS situation and how if a healer is legitimate, they know to refer potential AIDS patients to the local hospital as there was no known herbal cure helpful for AIDS patients, regardless of the superstition around it as being a “curse” disease. As I mentioned in the AIDS section, many people still believe “gri-gri” or evil sorcery plays a role in the spread of the disease and many traditional healers play into people’s fear by making false claims of being able to cure AIDS or being able to “give” AIDS to people they disagree with. It’s a terrible situation and only through education (and working with the healer community) can we hope to dispel this myth.
After our informative trip to the traditional healer, Aimee showed us to AED’s satellite association in Ketao. They had recently completed construction on a building and we got to see the final results. The health workers who ran the association explained what they did and the type of services the satellite association offered to its members. After touring AED-Ketao, we headed to the school to watch part of a peer educator training session. Aimee (who’s from Long Island and went to Emory btw!) was currently hosting a friend from Emory who was now in grad school at Columbia. Her friend was studying under a professor who had written a manual on how to incorporate West African traditions into peer educator trainings. Using the manual, Aimee and her friend were training several HIV/AIDS peer educators. The session we observed was a role-playing game. The presented scenario was that half the participants were members of an international AIDS conference that was taking place on a boat off the coast of Lomé. Due to a storm, the boat was sinking and there was only place for one person on the boat to escape safely and report the conference’s results to the rest of the world. The objective of the participants was to convince the jury (the other half of the training participants) of why they should be the ones saved. All the members of the conference represented different people involved in the AIDS crisis such as the Togolese minister of health, a publicly-open infected AIDS activist, a scientist who discovered the virus, etc. Funny enough and much to the chagrin of my fellow volunteers, after the first round of debating, the jury selected a member of a western ONG who was fighting for the rights of AIDS victims. We are pretty sure their decision had to do with the fact that there were about 20 PCVs watching the game. But then the rest of the participants became angry and demanded that the jury rethink it’s decision because they weren’t happy with the outcome which I don’t believe has ever happened before (usually the jury picks the mother with an infected child). The jury re-voted and this time they picked the scientist who was searching for a cure. So that’s was interesting to watch. After watching the role-playing game and eating an amazing meal of rice with peanut sauce and wagash (probably the best wagash I’ve eaten in country) we headed back to Kara to grab cheeseburgers and pizza from Chateaux.
Club Espoir
On our final morning before heading back to Agou, we went back to AED for one last activity: Club Espoir. Club Espoir, not to be confused with Camp Espoir, is a once-a-month children’s camp that is run entirely by PCVs. Open to all children who are members of AED, the children spend the morning and afternoon with volunteers playing games, sports, educational activities and arts & crafts. It’s a funded activity so the kids even get a free meal out of the club day. The purpose of the club is for the kids to have an opportunity to just be kids and interact with others in similar situations. We only had a few hours with them but we got to meet all the children who came in during our trip and after singing some songs and doing some dancing we went out to the field and played some games. I’m blanking on his name right now but this adorable kid who couldn’t have been more than 6 or 7 attached on to me and didn’t leave my side all morning. He was really cute and had this goofy smile. He stood by me during the sheep song and then pulled me by my hand to the field. I was heartbroken when I had to tell him I couldn’t stay much longer and had to go back to Agou. I don’t think he understood because he asked me if I would come back to the next Camp in September. I don’t know if I will but it would be awesome to go back and play with the kids.
So I just have to mention this one ridiculous game that we played because it was probably one of the funniest things I had ever seen. The game was called “Adam & Eve” and it was kind of like a mix between Marco Polo and Pin the Tail on the Donkey. To play, everyone needs to get in a big circle. Then two people are selected, a boy and a girl. Both are blindfolded and then spun around until they become dizzy. The object of the game is for the boy and the girl to find each other by yelling “Adam” and “Eve” (the boy yells “Eve” and the girl yells “Adam” obviously). While the boy and the girl try to find each other, the rest of the people need to yell as loud as they can and distract the participants from finding each other. It was one of the most ridiculous games ever but all the kids had a great time playing. I was sad to leave but having participated only got me more excited about starting a kids club at Vie Saine in Sotouboua.
Togo Bridges Falling Down
So back to the beginning where I mentioned how our 7 hour trip turned into a 10 hour trip. Backtracking a bit, training here in Togo for my stâge takes place during rainy season. This year apparently rainy season has been pretty bad, so bad that many bridges across the country, particularly in the southern parts of the country have flooded over or worse broken down. I believe right before we left for field trip, one of the main bridges on the Route Nationale near Notsé collapsed. Since the Route is the main pathway for trucks travelling north to south, this was obviously a HUGE problem. Luckily (or depending how you look at it, unluckily) the part of the Route with the bridge was south of Atakpamé meaning trucks were now being re-routed to go through Atakpamé and west to Kpalimé and then down to Lomé thereby bypassing the Route all the way south of Atakpamé (check out a map of Togo to better visualize what I’m talking about). This however was not the best decision in the world since, as I mentioned in my post-visit week post how bad the road is between Atakpamé and Kpalimé. That road was not meant to handle the kind of traffic of trucks and buses that were now being diverted that way. For all you civil engineers out there, I’m sure you can guess what happens when you add unnecessary stress on a road not built to handle trucks: collapsed roads. Due to additional rain and the increased stress from the increased traffic flow, part of the road between Atakpamé and Kpalimé sunk into a mud hole blocking the one of the only other ways south. Unfortunately, our car HAD to go on that road since our training site is ~15km from Kpalimé meaning we hit a HUGE traffic jam about two hours north of Kpalimé. We were stuck sitting for nearly 2 hours before we finally got the go ahead to pass by the sink hole. It was lucky that they were letting bush taxis through or else we would have been stranded in the “middle” of nowhere Togo. I really hope this situation clears up soon or else it is going to make travelling in the southern part of Togo a real b****! So yea, got back around 9pm and we were so exhausted, most of us skipped dinner and went to bed, getting ready for our last week and a half of training…
Pilabi che (Kabyé also for “good night”),
-Nikhil
So last week as you hopefully deduced from the title of this post, Peace Corps sent us on our mid-training field trip. The purpose of the field trip is to not only break up the “monotony” of training but to mainly let trainees see volunteers at work in their domain in other parts of the country. Unlike the business group, our health group was divided into two groups: half of us got a week-long field trip to Kara and the other half of us got only 3 days in Kara. The reason for the split was so that the first half of the health trainees who would be working with HIV/AIDS associations at post would have the opportunity to visit a real association to learn how to work with them as we did not have that opportunity in Agou. Tchao, our APCD, sent us to Kara so we could observe and learn about ONG development and management from AED-Kara, or Association Espoir pour Demain – Kara. Since my main work in Sotouboua deals with working with an AIDS association, I was one of the lucky few to go for the whole week…
AED-Kara
Founded by PC Volunteers a few years ago, AED-Kara is one of the few associations for PLWHA (people living with HIV/AIDS) being funded by a partner NGO in Boston called Hope through Health (check ‘em out online…they are awesome!). The unique partnership makes AED-Kara very different from most HIV/AIDS associations in Togo. To start off with, I use the term ONG loosely. Unlike the traditional definition of a non-governmental organization, ONGs in Togo are merely grassroots organizations that try to fulfill the needs of their communities where the government is unable to. A great majority of supposed ONGs aren’t even officially registered with the government. I would love to go into more detail about this issue but we were never presented with straight up facts about tax brackets and Togolese laws during training so that is the most that I can tell you for now. Maybe one of the older business volunteers might understand the ONG situation in Togo a little better. But back to AED-Kara, which is a registered ONG in Togo…
AED is an association of “pris en charge” (PEC). I have never been able to get a proper translation or definition of PEC but it basically means “care of people”. Therefore AED is an association that cares for people living with HIV/AIDS. AED was originally founded to solely provide psycho-social support but it has now expanded its services to 6 domains based on Paul Farmer’s (yay!!!) model for integrated care of people living with HIV/AIDS in resource-poor communities: the base composed of home visits (“visite domicille”) with 4 pillars of nutrition programs, access to drugs (against opportunistic infections), OVC support (orphans & vulnerable children), and a PMTCT program (prevention of mother to child transmission) with the roof representing psycho-social counseling and support. Since AED doesn’t get a lot of support (particularly financial) from the government, it’s partnership with Hope through Health allows it to sustain when other similar associations struggle to survive. We didn’t go into too much detail about the exact nature of the cooperation between the two organizations but it does allow AED to serve as a jaded beacon of hope for other associations. I say jaded as it’s a bit unfortunate to have US funding thanks to the help of Peace Corps volunteers. This leads to problems elsewhere since now other similar associations expect the “same” from other volunteers which will most likely never happen as I said before since AED is in a unique and rare position, a position other volunteers most likely can’t and really shouldn’t put themselves in as it leads to dependence on foreign support.
Anyways, using AED as a “model”, we spent the first 4 days at AED learning about the model of care and meeting with various members of the association. We spent the first day talking about Paul Farmer’s model and learning about how to come up with a strategic plan. On our second day at the association we learned about the various programs and we had the opportunity to shadow several health workers. I went to a session on finances to learn about AED’s financial model hoping it would be useful in helping VST with financial support. I also sat in on a few counseling sessions with infected patients. It was really heartbreaking to hear about people’s situations, although it was motivating to see how passionate all the health workers were about their work and their desire to help the patients. On our third day we spent the morning doing home visits with the “accompagneuters”. During home visits, the health workers basically visited homes of people who did have access to ARVs and made sure the people were taking their drugs properly. It was cool because they modeled their home visit program off the tuberculosis DOTS (directly observed treatment short-course chemotherapy) program, a strategy where health workers make sure patients adhere to a strict regimen of medications over a specific period of time. That afternoon, we sat around discussing the HIV/AIDS & ARV situation in Togo (more on this later). On our fourth day, before the rest of our health stâge came up to Kara, we split up into groups and discussed various strategies we could implement in our communities to develop and manage AIDS associations. Luckily we ended the day on a hopeful note as the various members of AED held a fête in our honour. After singing some songs and eating some food, several members had the courage to tell us their stories of how they became infected and how they were coping with AIDS. It was so inspiring to see members who had nothing but were optimistic enough that they could fight the disease.
HIV/AIDS & ARVs in Togo
The HIV/AIDS situation here is not only frustrating but extremely depressing as well. When I first did research on the AIDS situation last year based on data from the CIA World Fact book, the situation seemed hopeful as unlike many other countries in Africa, Togo’s HIV/AIDS prevalence rate was around 4% (compare this to countries like South Africa and Botswana where prevalence rates are between 15 % - 25 %!). This is not to say that the statistics are wrong but merely that the statistics are not representative. Statistics such as prevalence rates are great when surveys account for the true population; however if there are hundreds or thousands of people unaccounted for in the true population, which is very easy to do in a country like Togo where people live in remote areas, then it’s impossible to find a true prevalence rate. Let me describe it another way: Say there is a population of 1000 people and the prevalence rate within that population is 10%, meaning there are 100 infected people. That 10% rate is only accurate if all 1000 people got tested. If only half the people got tested, then the 10% is an inaccurate rate because there could be many more sera-positive people making the true rate much higher. But now the question is why did only half the population get tested and not the other half? It can’t just be because people live in rural areas otherwise other countries in Africa would have similar problems. The underlying reason is stigmatization against the disease & discrimination against infected people. People don’t want to be tested because they fear being shunned from the community, a valid fear in a collectivist culture. One of the biggest challenges of the PC health program in Togo is not only correcting misinformation surrounding HIV/AIDS (many people in Togo still believe that you can get HIV by sharing razors, through mosquito transmission, and through “gri-gri” or evil sorcery) but also fighting against stigma and discrimination and helping those infected to live peacefully among their Togolese brethren. The disease is largely misunderstood, particularly in the often neglected rural communities.
Now moving on to the ARV situation. As one of the poorest countries in the world, Togo obviously does not have the financial resources to purchase ARVs for all the infected people in country. A few years ago, thanks to a large donation of about $40 million dollars from the Global Fund, Togo was able to purchase ARVs from India & South Africa. Although the original price for the purchased ARVs was around $17 per month, after a carnet system was implemented, the price dropped down to about $2 per month. The carnet system involved entering a lottery for a prescription carnet which would allow you to receive ARVs at the reduced price. However last year, The Global Fund decided to cut the 2nd round of funding for Togo’s ARV program due to corruption issues (not sure where it was occurring but it was either within the Ministry of Health or else within Global Fund Togolese partner: the PNLS program, the national non-governmental program against HIV/AIDS). This now has dire consequences for all infected people in Togo as ARV treatment is a life-long commitment and it’s very dangerous for a patient to not adhere to his/her ARV regiment. The Global Fund agreed to continue donating ARV drugs to people on the carnet until a few months ago but no new people were allowed to enter the lottery for a carnet and the Global Fund would only re-start the ARV program if Togo re-applied in the next round of funding contingent upon Togo cleaning up its act. However until then, the real “losers” are the infected Togolese who now have no hope of receiving any sort of treatment…I could go into a lot more detail but I think that pretty much highlights the important parts.
Sooo, to better understand the interplay of the HIV/AIDS situation and the ARV situation, let me recount a story of a lady I met during a home visit session. There was this one lady who had lost her job selling vegetables in the market because a “rival” marché mama had spilled the beans that the lady was infected. Due to the heavy stigmatization of AIDS, people stopped going to her vegetable stand making it hard for her to earn any sort of income. No money meant she was now unable to pay rent or care for herself in any way. Even though she was one of the few women with a carnet, she was now in danger of stopping treatment since she didn’t even have the money to buy the necessary food to eat with her medication. This is the kind of stories that you will hear all over Togo. And here we are pretty much powerless to do anything. If we just donate money to the women, then we run the risk of destabilizing our roles as agents of development and instead become agents of funding; however if we don’t do anything at all, the lady is sure to die. Talk about a catch-22…
Where we as volunteers will go from here, I have no idea. Hopefully the situation will seem less bleak the more I find resources within the Sotouboua community.
Hotel Kara
Since field trip week is supposed to be a sort of mini-vacation from training (or at least that’s what it felt like), Peace Corps treated us by paying for us to stay at the amazing Hotel Kara. My how my standards have changed! In reality, Hotel Kara is probably comparable to a Howard Johnson or Budget Inn back in the US but by Togo standards, we might as well have been put up at the Ritz-Carlton (okay so maybe it was more like a really nice Hilton but you get the point). We had air-conditioned rooms, hot water, flushing toilets, maid service, televisions and A SWIMMING POOL!!! This was my first time being at a swimming pool in over 2 months and it was amazing! The hotel really is quite beautiful (check out pictures online), again by Togolese standards. Taylor, Bree & I spent all of our lunch breaks during the week laying out by the pool and taking it all in because who knew when we would be able to swim in an actual clean swimming pool again for a while! We lucked out with beautiful weather for the first three days so I even got to tan a bit (not that I need to, but like I said, I was relishing the fact that I could!). Luckily when the rest of the stâge came in on Thursday evening, they lucked out with about 2 hours of good swimming time with us. It was great to just hang out by the pool and relax as a stâge, complete with diving contests and chicken fights :) We never did find out how much rooms are but I don’t think I’ll ever be able to “afford” staying there again and even if I could, I don’t think I would want to waste the money when that money could be put to more important stuff (like real cheeseburgers from Chateaux!).
Ketao
When the rest of our health stâge came up at the end of the week we spent that Friday in Ketao, a small village about an hour east of Kara-même. The purpose of our trip was three-fold. In the morning we went directly to a guerisseur-traditional or traditional healer to learn about traditional medicine and its impact on the Togolese health system. It was interesting to hear about traditional healing and how the tradition was passed along from generation to generation. The healer we visited was a Peace Corps certified healer and he showed us a list of ailments he was certified to treat as well as showing us some of the natural medicines he used. He also explained how he understood the gravity of the AIDS situation and how if a healer is legitimate, they know to refer potential AIDS patients to the local hospital as there was no known herbal cure helpful for AIDS patients, regardless of the superstition around it as being a “curse” disease. As I mentioned in the AIDS section, many people still believe “gri-gri” or evil sorcery plays a role in the spread of the disease and many traditional healers play into people’s fear by making false claims of being able to cure AIDS or being able to “give” AIDS to people they disagree with. It’s a terrible situation and only through education (and working with the healer community) can we hope to dispel this myth.
After our informative trip to the traditional healer, Aimee showed us to AED’s satellite association in Ketao. They had recently completed construction on a building and we got to see the final results. The health workers who ran the association explained what they did and the type of services the satellite association offered to its members. After touring AED-Ketao, we headed to the school to watch part of a peer educator training session. Aimee (who’s from Long Island and went to Emory btw!) was currently hosting a friend from Emory who was now in grad school at Columbia. Her friend was studying under a professor who had written a manual on how to incorporate West African traditions into peer educator trainings. Using the manual, Aimee and her friend were training several HIV/AIDS peer educators. The session we observed was a role-playing game. The presented scenario was that half the participants were members of an international AIDS conference that was taking place on a boat off the coast of Lomé. Due to a storm, the boat was sinking and there was only place for one person on the boat to escape safely and report the conference’s results to the rest of the world. The objective of the participants was to convince the jury (the other half of the training participants) of why they should be the ones saved. All the members of the conference represented different people involved in the AIDS crisis such as the Togolese minister of health, a publicly-open infected AIDS activist, a scientist who discovered the virus, etc. Funny enough and much to the chagrin of my fellow volunteers, after the first round of debating, the jury selected a member of a western ONG who was fighting for the rights of AIDS victims. We are pretty sure their decision had to do with the fact that there were about 20 PCVs watching the game. But then the rest of the participants became angry and demanded that the jury rethink it’s decision because they weren’t happy with the outcome which I don’t believe has ever happened before (usually the jury picks the mother with an infected child). The jury re-voted and this time they picked the scientist who was searching for a cure. So that’s was interesting to watch. After watching the role-playing game and eating an amazing meal of rice with peanut sauce and wagash (probably the best wagash I’ve eaten in country) we headed back to Kara to grab cheeseburgers and pizza from Chateaux.
Club Espoir
On our final morning before heading back to Agou, we went back to AED for one last activity: Club Espoir. Club Espoir, not to be confused with Camp Espoir, is a once-a-month children’s camp that is run entirely by PCVs. Open to all children who are members of AED, the children spend the morning and afternoon with volunteers playing games, sports, educational activities and arts & crafts. It’s a funded activity so the kids even get a free meal out of the club day. The purpose of the club is for the kids to have an opportunity to just be kids and interact with others in similar situations. We only had a few hours with them but we got to meet all the children who came in during our trip and after singing some songs and doing some dancing we went out to the field and played some games. I’m blanking on his name right now but this adorable kid who couldn’t have been more than 6 or 7 attached on to me and didn’t leave my side all morning. He was really cute and had this goofy smile. He stood by me during the sheep song and then pulled me by my hand to the field. I was heartbroken when I had to tell him I couldn’t stay much longer and had to go back to Agou. I don’t think he understood because he asked me if I would come back to the next Camp in September. I don’t know if I will but it would be awesome to go back and play with the kids.
So I just have to mention this one ridiculous game that we played because it was probably one of the funniest things I had ever seen. The game was called “Adam & Eve” and it was kind of like a mix between Marco Polo and Pin the Tail on the Donkey. To play, everyone needs to get in a big circle. Then two people are selected, a boy and a girl. Both are blindfolded and then spun around until they become dizzy. The object of the game is for the boy and the girl to find each other by yelling “Adam” and “Eve” (the boy yells “Eve” and the girl yells “Adam” obviously). While the boy and the girl try to find each other, the rest of the people need to yell as loud as they can and distract the participants from finding each other. It was one of the most ridiculous games ever but all the kids had a great time playing. I was sad to leave but having participated only got me more excited about starting a kids club at Vie Saine in Sotouboua.
Togo Bridges Falling Down
So back to the beginning where I mentioned how our 7 hour trip turned into a 10 hour trip. Backtracking a bit, training here in Togo for my stâge takes place during rainy season. This year apparently rainy season has been pretty bad, so bad that many bridges across the country, particularly in the southern parts of the country have flooded over or worse broken down. I believe right before we left for field trip, one of the main bridges on the Route Nationale near Notsé collapsed. Since the Route is the main pathway for trucks travelling north to south, this was obviously a HUGE problem. Luckily (or depending how you look at it, unluckily) the part of the Route with the bridge was south of Atakpamé meaning trucks were now being re-routed to go through Atakpamé and west to Kpalimé and then down to Lomé thereby bypassing the Route all the way south of Atakpamé (check out a map of Togo to better visualize what I’m talking about). This however was not the best decision in the world since, as I mentioned in my post-visit week post how bad the road is between Atakpamé and Kpalimé. That road was not meant to handle the kind of traffic of trucks and buses that were now being diverted that way. For all you civil engineers out there, I’m sure you can guess what happens when you add unnecessary stress on a road not built to handle trucks: collapsed roads. Due to additional rain and the increased stress from the increased traffic flow, part of the road between Atakpamé and Kpalimé sunk into a mud hole blocking the one of the only other ways south. Unfortunately, our car HAD to go on that road since our training site is ~15km from Kpalimé meaning we hit a HUGE traffic jam about two hours north of Kpalimé. We were stuck sitting for nearly 2 hours before we finally got the go ahead to pass by the sink hole. It was lucky that they were letting bush taxis through or else we would have been stranded in the “middle” of nowhere Togo. I really hope this situation clears up soon or else it is going to make travelling in the southern part of Togo a real b****! So yea, got back around 9pm and we were so exhausted, most of us skipped dinner and went to bed, getting ready for our last week and a half of training…
Pilabi che (Kabyé also for “good night”),
-Nikhil
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