Eat!

Men and women have very distinct roles – for example, the women cook and clean, the men pack up the cars and carry bags. The guys would even fill up a bucket of water and carry it to the shower for me (none of the villages had running water). I’d be walking through the villages with a team of interviewers and one of the guys would always insist on carrying my shoulder bag. I eventually stopped insisting that I could carry it since it was a battle that I’d never win. I actually haven’t carried anything in two months. It’s quite nice, really.

The second night, I’d asked the women if I could help with cooking and was told that « it’s done » but when I saw that the rice hadn’t even been boiled yet, I insisted that I be put to work. I was given the task of chopping onions and then a woman taught me how to clean the rice (which had sand in it after riding on top of the car through the desert) – shaking and blowing the bits of dust away over a mesh plate, and then sifting through the grains and picking out bad pieces or chunks of dirt.

The women made delicious sauces with onions, oil, tomatoes, oil, salt, pepper, tomato puree, oil, and peanuts. And oil. People like their oil here. I’ve heard that if one is served a dish without much oil, the cook is considered « skimping ». No one’s going to risk that kind of insult here. But after working outside in the heat all day, hearty meals always hit the spot and I rather enjoyed the excuse to disregard any dietary guidelines regarding fat.

For meals, everyone huddles together in a circle, sitting or squatting, washes hands with water in a bowl, and digs in. The village chief’s family would usually prepare lunches for our team and we’d eat after completing all of the surveys, typically around 1 pm. Oftentimes, the women in our group, or sometimes the village matron, would prepare dinner for everyone. After the first week, I realized that I hadn’t used an eating utensil in days. The rice is served in a large metal bowl and then the sauce, with chunks of meat in it, is poured from a smaller bowl over the rice. I was taught how to form a ball with the food in my right hand but never quite mastered a graceful technique and usually ended up wearing a third of the meal. I got used to being the comic relief.

Every meal, I heard someone insisting that I eat more, « Shelby ! Il faut MANGE ! » Men and women alike would pick up a pieces of meat from one part of the communal bowl and place it in the bowl right in front of me, making sure that I was always eating enough. I was definitely in good hands with this group. And after being forced to speak French (or keep quiet), I’m pleased to report that my French might actually have improved.

Ami Diop

Like the kids who called me « She-ppy » many people have a hard time saying Shelby. It’s just not a familiar name here. I mix up the names of people here all the time, too, so it all evens out. However, there’s the funniest thing here, « joking cousins » where people make fun of each other – good-naturedly – of their names and where it implies one is from. I honestly don’t really understand all the nuances but it cracks me up since people find it hilarious.

I was given the name « Ami Diop » during my first week here and it’s turned out to be an easy ice-breaker, especially when people just don’t seem to « get » my name. In one village, while meeting with the chief and the other leaders, I followed the lead of my other American counterpart and introduced myself as Ami Diop and was met with cackles of laughter. One of them said « Au revoir, Madame Diop » as we left and, for a moment, I thought, « Who’s Mme. Diop ? » then remembered, « Hey, that’s me ! » Diop is actually a Senegalese name so in another village, one of the leaders told me, with a twinkle in his eye, that I must change the name for the day to Ami Nané, the common local surname.

I stayed with a family one night in Kolokani after my bout of illness while waiting to meet up with the team again. Once I introduced myself as Ami during dinner, I never heard Shelby again. They would say, « Ami ! » and look over, making sure that I’d respond, then ask me a question or tell me to eat more. It’s the most random inside joke when people know it’s not your name and they continue to call you by that name.

That day had the potential to be an incredibly frustrating day because everything was out of my hands, but I felt uncharacteristically relaxed. I had been dropped off at a supervisor’s house (stranger to me initially but friendly and served lunch right away, so all was fine in my world) in a town a couple of hours from Bamako with the assurance that the team would come by that evening … or perhaps in the next day … or so … to get me (the team had no cell phone reception wherever they were so couldn’t confirm). The team didn’t show by dark so I ending up eating guava fruit and watching the Mali-Côte d’Ivoire soccer match on TV outside (run off a generator while the rest of the house was dark and Mali lost 5-6 in OT … as they’ve won only once in the past 20 games, it was a big upset). Neighbors sauntered by and sat down, and I watched little boys give up their seats for older men while women stood in the back, nursing babies. At one point I counted 18 people huddled in front of the tube. I had been instructed to sit on a cot bed that had been brought outside for lounging. It was indeed comfy, but I felt absolutely ridiculous while everyone else sat on chairs or stood.

After the game, we ate dinner and I continued to hear questions directed to « Ami ». I took a bucket shower in the rectangular mud structure outside and admired the stars (if you keep your face – and most importantly, your nose – to the sky, it decreases the potentency of smells wafting up from the hole in the ground below), then crawled into bed, feeling full and clean. I slept on a mat on the cement floor under a mosquito net and conked out til 6:30 the next morning, when I awoke to these hilarious guys singing « She rises ! » in Bambara. I must have looked quite confused when I opened the door of my room and walked out to the living area because then they started talking to me in French, translating what they’d said in Bambara (as if that would clarify everything). I was again instructed to sit down and watched as fresh, hot tea was promptly mixed with 4 heaping spoonfuls of sugar (I cringed) and a few scoops of powdered milk. He poured it back and forth between two mugs to cool it off and handed it to me. I sipped the sweet tea and ate bread and butter and reconsidered the advice I often give to limit sugar. It just amazes me – the generous hospitality with which foreigners are greeted here, particularly uninvited, unannounced foreigners. (By the way, the team picked me up at noon that day at the health center.)

GOBAMA !

Speaking of community organizers, hearing the election results was cause for celebration! I wish that I could report that I was dancing in the desert sand when Barack Obama won the election, but instead I was recovering from a nasty 24-hour bug in a hotel in Bamako. I had eaten something that my body rejected several times and I still can’t identify the culprit but was feeling much better after a couple of days. I was utterly disappointed to miss a few days in the field in the middle of the survey, though it was great to watch the Grant Park speech on CNN. I feel like I’m proud to say where I’m from again, after 8 years of whispering « the US » when asked where I’m from while traveling. It’s fun to watch people’s reactions here though and watch their faces light up when I tell them who I voted for.

It was actually a bit lonely – such a celebratory occasion but no one to with whom to celebrate. Thankfully the hotel staff knew me since I’d been there long enough, and they gave me high fives when I went downstairs for soup. A car full of the interviewers called me from the field with felicitations about the election and said to bring something back to the field to celebrate. It was nice to know that I wasn’t forgotten by the team and, to their delight, I showed up with a half dozen watermelons.

The daily grind

We would generally rise between 4:30 and 5 am to be on the road to the next village and arrive by 7 am so that we could conduct the interviews before the women left households for work in the fields. We’d meet with the village chief to conduct formalities and then a community volunteer would take the team to the center of the village, where we’d number all of the houses in and randomly select the starting households for the interviews with mothers.


I would follow one pair of interviewers each day, observing the interviews and helping with the process of taking and recording arm measurements, answering questions from interviewers, and reviewing questionnaire forms for accuracy and completeness prior to leaving each household.





















It pained me to hear women report that they had lost children. What perplexed me the most was their seeming acceptance of such loss as God’s will, « the child was not meant to be here now ». My understanding, from conversations with people here, is that when one dies families rarely inquire about the cause of death. There are more children to be had. Successive children are sometimes named the same name as the child who died.

There were 20-year-old women who’d had 2 children, and 30-year-old women who had 8 children total but now had 6. It was devastating to watch a woman state her loss as simply matter-of-fact, as if she’d been asked if she had washing to do or a husband to feed. This makes the prevention of malnutrition especially challenging – in areas where child mortality is not viewed as preventable (or might be viewed as interfering with God’s plan), it’s extremely difficult to explain that it’s possible for a sick child to survive and for his/her health to improve with nutritional rehabilitation.

Women work relentlessly each day, carrying water or huge bundles of wood on their heads, caring for all the children and other family members, cooking, cleaning, and washing. In the early mornings I’d hear they rhythmic sounds of corn or wheat grinding with alternating thuds as the huge stick would pound into the wooden bowl. Seeing women laboring and caring for their families (while the men lounge in the shade and sleep or drink their tea), as well as the distances between some of the villages and the health centers, I have a better sense of why the nutrition services at the health centers appear to be drastically under-utilized : there are more children to take care of, there is more work to be done and it’s just not realistic to expect these mothers to travel with a child who is ill, leaving behind other children for days to sit in a health center (where there are no services for the mothers, like food and a bed to stay with her child). From some villages, we’d travel an hour in the car on a sandy road before we’d arrive at the health center. I can’t imagine how long the same journey would take by foot or by donkey cart, especially in 95-degree heat. And how disappointing to reach a health center where the supplies of fortified flour or a peanut-based food supplement have expired or haven’t been delivered for 2 months.

Still, I am amazed by the resilience of women and children in the villages. Despite having little or no education, few material goods or modern amenities, no running water, no electricity, suffered the loss of children, carrying out excruciating physical labor every day, and constantly deferring to a husband’s wishes, by and large, the women I met beamed with an unmistakable «joie de vivre» : they are blessed with children, surrounded by large, extended families, and they seem genuinely happy.



Despite this, there is still a need to improve the services available to people in these remote areas. Children are always coughing and have runny noses because of respiratory infections and have patches of hair missing or minor cuts that won’t heal on elbows or knees because of malnutrition. In each village, I saw children whose arm measurements confirmed severe malnutrition, along with swollen bellies and protruding belly buttons due to micronutrient deficiencies and/or parasites. I found it very difficult to estimate a child’s age – one infant in particular stands out in my mind because he looked like he was one month old, but the vaccination card confirmed that he was 11 months old.

Although intensive nutrition rehabilitation centers exist and there is clearly a need for these treatment facilities, the demand has yet to be created. Through informal conversations, it seems that one of the most realistic approaches to create awareness of the severity of malnutrition in Mali is through community campaigns that involve educating grandmothers, men, and village leaders to promote good health practices within their families and their villages. I watched women breastfeed an infant for 2 minutes and then resume working – no time to sit and nurse for 30 minutes, every 2-3 hours, for these women. Changes won’t happen overnight, but I also hear encouraging stories of women in villages demonstrating to other women the positive effects of improved health practices … the most credible community mobilizers!

Village life

Besides spending time talking and dancing with the interviewers, meeting the caregivers and children in households, village chiefs and health agents and getting a glimpse of village life was the best part of the evaluation. People were remarkably friendly, welcoming, hospitable, and generous – always spreading out mats for us to sit on or offering us wooden stools or chairs.

I enjoyed watching children follow the surveyors through the villages and hearing their giggles when they’d call me « She-ppy », after I attempted to introduce myself in Bambara. The mothers of these kids were howling with laughter watching me with their kids – the kids would ask me questions but didn’t quite understand that although I know how to say, « ne togo Shelby », I didn’t understand another word of Bambara so my blank expression left them entirely at a loss.

But, they’d heard my foreign name and continued to try it out, so for the duration of the interviews, I’d hear one whisper « She-ppy » and then peels of laughter when I’d turn to the child who said it and wink or poke their belly. The kids would sit right next to me, grab my hand and give me a shy smile while raising their shoulders to their ears. When we drove out of the village that day, I heard « SHE-PPY !! » and saw 5 of them running out to wave goodbye while jumping up and down. I opened the window and waved, quickly asking the interviewers how to say goodbye in Bambara.

At times I felt like an animal at the zoo. Kids would stare at me with wide, curious eyes, sometimes expressionless, other times giggling. During some interviews in the households, babies would look at me and start crying if I got too close. In one village, an adolescent woman with obvious development delays walked right up to me and took my hand and flopped it back and forth – palm facing up, palm facing down. Then she took my arm and twisted it gently. Then she put her hand right on my face, cried out, and ran off. I still can’t decide whether or not I scared her. While we were walking through a village in the far north, one of the interviewers with our team said to me, « Some of these kids have never seen a white person! » I asked, « Really ? » and she nodded and linked my arm in hers.

Anecdotally, it seemed like most of the women interviewed had no education or perhaps incomplete primary school. I don’t recall a village where any of the households had electricity. Sources of water were open wells, occassionally covered wells, and pumps. A few villages closer to Bamako used motorbikes as primary modes of transport, but the majority of villagers walk, ride bicycles, or use donkey or horse carts as their main modes of transport. Most of the population practices subsistence agriculture and we’d drive past staple crops of sorghum, millet, and maize each day. There are cash crops for peanuts, cotton and there’s also cottonseed oil production and wheat flour mills.

Mali has strong radio network and even very remote areas are serviced with radio for sources of info, but health agents, village chiefs, and family members also fill the role of providing information. In rural households, there’s usually a head of household who controls the allocation of resources for the large, extended families. Polygamy is common and the mothers-in-law and senior wives play influential roles in making decisions for the family. Mothers, sisters, grandmothers, and co-wives share the responsibility of caring for children and household work.

Mademoiselle Pasteque

It’s watermelon season here and, hands-down, the most refreshing thing to eat when it can’t possibly get any hotter outside and we haven’t passed a market to buy fruit for days. Despite carting around a whole carton of « Shelby’s water » in the car (while everyone else drank straight from the pumps or wells), I think my constant state of dehydration and steady diet of rice, meat, biscuits, and nuts rendered watermelon an extra special treat for me. Although I honestly can’t say why it turned out to be such a funny point with everyone, I earned myself the nickname « Mademoiselle Pasteque », I think because my enthusiasm for the fruit made the team laugh since I always broke into an enormous grin every time when someone cut one up for the group and invariably handed me the largest wedge. Maybe they all just assumed that I was crazy and it seemed like a good excuse to laugh at me and to let me think that they were laughing with me.

Field notes

It feels weird to type. I haven’t used in a computer in 3 weeks ! I’ve learned so much in the past few weeks and can say with certainty that it was an adventure. It was, in a word, awesome. While waiting for everyone to arrive at the office and packing the cars, I was sitting with 3 of the interviewers and one asked me, « Are you ready ? » For once, I got the grammar spot on and replied in French, « I was born ready ! » and they doubled over laughing. It seemed like a good start to this little jaunt.

We left Bamako on a Sunday afternoon, cars packed so full that I wasn’t sure there would be room for all 24 people in them, and drove north for 5 hours. The road turned to dirt and sand after 3 hours and we didn’t see pavement again.













We slept at a health center the first night in Nara and ate omelets for breakfast at the bustling market in town the next morning. I watched the man crack an egg into a glass jar, add chopped onions and pepper, and shake it before opening the lid and dumping it into a hot frying pan. I also ate the most delicious bread I’ve ever tasted – baked over a fire in the oven and so hot to the touch that I dropped it onto my omelet. We sat at the counter in the open-air market stall which had a corrugated metal and cardboard roof supported by big wooden beams. I turned around and saw men leading two camels through town and kids riding carts pulled by donkeys. We were close to Mauritania and heading to villages just 3 or 5 km from the border.

To say that logistics are challenging in these harsh field conditions is an understatement. The last road sign that I saw was about 4 hours into the trip on the first day. I never once saw a map. We had to carry plenty of extra gasoline because you just never know when you’ll need it nor when you’ll find it. Drivers, in my opinion, are all-around logisticians –navigators, mechanics, and networkers. They determine the route without ever consulting road maps (they don’t exist), fix the cars when something breaks, and never hesitate to stop and ask for directions. One day, they chatted with a man who offered and then drove an hour on his motorbike to show us the road from his village to the next. Sometimes, someone whom we’d asked for directions would saddle into the front seat and ride with us for a bit, steering us in the right direction. Mostly, they simply rolled down the windows in the car and asked people working in the fields which way to a certain village, but it always seemed kind of exciting, relying on people to show us the way. But most importantly, the drivers were the best DJs – Fode Baro’s Foufafou album on cassette tape was the soundtrack of the trip and there were plenty of dance parties in our car. Africans love to dance and I made friends fast by joining them.

Just a few days into this adventure, our car got stopped in the sand. Yup, totally stuck. Fortunately, the other three cars had taken the road less traveled when the tracks forked so at least it wasn't all four cars stuck. They stopped and ran through the tall grass and all the men tried to push and lift the car out of the sand. No luck.

























One of the drivers brought another car over, thinking that one could tow ours out of the sand. Good thought, until that car also got stuck ! It was all fun and games for those of us watching and taking pictures, until we realized that the sun would dip below the horizon in only another 30 minutes. The village where we were headed for the night suddenly seemed very far away. And what about dinner ?! I needn’t have worried. Finally, with the help of a third Land Cruiser, some contraption to pull the car, and a lot of muscle power (ALL the guys in our group), the cars were back in action and I went from taking photos to peeling potatoes for dinner.

We’d sleep in villages at the health centers or in schools, sometimes inside, but mostly outside. My tent was made of out mosquito netting and it was amazing to sleep under the stars every night - without any lights nearby, there were far too many stars to count and the sky was gorgeous. The villages are so peaceful and quiet. Only the sounds of donkeys braying or roosters would make me stir. Or someone snoring in a neighboring tent.