Dr Carol's reflections on the trip

Carol writes:

The time seems to have gone so quickly this week — I can hardly believe our Senegal Mission training is over. Everything has turned out better than I had hoped for: our 13 students were eager and attentive the entire time in spite of the 12 hour training sessions. Friday was our “Graduation” so after our morning devotion and our review of Thursday’s material, the students were assigned to create a program demonstrating what they had learned. They put on a cute skit with a CHW visiting a home in which the son had poor hygiene and bad health habits. Of course, his mother took the rap for not training him properly! Fortunately, he saw the light and then performed a rap song about how the “agente santé communautere” had taught them what they needed to do to be healthy. They received rousing applause from all present and we hope to put it on ”Youtube” with a link to our blo., After receiving their certificates of completion of the first part of the course, with hugs all around they left for their villages.

We were greatly blessed by the students’ involvement and commitment to all aspects of training, especially to the social justice issues we addressed each evening. Before dinner we spent one or more hours discussing community, mental health, education, substance abuse and finally domestic equality (and whether men were justified for beating their wives for infractions such as spending too much time on their cell phones!) I think they will remember that discussion a long time — it went on for three hours. I think Tom had tremendous impact when he said that men who were arrested for domestic violence were considered cowards to beat up on someone weaker than you are(!). I think everyone participated in that discussion, with the older men and all the women agreeing that beating a woman never helped to “educate” her as to her responsibilities.

We had a nice evening out together Friday with Pastor Paul and Mama Kittie, Dr Bashir and Pape and Dionsenour and Nancy’s sister Karen at an African restaurant with a special “ethnic” night representing Madagascar. Only Tom was unable to participate, being the third of our group to have been struck with “Idi Amin’s revenge”. We had to pack in the dark when we returned to the guesthouse due to another power outage and had only about 3 hours sleep before Dionsenour returned to take us to the airport for our flight home, which was uneventful.

I am convinced that we accomplish vastly more doing these CHW trainings than we ever were able to accomplish with the village clinics. The ability of the CHWs to have an ongoing teaching relationship with the villagers and their ability to monitor and manage chronic health conditions is a critical part of health management that can’t be accomplished by episodic village consultations by either mission teams or the wellness team in Senegal. In my opinion, it should be much more effective and much less costly to provide the CHWs with the support and the supplies they need with the Wellness Team as backup than continue to rely on the episodic Village Consultation model of health care.