A day in the life: Progress on sanitation and malaria prevention project

After many educational sessions and the approval of a grant application, my work partners, village members, and I have started to build showers. The first stage of this building process is the drainage pit (soak pit). Over the past week, all of the soak pits have been created, and now it is time to create the cement blocks to begin the construction. 

Below are some images to share what this process looks like:

Last week we measured the locations of the showers and soak pits so that each family could dig the 1 meter deep hole for their soak pit.

Left: Men forming the cement bricks. These bricks will take about a day to form, so that the construction of the shower structures can commence one or two days from the time of this photo. Right: A man showing how he dug his 1 meter deep hole for the shower's soak pit (where the shower water will drain).

A daughter and her mother prepare for the shower construction as they transport sand to use to mix into the cement, which will eventually create the shower's bricks.

Summer camp in Togo: Camp UNITE

Peace Corps volunteers help to organize a handful of different summer camps here in Togo. There are camps about science, the environment, life skills, a camp for children with disabilities, and a camp for children who are infected or affected by HIV/AIDS. In May, I participated in Camp UNITE as a counselor of apprentice girls. The week was the same as any other week of summer camp that I've experienced - extremely busy, extremely fun, extremely tiring, and extremely rewarding. Camp UNITE focuses on life skills and example session topics include: abstinence and family planning, citizenship, food security and nutrition, HIV/AIDS, income-generating activities, leadership, the reproductive system, and self-confidence. Just like other summer camps, we slept in "cabins", participated in a talent show, ate in a meal hall, hosted a dance party to celebrate the week, and formed little families of our own.

To share Camp UNITE, below are some pictures of camp activities:

This is one of the "classrooms" at camp. You can seen the campers listening intently, and two counselors in front presenting.

The girls are lined up and listening, ready to begin participating in a game.

The last day of camp is an opportunity for the campers to apply and share the skills and lessons that they have learned. We traveled to a nearby village, and the girls presented life lessons to an audience.

Before the girls gave their group presentations - which were in the form of skits - we paraded around town , sang camp songs, and even danced. 

The girls presenting, with the audience surrounding them.

A picture of all of the camp counselors.

At the finish of the last night of camp, we all participated in a candlelight ceremony to reflect on what we had learned at camp, and how camp had impacted our perspective of how we would like to make choices that will inform our futures. 

This just in from Togo

I was informed that Togo was recently featured in the news and I wanted to share this feature, and others, with anyone who may be interested. The feature's captions prove true to what I have been witnessing - from a very far distance - across the country. From my personal experiences and discussions, the expression of protest that is briefly illustrated in this photo is found in various degrees (varying from 0 to semi-aggressive protests) among the people of Togo.

Other relatively recent Togo-related articles:

• Article via ABC News elaborating on the story shown in the WSJ photo, a brief update on the story, and an earlier post of the story 
• UN News, Togo is also a peacekeeper

To any potentially concerned friends and family - the Peace Corps continues to keep all volunteers informed of activities that may concern us, and directs us to take appropriate precautions when necessary.

A day in the life: Introduction to a project focused on sanitation and malaria

Malaria plays a significant role in life here in Togo, especially during rainy season when mosquitoes have the easiest time locating places to reproduce. How serious? Malaria is the most frequently recorded cause of death in Togo. Really? Yes, in 2010 malaria was the cause of recorded death for about 42% (1,113) of children under 5, 12% (380) of individuals 5 and older, and 7% (1,507) of pregnant women*.

One of the projects I have been working on involves the connection between stagnant water and malaria. As many of us know, malaria is carried by mosquitoes. The more exposed one is to mosquitoes and the more vulnerable one is to mosquitoes’ bites, the more prone one is to the contraction of malaria. One method of controlling the presence of mosquitoes is through limiting the reproduction of mosquitoes. Mosquitoes lay their eggs in stagnant water, which is where mosquito larvae develop. Therefore, if one minimizes the presence of stagnant water, one limits the opportunities for mosquito reproduction and development, lessens the concentration of mosquitoes in one’s area, and reduces one’s risk of contracting malaria.

Water – mosquito babies – mosquitoes – mosquito bites – malaria

No water – 0 mosquito babies – 0 mosquitoes – 0 mosquito bites – 0 malaria

When my work partners first introduced this project to me, they took me on a walk through the village demonstrating the presence of stagnant water. Their proposal was to construct 10 showers throughout the village. These showers would demonstrate a proper drainage system. The showers would lessen the amount of stagnant water, and show community members how to replicate this system within their own living space.

When we conducted this initial visit, I captured some photos of local showers and the poor drainage of water. These pictures were taken during dry season: 

Images of showers in the community

Images showing the current prevalence of stagnant water and blocked drainage areas

Concrete in Togo is expensive. Proper drainage systems demand concrete, therefore making showers with proper drainage more expensive. However, my work partners and I hope to build an understanding of the importance of proper drainage construction, demonstrate a cost-effective method of construction, and inspire community members to build low-cost showers of their own.

The foundation of this project is not the construction of showers, but the educational sessions that my work partners and I present to community members. These educational sessions are attended by prominent community members, and are conducted to establish a common understanding of the connection between stagnant water and malaria, and the importance of lessening the presence of stagnant water for the community’s health.

We held our first educational session last week. The session covered general malaria knowledge, and a review of how to wash a mosquito net. We’re building from malaria, to malaria prevention, to stagnant water prevention, to overall community sanitation. 

Local community health workers demonstrating how to wash a mosquito net

Village locals at the educational session

Hopefully over the next few months I’ll be able to show you some more progress on the community’s project towards sanitation and malaria prevention!

*These numbers were taken from a 2010 annual report conducted by a division within the Togolese government, “National Program of the Fight against Malaria” (Programme National de Lutte contra le Paludisme, PNLP).

Youth group activities

Over the past few months, two work partners and I have been working with a youth group discussing topics related to sexual health such as sexually transmitted infections and diseases, and the prevention of HIV/AIDS. This past weekend, we completed our unit on sexual health and to celebrate we cooked a Togolese meal together, and I brought along the American dessert of banana bread. It was a beautiful cultural exchange and an enjoyable three+ hours spent playing logic games, discussing cooking skills, and talking about our youth group.

Many of my youth group members snapped photos of the food-preparation process, and captured some images of one another, too:

Stirring our meal - pieces of local "potato" in a tomato-based sauce

Food preparation, notice the "stove" on which the pot is cooking. The surface of the stove is filled with charcoal, and the heat is controlled by an individual fanning the charcoal.

Bon appetit!

A few happy youth group members

This just in from Togo

Over the past eight months that school has been in session, public elementary, middle, and high school teachers across Togo have been periodically striking to demand better working conditions. From what I have been told, this is in no way unusual. The duration of each strike is different village-to-village, town-to-town, and city-to-city. Over the past two weeks the presence of strikes across the country has been especially strong, both in prevalence and in duration. In some areas, students have demonstrated in peaceful ways - such as assembling together, or marching - to express support of their teachers' demands. The largest cities in Togo are the capitals of the five regions. These cities are some of the most visible areas, and host the largest populations. Recently, in some of the regional capitals, the peaceful demonstrations of students and teachers have been relatively large for Togo. Yesterday, what initially began as a peaceful protest in the northern most regional capital, Dapaong, became tragically violent. The article below reports that "security forces had fired bullets in the air to keep the crowd under control". Either way, the originally peaceful protest ended with the death of at least one young student. [Although the below Washington Post article cites one death, I have heard that it may be up to three.]

To any concerned friends or family - all Peace Corps volunteers are safe and we were not in any danger.

Today all schools were closed and I have been told that negotiations regarding teachers' conditions have commenced. I hope that a resolution that leads for better working conditions for teaches, and therefore better learning conditions for students, can be reached.

Washington Post Article - Union official: 1 student killed, 1 wounded in demonstration in tiny W. African nation of Togo

Insight into project work: Camp Espoir

The past few months, I have had the privilege of working with three other PCVs in organizing a summer camp, Camp Espoir. This summer camp is the result of a partnership between the Peace Corps and nine Togolese nongovernmental organizations (NGOs). Each month, these nine NGOs host a Club Espoir meeting for children infected with, or affected by, HIV/AIDS. I attend these Club Espoir meetings each month, and I always have a blast with the kids who attend. We sing songs from camp, play games, and review topics related to education and health. The kids are knowledgeable, curious, and extremely engaged throughout our meetings. The children who attend the monthly Club Espoir meetings at the nine NGOs are previous and future Camp Espoir campers. The knowledge gained by campers at Camp Espoir is carried through to their Club Espoir meetings, and the bonds that the children create at camp form the foundation of a support system for the children in their local communities. As a previous summer camper in my youth, and as a summer camp counselor at Project Morry during college, summer camp holds a place close to my heart. I am so excited to share a few weeks this summer with the children of Camp Espoir.

In order to share Camp Espoir and local Club Espoir activities, another PCV and I have created a website - campespoir.wordpress.com - please feel free to check it out! You may notice a familiar voice when you read some of the Tales from Togo entries!

Two girls and I at a local Club Espoir meeting

"What's the weather going to be like today?"

In America we have names for the seasons: spring, summer, autumn, winter. In Togo we also have names for the seasons, which translate in English to: rainy, dusty, hot, dry. Do we romanticize the seasons in America with pretty names? Spring is rainy, summer is hot, winter is dry... Perhaps we do, perhaps we also are not as connected with the conditions of the earth and the weather. No matter the season, in America, my diet is the same, my water still comes from a faucet – both hot and cold, on demand, and is never limited – I can always find a comfortable temperature in my house, and both my work and my weekly schedule remain constant.

Here in Togo, it is always hot. I have worn a long-sleeved shirt less times than I have fingers and I have worn a sweatshirt once, when I was in an overly air-conditioned office. Sunscreen is required year-round – and yes, this includes dusty and rainy season. However, even though my wardrobe remains constant, the features of my surroundings change with the seasons. By the end of rainy season, the grass in fields is taller than I am. In dusty, hot, and dry season, the crackly grass has been burned and reveals piles of trash – mostly plastic bags used for food or water. At least I don't have to worry about hidden snakes.

The other weekend, my sitemate, Ta'Mar, and I decided to escape our usual dusty season scenery and visit a friend, Arvo. Arvo lives in a small village located near a Togolese National Park. Although the area was not glowing green and the rivers were not overflowing, the motorcycle ride there was enough to convince me that yes, I do belong in Togo – at least for these next two years.  

Images taken on the motorcycle ride to Arvo's village. Upper-right: mosque; lower-right: classic scene of loading/unloading "bush taxis"; lower left: piles of wood on the side of the street for sale (a classic image during dusty and dry season); middle-left: a home among the scene; upper left: an ambulance passes.

Upper-right: trees during dusty season; middle-right: the view from Arvo's house at night; lower-right: view from the motorcycle drive; left: part of the visit including dancing at a wedding celebration.

Let's get down to business

Recently, I drafted an article for a Peace Corps, Togo in-country publication, which is released for volunteers and Peace Corps staff – think college magazine or newspaper. As I was thinking about what to post for a blog entry, I realized that this may be information that I could share to further illustrate some of my work here. I edited it a bit as my audience is different – but the story remains the same.

The Battle for Clean Street Food: Environmental Impacts on the Sanitation of our Food and Conveying the Repercussions

When I first came to my village, I was impressed by the strategies employed by my work partner and his team regarding the sanitation of food throughout town. First, I learned that it was necessary that all vendors of food were certified. Certification entails training on nutritional hygiene and sanitation practices – prepare food in a sanitary location, wash hands when touching food, cover food, do not prepare food when sick, wash all dishes, use clean water etc. – and periodic retraining on these practices. If a vendor is found mis-practicing or without the certification card, which includes a head-shot of the vendor, the vendor is subject to a fine. Before the vendor can sell again, it is mandatory that the fine be paid. I also accompanied the hygiene and sanitation department on school visits during the first week of the fall semester. These visits included educational sessions for all vendors at schools and ensuring that all vendors were certified. My work partner presented about the importance of dish washing, clean water, food preparation, hand washing, and attempting to control the flood of students grabbing for food. After watching the regulations exercised throughout town, I was feeling confident that my street food was impeccably sanitary.

Top: local street food; bottom: local trash pile.

One day at the hygiene and sanitation office, I came across a notebook documenting the street food vendors in town. The notebook included the status of each vendor’s health as each vendor is tested for intestinal parasites upon becoming certified to sell food. I conducted a brief randomized sample and calculated the approximate percentage of street vendors with intestinal parasites within any given one month. Sixty percent of street food vendors in town have intestinal parasites within any one given month. Street food vendors who do not have intestinal parasites at the time of the test receive medication preventing against parasites.

The close monitoring of street food vendors across town, in schools, and in the market occurs for a reason – even in a town with accessible sanitary water, the struggle to obtain sanitary food is a harsh reality. Unhygienic and unsanitary environmental conditions impact the contents of our food. My work partner often informs me about inspections that he conducts throughout town. Although street vendors are certified and are therefore aware of sanitary food practices and the enforcement of these practices, street food stands are located immediately next to makeshift latrines, or large piles of trash. The street vendors may be taking precautions, and the agents of hygiene and sanitation may be accurately prescribing medication for the control of intestinal parasites; however, there are a few missing pieces to the equation of sanitary food.

When I ask agents of hygiene and sanitation about the major road blocks on this mission to behavior change they explain to me the challenge of conveying the gravity of sanitation to an audience that has an extremely minimal foundation of science. I don't see my intestinal parasites and worms. I see that fly, but I don't know that it's coming straight from the neighboring pile of excrement. I don't see the germs. In fact, that looks clean. In order for behavior to change, it is necessary to communicate the contamination of this seemingly clean environment and just how deeply that impacts one's health. This is where our work comes in, and this is where – if you ask me – the work gets fun.

To encourage individuals to wash their hands, we use oil or glitter to represent germs. Just like you need soap to wash off oil or glitter, you need soap to wash off germs. Thankfully, it is commonly understood that germs cause sickness. Now, how does one encourage one not to defecate in public? A community mapping activity that relies on a village-wide walk collecting samples of public excrement and showing not only the prevalence of public waste, but also the cycle of flies moving from your plate of lunch to that pile of you-know-what a few feet away. This visual, hands-on, community-centered activity conveys the message. The way that you shape your environment's sanitation can directly affect your health. Can you see it?

This community exercise to inspire behavior change related to public hygiene and sanitation practices is a brainchild of Kamal Kar, who is a public health worker. The exercise that I briefly mentioned is a strategy known as community-led total sanitation (CLTS). More on CLTS, or Kamal Kar, can easily be found through a search online. The training manual for CLTS workshops can be found online here: http://www.communityledtotalsanitation.org/resource/handbook-community-led-totalsanitation.

Back to Togo

I write this entry as I begin my nine hour layover in Istanbul, Turkey. I am returning from a 20-day visit to the good old United States of America. The trip was absolutely beautiful in every sense, and although I am looking forward to resettling in my home in Togo, I must admit that it was difficult to leave.

While I was visiting I found myself answering many different questions, and attempting to share the reality that is my every day life in Togo. It's challenging to convey the culture, the work, the attitude, and the way of life that I am now living. Two more straightforward themes were related to my life and work, and I'll attempt to talk a bit about those here...

Where do I purchase my food? I purchase my food at a market. What is a market? Well, there is one market in my village (and I am thankful to have an extremely plentiful market – for Togo standards – just a five minute walk from my house) and literally anything that I can purchase is sold at the market. The market is a football field-sized area (the ground is dirt) that is jam-packed with, for lack of a better description, old and rickety lemonade stand-esque structures that host varieties of goods. Women and children – the vendors – stand behind the stands and sell the goods. 

An image from market day in my village

What do I eat? I am fortunate enough to have access to a fairly wide variety of vegetables, and therefore maintain a vegetarian diet. All produce is seasonal, however I nearly almost have access to – vegetables: tomatoes, okra, lettuce, cabbage, carrots, cucumbers, green peppers, beets, and a bitter version of eggplant; fruit: bananas, oranges, grapefruit, lemons, and pineapple; seasonally: avocados, mangoes, watermelon, and papaya; and other items: tofu, bread, eggs, beans, peanuts, locally made peanut butter, cashews, locally made “cheese”, sugar, salt, and varieties of local spices. What do I usually eat? My diet largely consists of beans – they're a great source of protein, easy to access, and easy to mix with other vegetables. I frequently eat foods with beans and tomatoes, salads, and Togolese egg sandwiches. What other items are available? Processed items that are available for me to easily purchase in my town are tomato paste, dry pasta noodles, margarine, a French-based variety of cream cheese, soy sauce, vegetable oil, vinegar, hot chocolate mix, Nescafe coffee mix, milk powder, and varieties of “cookies” and “crackers”. What do Togolese eat? I'll save the answer to this question for another entry, pictures would greatly enhance these descriptions.

What are you doing? My life in Togo is not nearly as regimented as my life has always been in the United States. The variety of my daily activities and weekly routines is partially because I am still – yes, still – in the process of settling into a routine in my village, but it is also partially a result of the nature of the culture that is Togo and work as a Peace Corps volunteer. All of my work is related to improving the awareness of healthy living habits – such as family planning, hygiene and sanitation, nutrition, and gender equity. Strategies used to improve awareness are mostly educational sessions with adults and children – sometimes at a conference made possible through grants, sometimes at the hospital, at local schools, at a house with a women's group, in a room with a group of children, or any place with any given group of individuals. Another common location for educational sessions is under a large tree – literally anywhere works as long as there are people who would like to listen. Work is much more casual in Togo. I am lucky to have a job right now that gives me a significant amount of freedom, which also allows me to be extremely flexible in my work with community members.  

I hope that this helps in starting to imagine my life here in Togo.  It's challenging to envision an everyday routine that is so different than the one that we are accustomed to in the United States.