As we begin a new, exciting and challenging year at MHOP with three (yes, three!!) program pilots planned, we are reflecting more and more often on our organization's commitment to remaining community-directed. To share her thoughts about this difficult task, Alex Harsha offered to cross-post a blog she wrote in November during one of the more trying periods of MHOP's development. For other posts by Alex, check out her blog, N be taa Mali la..., at akharsha.blogspot.com!


When I arrived in September, MHOP was struggling to reach a consensus with the CHAG on the issue of their re-elections. CHAG members were upset with our team, as the notion of elections suggested we did not like the work that they were doing. Some members even hinted that we were out to publicly humiliate them. Moreover, several members expressed serious concerns that MHOP has not delivered on its promises – intimating that the CHAG would unfairly take the fall for our failures during their elections. These conversations distressed us greatly, primarily because MHOP remains committed to local participatory governance and secondarily because the thought of failing the community is a difficult one to bear.

As many in “development” circles like to claim, MHOP is committed to working with (not for) the community we serve to ensure that our solutions are responsive to local needs and local capacities. But what does that mean? Buzzwords or not, how do you give them substance? Aid blogger TalesFromeTheHood has some interesting suggestions and critiques, here, where he discusses his experiences working with international development agencies. Community-driven projects take on a whole new meaning when the community cares less about microloans and more about securing AK47s to protect against warring neighbors.

Thankfully here in Bamako we don't have to tread that particular line, but that doesn't mean there isn't one to tread. So what about us? Is it enough that we have Malian staff in our core team, and that we have catalyzed the formation of community groups (like the CHAG) to assist in the design and evaluation of our programs? If we do not work effectively within those groups, if we fail to recognize our own biases or to be vigilant that our intentions match their interpretations, we risk trivializing the very core of our mission.

Now let's be honest for a minute and admit that in terms of development NGOs, MHOP doesn't play in the big leagues. We are not the kind of organization that can deliver 100,000 bug nets in under a week, or even two. We alone cannot provide free care for everyone, and we certainly cannot do it yesterday. But with a two-year CHAG partnership under our belts, a trained Community Health Worker team and a new community clinic receiving its final coat of paint, is it fair to say we are keeping up our end of the deal? Yes, most definitely, yes. We are working as hard as humanly possible to make our projects a reality and we have achieved a lot where others have not. Yet, part of “our deal” is to support the community to work for their own change, and so the fact that the CHAG has interpreted any of our project ideas as promises suggests that we are not fully achieving this higher goal. To improve, we  decided to begin within our staff.

I googled “cross-cultural communication exercises, management, africa” on Tuesday in a last ditch effort to help Devon pull together an intercultural training program for our new MHOP team. Over the past three weeks Dramane Diarra (community coordinator), Awa Ouattara (intern), and Leona Rosenblum (community health worker program coordinator) have joined us, making last week's team training the perfect opportunity to begin a conversation about cross-cultural collaboration. Unfortunately, the google-verse contains very little that addresses inter-cultural communication between Africans and Americans. (For future reference, however, if you are interested in working in Japan or China, you're in luck! Hundreds of well-paid agencies can offer you trainings on bridging the East-West divide. Go figure.)

Despite my failed search, our team spent the day on Wednesday discussing the many differences between Malian and American cultures. Drawing from “The Values Americans Live By,” an interesting piece by L. Robert Kohls, we shared our views on things ranging from punctuality, competition, freedom, and privacy or personal space. It was an enlightening experience and offered me the chance to reflect on the many hidden biases or paradigms that affect my interactions with Malians.

One major area of conflict in our office concerns time. As Americans, we expect that our time be accounted for or justified. I, for one, have always had a job where I punched in or out because I was being paid by the hour (or minute, or even second). I am used to judging my performance as both a function of its quality and of the time the task required. But how often do you think about what it means – what it really means – to talk about “spending time” on something, as if time was a thing to be used or dispensed as one pleases?

Sure, everyone knows that “African time” runs slow; but the cultural divide is not really about pace. Here, time just is. The day passes as you pass the day -- your meals, your loved ones, your life takes precedence over the ticking clock. Thus, my Malian colleagues were shocked and appalled by the suggestion that we log and justify our “work hours.” From their point of view, a job well done is a job well done, regardless of the amount of time it required. And when it takes you two hours to travel across town because your taxi blew its tire, or a month and a half to track down our clinic dossier, the logic of this view becomes clearer.

Of course, the differences in our conceptions of time has become somewhat of a trope in stories about Africa. While true, I want to be clear that many other things are similarly confounding and that at their core, neither “side” is wrong or right. To illustrate, let me describe our most recent adventure with the clinic construction crew. Mr. Maiga, the construction foreman, visited our office last week with a packet of paint chips to decide on the colors for the interior and exterior walls of the clinic. Excited that we're nearing the end of construction, we happily reached an agreement that the interior would be painted in dual tones, with reddish brown on the bottom and tan on the top, while the exterior would be a uniform deep red to help disguise dirt. We x'ed our preferred paint colors and he went on his way, asking that we stop by the clinic later to see a sample and make the final decision.

Two days later, Alex Ruby and I trekked up to the clinic with cameras in hand, hoping to okay the colors and get the final painting started without delay. When we arrived, however, we were surprised to find dual tone samples painted both on the outer walls of the clinic and inside the clinic rooms, and no deep red color to be found. After much debate, we discerned that the “interior” of the building is considered to be everything that is covered by the veranda, regardless of whether it is actually inside a room or not. Hmmmmm. As we say in Minnesota, that's different. But, really, when you are under a covered area and yet not in a room, who is to say whether you are “inside” or “outside”? It is something I never would have thought to ask but now serves to remind me that when working across cultures, there are no stupid questions. Making one's own definitions and interpretations explicit is critical to avoiding deep misunderstandings.

Cultural differences, however, cause more than just logistical friction. And when we work with the CHAG and evaluate the design of our projects, we must continue to remember that values differ and ideals are often lost in translation. For example, I recently had to quell some righteous feminist indignation when Dr. Diak suggested that the “health actions” completed by male members of the household should count for every child, while those completed by mothers only count toward their biological children. (If that's confusing, remember that Islamic polygamy is widely practiced in Mali, therefore households may include up to four mothers.) Arms crossed, nostrils flaring, I stopped him. I was appalled by the sheer iniquity of it – why should the men's actions be more valuable than the women's?

Dr. Diak patiently explained to me that asking men to do more than that would require they designate their actions towards specific mothers. That system could not only create significant family discord if fathers favored certain wives over others, but it would also likely dissuade men from participating at all. Women are the primary caregivers in Malian families and so if it means just as much for a man to contribute as it does for a woman, then there is no incentive for fathers to participate. My reaction against this design was instinctive but, ultimately,  I think Dr. Diak is right. To be successful, our program must consider carefully the economics of family life here, working within the system as it currently exists. If our ultimate goal is to encourage community engagement and co-management of healthcare, then perhaps my feminist sensibilities will have to take a back seat on this particular ride.

Similarly, while we had initially hoped to hold popular elections for all CHAG members, in light of their extreme resistance and our consultations with Sikoro's dugutigi (village chief), we may have to re-evaluate our designs. When we make a final decision regarding our selection process, we will again have to weigh very difficult issues: is it a compromise of our values to have the elected secteur-tigis choose their own CHAG representatives, or is that an expected (and accepted) form of community participation in the Malian context? In navigating these challenging waters, I trust that we will stay true to our mission to both work within the community and to improve it. And the simple fact that we are tackling these unsettling questions gives me hope that we are who we say we are: a community-driven organization.

Recently, two adventurous and philanthropic Norwegian medical students from Jagiellonian University in Krakow, Poland embarked on a tremendous journey - a 9,000 km charity road race from Budapest, Hungary to Bamako Mali, all to benefit MHOP.  MHOP congratulates Sebastian Orskaug and Johan Hjort for successfully completing their ambitious goal and thanks them for the €2.000 worth of supplies and medication that they donated to our new clinic.  Best with your continued medical studies and keep in touch! Here's more about Sebastian and Johan: We Are Home - Copernica Adventures Aid Project When we started planning our participation in the Budapest Bamako more than a year ago we had a clear vision of what we wanted. Following the spirit of the original B2, the "Caravan Humanitaire" was essential to us. By collecting small donations from friends, fans and family we managed to raise € 2.000 before departure. MHOP: ...continue reading

I ni ce and hello from Bamako! My name is Alex Harsha, and I am from New Ulm, Minnesota. I am a recent graduate of Lewis & Clark College in Portland, Oregon, where I studied international relations and bio-chemistry. It was an interesting, challenging (and odd) combination, and it allowed me to deepen my interest in global healthcare issues. While at Lewis & Clark, I became a member of an organization called SMS:Medic (http://medic.frontlinesms.com/"Frontline), an organization that I believe will have a major impact on global health systems through its pioneering use of a simple, low-cost mobile technology program. In May, MHOP decided to pilot FrontlineSMS:Medic with their CHW program, and I jumped at the chance to join the team as Infotech Coordinator. So what will I be doing, and why? Few would deny that this is now a critical time in global health. While epidemics of HIV/AIDS, tuberculosis and malaria continue to claim growing numbers of lives, the ...continue reading

In 2010, MHOP has welcomed several new members to our team. Two new Americans, Alex Harsha and Leona Rosenblum, have recently begun their year-long posts as Infotech and CHW Programs Coordinators. We have also welcomed two new Malian staff, Dramane Diarra (Community Coordinator) and Awa Outtarra (Programs Intern). MHOP welcomes our new members on board and looks forward to sending updates about their projects!

Looking for creative and simple gifts? Here are a few ways to shower friends and family with presents AND promote health change in Mali! On December 19th, award-winning artists Geddes Levenson and Annie Blazejack will be partnering to each create 12 pieces of art in 12 hours. Looking for a more creative gift? Sign up to pre-purchase a piece. The surprise drawing, painting, or collage can arrive in time for Christmas for those who celebrate it. Purchase one piece for $200, or two pieces for $325 (includes standard mailing costs). Half of the profits will go to MHOP and be tax deductible. Click here or email anna@malihealth.org to order. Geddes Levenson Annie Blazejack For smaller gifts, you can also give a donation of any amount in a friend or family member's name. They will receive a holiday card and letter from MHOP thanking ...continue reading

  That's right, we came in 1st Place!  At the final count, we had 343 unique donors, who donated a total of $38,151, which was matched with $13,572 from Global Giving, and won us a $10,000 bonus! That means that thanks to your help, Action for Health now has an additional $61,723 for 2010. That is a huge help, and we cannot thank you enough.  By helping to support Action for Health, you are working with us to reduce child mortality in a country where 1 in 5 children die prematurely. Action for Health allows slum residents to exchange community service work, or "Action Fees," for free health care. Action Fees range from working at a recycling plant to volunteering in local elections to participating in health festivals. Community Health Workers and our new clinic will provide free services, and in exchange, families� health actions will create social, political, and economic value that will be re-invested ...continue reading

Over the past six weeks, MHOP has welcomed several new members to our team. Two new Americans, Alex Harsha and Leona Rosenblum, have recently begun their year-long posts as Infotech and CHW Programs Coordinators. We have also welcomed two new Malian staff, Dramane Diarra (Community Coordinator) and Awa Outtarra (Programs Intern). We are excited to begin working with these enthusiastic and dedicated individuals, and would like to take the opportunity to introduce them and their projects to you. Arriving in mid-September, Alex Harsha is not quite a Malian rookie any longer, though she readily admits that the challenges of navigating life in Bamako still leave her feeling like a five year old on a regular basis! Regardless, we are confident that Alex and her project will be a great success. But let's just let her tell you about all that... I ni ce and hello from Bamako! My name is Alex Harsha, and I am from New Ulm, Minnesota. I am a recent graduate ...continue reading

Thinking of making a gift to the Mali Health Organizing Project? November 10th marks the start of MHOP’s 3-week matching campaign! When a donation is made to our new initiative, Action for Health, through GlobalGiving between November 10 and December 1, our partner Global Giving will match that donation at 30%, 40% or 50%.  Matching funds are limited, so act quickly. Action for Health allows slum residents to exchange community service work, or "Action Fees," for free health care. Action Fees range from working at a recycling plant to volunteering in local elections to participating in health festivals. The program aims to reduce child mortality by 90% in a country where 1 in 5 children die prematurely. We’re counting on our supporters to help us raise more money for Action for Health by spreading the word! 1) Pass along this message on to your friends and families and ask them to tell others. Announce the campaign on your blog, twitter, or ...continue reading

This month MHOP worked to provide clean water with our javelisation (bleaching) campaign.  For many years, it was the role of the mayor's office to bleach private and community wells each year in order to keep them free of parasites and other bad things.  However, this program has fallen by the wayside in recent years.  The CHAG (the community group that advises us) suggested that we do that as a service to the community, and we decided it seemed like a good idea.  So, Moustaph (the CHAG member who had the idea), Awa (our Malian intern), and I went to all the houses of our target families to check if they had a well, and then we got the CSREF (the health center for this side of town) to provide technical expertise in bleaching the actual wells.  Within a few days, it was all done!  Here are some photos from the day; the first is from when we talked to the dugutigi (village chief) to tell him what's up, and the second is from bleaching the ...continue reading

It is my last three weeks in Bamako I am reveling in small pleasures: eating mangos the size of my head, taking bucket baths, and taking a backseat at our team meetings.  As many of you know I will be headed to medical school at Brown University on August 12, financed by the Jack Kent Cooke Foundation.   I am passing MHOP's reins on to our Malian leaders and Anna Ninan. For me this leadership transition is like being a mother sending her child off to college on the first day of school: I am looking on nostalgically, but MHOP is sprinting full-speed through the doorway. It is exciting to see this organization move from into adulthood, and inspiring to see it in capable hands. I will remain involved, chairing the board for the next few years and returning to Mali in summers and yet another leave-of-absence.  I look forward to when I can come back to MHOP with the medical degree and skill set to help us move from our organization.

One of MHOP's strategies for growth is to develop partnerships with larger NGO and government programs who will be able to use their resources to implement exciting and innovative projects (developed by us!) across Mali and West Africa. Of course creating these relationships can be difficult, so it was very exciting when the National Department for Social Protection and Economic Solidarity (DNPSES) invited us to participate in a workshop on their new national insurance program. The DNPSES is starting a two-part insurance program in 2010. AMO, or obligatory medical insurance, is directed to salaried employees in the public and private sectors. AMO is designed to build on the national insurance/Social Security programs already in place. The second program, RAMED, will provide free health care for the poorest 5% of the population. MHOP is most interested in RAMED, and we would really like to be involved with the development of this program, ...continue reading

Hey! My name is ADAMA KOUYATE. I am studying English at the University of Bamako. I am in my fourth year; I have an internship with MHOP since June 2008. So I am the responsible for communication and coordinator for the radio project. These last four years have been really busy since I have been conducting many surveys in some respects. First; it was the survey in ten slums of BAMAKO. The survey consisted in doing focus groups with ten young persons and three old persons in each of the ten slums. We ask them questions about the most pressing problems of their community, what they did to solve these problems, what they expect of the government, what they know about their health rights. This survey allowed us to know that cleaning up, health care and the lack of purified water are some of the most pressing problems slum's inhabitants are facing today. It also allowed us to determine that more than 85 percent of the persons in slums don't have access ...continue reading

Les deux dernières semaines ont été très charge par des études sur terrain ;précisément la localité de MEKIN SIKORO. Cette étude est orientée spécialement sur les possibilité d’erdication des déchets plastiques par des recyclages .Actuellement les déchets plastiques sont entrains de faire des dégât énormes jusqu'à voir la mort des animaux domestiques et la degration du sol En fin d’atteindre les objectifs nos objectifs; j’ai effectue une étude de faisabilité de recyclage des déchets plastiques en collaboration avec le professeur/chercheur MODIBO TRAORE de la faculté des sciences économiques et de gestions de l’université de Bamako /MALI. Cette étude a nécessite la collaboration absolue de la communauté de MEKIN SIKORO ;qui devant ces déchets plastiques se voit impuissant pour lutter contre ce genre de déchets. Le problème majeur des déchets plastiques au mali est dit à l’implantation des usines de fabrication des articles en plastique tels que les petits sachets ...continue reading

NB: Most microfinance programs loan to people with existing businesses. We loan also to women who wish to start new businesses. To help them create effective business plans, we conduct monthly trainings on business planning where prior borrowers and members of the microfinance committee train the new members using bambara and visual curriculum materials. - Caitlin Cohen From Modibo Niang, our Malian Director: We launched a large training program in our meeting room of our community center on Saturday the 7th of February, 2009. There were a total of 23 women in this training, lead by two members of the microfinance committee and supervised by me, the Director of the Project. These women learned about the importance of researching the income and expenditures of their enterprise, the need to choose an enterprise for which they have adequate training, and estimating availability of funding for their work. They also learned about supply and demand ...continue reading

By Devon Golaszewski. Recently, I've been focusing on income-generation projects as part of our health-financing research . The idea is that by finding an alternate source of funding we can either reduce the cost for all patients, by reducing consultation fees or the cost of drugs at the pharmacy, or create a “solidarity fund” which will provide free care for certain services or certain patients, such as free malaria care for all children under-5. We would really like to create a clinic-linked industry that benefits the community in addition to making money for the clinic. One idea is to create a plastics recycling factory, which will turn the enormous amount of plastic waste in Sikoroni into useful items:buckets, sandals or even building materials such as paving stones or beams. We can pay local children a small sum to collect plastic litter, and with the help of organizations such as Engineers Without Borders and Brown University professors develop ...continue reading

Niang, Sara and I met with the president of the Malian National Assembly's health committee today. There is no existing committee for primary health care. We proposed and she agreed to create a subcommittee expressly to advocate for universal primary care health coverage for indigent people. We are meeting with a group of senators in late may to put this committee and a yearly "attelier" (planning session) in place, and we will hopefully be working with the Department of Social Development and Economic Solidarity's new program RAMED to determine realistic and health-access based measures of "indigence". Its long term, but with enough grassroots organizing to back it up, we might be able to drastically improve health coverage.

Written by Mariposa Garth-Pelly. Having lived in Bamako before I packed to return with the notion that if I'm comfortable wearing it it is OK to wear. That was until I arrived in Sikorro. Sikorro is a world apart from other Bamako neighborhoods. It is more village-like than other areas—we have electricity, but no pretense of running water, poor roads, and a moral conservatism that yesterday resulted in me being chastised for wearing knee length basketball shorts (too short!) that would have been perfectly acceptable in Bamako's more developed quarters. Sikorro one of the oldest neighborhoods of the capital, but it is chronically neglected when it comes to government services. Many people moved here recently from more rural areas and don't intend on staying long (thought they often do). I will be working on our Siguida Keneya, Health in Our Homes Program. This program is based on an action for health model whereby people are given free health care in exchange ...continue reading

Written by Julie Siwicki. The Brown MHOP student group has been collaborating with Providence, RI's own Metro Mart Convenience Store since mid-November. The cashiers have kept a donation jar on the counter for MHOP, and the owners have generously matched all funds in the jar. They helped us raise nearly $200! A special thank you to Pramesh and the cashiers for their enthusiastic support. We'll definitely be keeping in touch with them regularly... not only as MHOPpers but as hungry college students looking for convenient snicky-snacks! Please stop by and thank them yourself at: Metro Mart Convenience Store 221 Thayer Street, Providence, RI (401) 273-4407 ...continue reading

Written by Sara Rosen Dugutigi is a Bambara word meaning chief of the village ( dugu is village and tigi is chief). Dugutigi’s all around Mali, and Africa, are quite important and quite powerful. If there are any problems in a village, or any projects started, he must be consulted. If a meeting happens that dugutigi isn’t aware of it, problems normally ensue. Even though Sikoroni isn’t a small village, dugutigi’s still exist in each neighborhood in Bamako. Sikoroni/Sourakabougou held a large General Assembly meeting last week to talk about the committee that will run the new clinic that we’re building. The dugutigi of Sikoroni was invited, but unfortunately a faux-pas was made: He was offered the wrong chair, and was therefore offended. This extremely important meeting thus started off on the wrong foot. After some heated conversation about who was to be on the Board of the new clinic, and lots of yelling coming from discontented ...continue reading

Helen Shariatmadari left London five weeks ago in a shiny-grey sticker-covered 1991 Volvo with about 105,000 miles named "Jesse". Despite the fact that Jesse is almost as old as some of our interns, the car runs marvelously and made it all the way to Bamako, where Helen and David kindly donated her to MHOP to be our first "health taxi". Jesse cannot be a regular ambulance because of her size and lack of room for equipment. That said, our clinic is located in a place where taxis do not go; We will use her to transport non-emergent patients to the regional health center to get healthcare that we cannot provide at our clinic such as care for AIDS, diabetes, and pregnancy complications such as pre-eclampsia. Additionally, MHOP recently purchased a moto for our director to use for work-related travel and visiting collaborators. Motos are a marvelous form of travel in Mali because they permit you to escape the terrible traffic and get through roadways that ...continue reading

My name is Mariam A. Diallo; I am a resident in Vermont. I just arrived from Mali a few days ago. My trip back to the US was okay until when I arrived at JFK (New York). I waited for my luggage for two hours and came to find out that it was still in Mali. They had to leave some luggage there because the plane was full. It was just my luck. During my stay there I got the chance to work at MHOP. It was great experience for me. During my stay I have worked curriculums for organizing a campaign in french. In order to have a good turnout you need to follow four steps, which are: Step 1: Ask the what Questions. To begin your action planning you need to ask the what questions like what is the issues? What research needs to be done? What are the goals? Step 2: After asking the What Questions , you need to ask the Who Questions . They are four groups that you must consider when developing action plan. The four groups are: targets, core ...continue reading

This week in Sikoroni (in commune 1 in Bamako) I held a series of focus groups with the community and health personnel about health financing. Over the course of the meetings, we learned much about the quality of life of the population of the neighborhood. More than 80% of people do not have access to health care, mostly because of a lack of financial means. The health personnel mentioned that many people work in town and thus seek care there, and also that they do not have confidence in local health agents. These two cases explain in part the massive lack of care-seeking behavior in the neighborhood. According to the community, the lack of care-seeking is due to a lack of means to pay for health expenditures, (even if the human resources are good), but also the lack of qualification and experience of health agents. In effect, we will need to conduct more involved studies to put in place a functional health financing system in this ...continue reading

Translation: The residents of Sikoro/Sourakabougou came out in large numbers today for the laying of the first brick of their community health center. Valued at more than 22,000,000 FCFA, the center will permit the population to benefit from proximal care. In six months the residents of Sikoro/Sourakabougou will have their community health center. At the laying of the first brick a high time was had by the notables of the neighborhood, the authorities of the commune, as well as the members of the Association "Sigida Keneyali". "The CSCOM will permit more than 50,000 souls to benefit from primary healthcare and ameliorate the health coverage and health indicators in this district of Bamako." The Association Sigida Keneyali, thanks to whom this project has seen this day, has, as its work, several projects of this nature. This is why the director of the project stressed the importance ...continue reading

Mali is hot.  There is no mistaking it.  In my quest to get some green vegetables back into my diet I considered buying a refrigerator so I could go into town once a week to shop for veggies, and then store them in my home.  The problem is that my electricity is both expensive and unreliable.  The solution?   The $ 5 refrigerator!   Ingredients:   1)    Porous earthenware container (called a gi fiyen) ($2) 2)    Plastic bucket ($1) 3)    Metal stand ($2) 4)    MUD (FREE)   You put the sand and water mixture into the earthenware pot, put the plastic pot inside the mud, and the whole thing on the stand.  The water seeps out of the pot slowly and evaporates, cooling off the mud, and keeping the contents of the plastic bucket about 20 degrees cooler than the ambient temperature.  If you want things to get really cold, you can put a block of ice inside and it acts as a ...continue reading

What is the best way to make a fundraiser work well?  Make it fun!   For us to build a government-funded clinic in Mali, we need the community to fundraise at least 10% of the cost.  Our Community Health Action Group and our Peace Corps Volunteer headed up an initiative to combine a soccer match with free AIDS testing and a benefit raffle to help the community fundraise for the clinic. The morning was kicked off with AIDS education from our partner project, Djekafo.  They showed films and skits and dialogues about AIDS.  We brought the major AIDS project from downtown into Sikoro to do free voluntary counseling and testing for anyone who wanted it.  According to CESAC we had an excellent turnout for in-the-field testing. The chiefs of the village also offered some words. The afternoon featured a soccer match between Sikoro (in ChocoMali-sponsored white T-shirts) and Sourakabougouni (in our own AIDS day black T-shirts).  While there are some ...continue reading

Hundreds flocked to Brown University on Friday night to hear Malian musician Vieux Farka Toure in support of MHOP. Vieux and his band played to an energetic crowd eliciting song, laughter, and lots of dancing. What's more, they helped to raise $2,000 for Sikoroni's new clinic,  which will begin construction in late November! Vieux and MHOP share a passionate aim to relieve malaria in Mali. Vieux has always worked to eradicate this disease in his home country, with 10% of his album sales benefitting this cause. Malaria is also a top concern in Sikoroni. Many of MHOP's projects address it; for example net distribution and impregnation, health education, and a new clinic to serve malaria patients. Vieux's performance was a success in all dimensions; it brought in not only much-needed clinic funding, but also drew attention to MHOP and its work among Brown students and the greater Providence community.

I just attended the Network: Towards Unity for Health conference in Bogota, Colombia. There are 340 participants from 45 different countries, all of whom are trying to tackle primary health care and health education.  Discussions include brain-drain, medical school educations, and how to promote pro-poor healthcare policies. I was invited to present a workshop entitled “Using Health to Build Power” about using community organizing strategies for health. The diversity of participants was incredible… I learned about medical education in Mozambique and at Harvard, anti Gender-based violence campaigns in Egypt, and clinical outreach in Nepal.  It was a pleasure to share our model and see how it is applicable to projects around the world. One of the most amazing parts of the experience was the site-visit.  I spent a day at each of two healthcare programs in slum communities south of Bogota.  The slums here are nothing like in Mali: one of them, Ciudad Bolivar, has ...continue reading

Julie Siwicki and I visited the home of Brown University President Ruth Simmons’ today to meet the President of Liberia, Her Excellency Ellen Johnson-Sirleaf.  It is quite a thing to be introduced to your biggest heroes by another idol! (And they actually look a little like each other, as well). After threats to her life, two long stays in exile, and being charged with treason, President Sirleaf became the first elected female head-of-state in Africa.  On top of that, she is now in charge of rebuilding a nation after 14 years of civil war.  And the rest of us think our jobs are hard! President Sirleaf won the vote in 2005 in Liberia by mobilizing female supporters and quadrupling the number of women registered to vote. She is an inspiration to us all, a testament to the unbelievable power of an iron will.   Julie and I are extremely honored to have had this opportunity. I am flipping through photos now of our women leaders in Mali, trying to guess which of ...continue reading

I'm back home in MA after spending the summer in Bamako and still trying to adjust to the intense differences between Sikoroni and the states.  Hot running water and preserving produce in a refrigerator are welcome luxuries, albeit still somewhat perplexing knowing how expensive and even downright impossible such taken-for-granted amenities are in Bamako's slums.  Since my last blog update in July, the waste management program, specifically, has made exciting progress.  The CHAG completed a survey of nearly 100 households in Sikoroni's six districts about interest in and barriers to waste-management service subscription.  Now that I’m back stateside, reliable electricity and technological access will allow me to tabulate and analyze these results, which I will summarize, email to Niang in Mali to ensure that it is discussed in detail with the CHAG as plans progress to expand the program.  Such administrative work is much easier stateside due to the laws of ...continue reading

Radio Sigida Joli (Building communities, beautiful communities) Imagine no newspapers. Imagine your daily TV broadcasts are all in German.  You’ve never used the internet, have no email account, and cannot afford phone credit.  One of the biggest challenges to grassroots action in Mali is simply communication!  This summer MHOP has started research for a program to bring the voices of slum neighborhood residents into the public arena by radio!  With funding from the Huntington Public Service Award this project will help people discuss the problems in their communities, innovative local solutions, and concrete steps for getting involved. Adama Kouyate, a student at the University of Bamako, is the principle Malian intern on this project.  He has started a series of 10 focus groups in slum neighborhoods of Bamako to figure out what stations people are listening to, what stories they want to tell, and the solutions they have to share with each other.  So ...continue reading

After a brick laying community ceremony on November 25th, construction of a health center for 60,000 underserved slum residents will begin!  The clinic is scheduled to be completed by June 2009, so Ben and I have spent the last few weeks revising a list of the medial supplies needed to equip the clinic.  We met with Dr. Magdalene Togo, the ex-chief of medicine of the national hospital, at the Ministry of Health to better understand what clinic equipment we could expect to be “prise en charge” (provided by the government) and what will need to be provided by MHOP. The health ministry is located in the presidential compound on top of an imposing hill overlooking all of Bamako.  After spending all summer in the shadow of the president’s hill, we finally got to approach the center of Malian bureaucracy.   Caitlin, Niang, Ben and I took a cab up the winding road past series of murals of past Malian presidents.  But halfway up the hill, our taxi would go no ...continue reading

    Yesterday, Cari and I ventured across the Niger River to the other half of Bamako. The occasion: La Journée Panafricaine des Femmes. Not knowing what to expect, we were surprised and delighted to enter a large auditorium filled with women all wearing clothes of the same fabric!!! It was designed specifically for the occasion – the date and the seal of the Panafrican Women's Organization appeared on the fabric design.     The day is an annual convention-of-sorts where women and men come from across the country (and all of West Africa??) to mingle, eat, and address pertinent issues. This year the theme was "Impacts of Globalization on Poverty in Africa", with a focus on the role of women. Participants spoke, performed skits, danced, and sang on a stage in front of the wonderfully-matching audience.     I loved seeing these women taking such an active role to find poverty alleviation solutions. It fits nicely with the mission behind Musow ...continue reading

I sit in the courtyard drafting this blog amidst a large group of energetic women  in a circle under the shade of the mango trees diligently chopping large piles of onions and garlic.  In the corner, a local Sikoronian, Ami, paints traditional Malian geometric designs of henna on Caitlin's feet and hands.  The festive air is contagiously exciting.  Better yet, it poured throughout the night leaving today's air cool.  With all the bustling, the break from the heat is appreciated as tomorrow, MHOP's Malian director will marry!  On behalf of the MHOP staff, congratulations, Niang!   The week has brought other exciting updates as well.  Specifically, our waste management program, Sikoroni Jeya, has made terrific progress.   We have spent about a month gathering information from various local and governmental actors, which has proven to be both extremely frustrating and extremely rewarding.   The frustrating -  a number of ...continue reading

Today was a glorious day. Glorious is really one of the only ways to describe it. It was a Saturday and the day was largely filled with fun, as Saturdays should be. I woke up early to help Niang set up our mosquito net impregnation station  in one of the communities we work with. "Impregnation" is chemical treatment to kill mosquitoes, and it is responsible for about half of the preventative effect of a mosquito net. This was a great way to follow our recent survey, which found that mosquito impregnation and use was a huge problem.  While overall, project participants seem to be doing what they can do stay healthy, many individuals are still not sleeping under mosquito nets. When asked why, a lot of them said that they are only free for pregnant women and children, so they don't want to spend the money or don't think it's worthwhile for other family members to use them. However, that having been said, a large number of individuals still DO use mosquito nets but don't know ...continue reading

I think it's worth recording the many different kinds of interactions I have with people here. One big category: communicating with the host fam. I'm staying in a compound that houses about 35 people. Though I haven't yet figured out the exact relations between them all, I'm pretty certain that they're all related somehow. Only a very small percentage of them speak French – the dad (one of them) and two teenage girls. Everyone else speaks strictly Bambara. I'm taking a course in Bambara 3 days/week, but my skills aren't quite where they need to be for easy conversation. I talk to the two girls a lot. Their names are Aisha and Kadya. They explain a lot and teach me words in Bambara. Very helpful. My interactions with the women of the household are a little different. Both parties are acutely aware of the language barrier, but I feel like there's a mutual desire to "bond" or what have you. We exchange a lot of smiles, greetings, and handshakes. Sometimes they say something complicated ...continue reading

Aw ni sogomo!  Awn be Mali la.  (Good morning from Mali!)  We've been in Bamako for about a week now, and all of the volunteers have moved into Sikoroni. The first morning of our arrival we all received Malian names from one of the chatty market vendors.  I was pretty exhausted from the flight and didn't realize that our names would become such an important part of my summer here.  Since then, we've introduced ourselves at each store or house we've visited with our Bambara names.  Our first names are never enough, and we are always pressed to go around and say our last names, after which everyone laughs hysterically, telling us the stereotypes and stories of the rivalries between the different families.  Julie is constantly teased because she is a Kulibali- everyone laughs that her family is known for eating beans.  I'm a Haïdra, from a religious family, so the joke is that I must know the Koran really well.   Cari is a Kouyaté, a ...continue reading

A note from our director, Modibo Niang: Chaque trois mois toutes les ONGs et Associations de Developpement de Sikoroni se reunissent pour discuter des problemes et essayer ensemble de trouver des solutions ou propositions de resolutions. Ses propositions seront presentees a l'autorite competente pour une bonne execution. Sigida Keneyali a participe dans le CCLDS depuis le debut. On etait heureux de parler de nos programmes avec la communaute le 30 decembre. On a bien discute le centre de sante à Sourakabougouni, et comment faire demarrer la collecte des fonds pour que le centre soit realise le plus tot possible. Tout le monde a apprecie la bonne nouvelle.

We take for granted how much words matter | being able to write down a name next to a phone number, your grocery shopping lists, emails to friends, street signs... When you have spent most of your life as a student (as I have) words become the domain of library stacks and theory.  But words are a pragmatic necessity. Literacy is key to health, to keeping records, to getting directions, to taking notes, to running businesses, and to political empowerment.    I am delighted to say that the women's program has started its most ambitious initiative.  I had the distinct pleasure of sitting in on their first session of a new program last Monday.  Mme Aisata Touré, a trainer with the CAFO, the local women's group, stood in front of 36 women in her big pink chalk-stained boubou.  Half of these women are widows or single mothers.  She explained the letters of the bambara alphabet , with little anecdotes to explain each one's shape.  Us catch water, ...continue reading

Mali Health Organizing Project is pleased to present our new site, thanks to the hard work and kind donations of Orchid Suites Inc, Michael Stein, Nicole Veilleux, and Caroline Mailloux! 

Welcome to the Mali Health Organizing Project Blog! This blog will be updated by our onsite volunteers and Malian director.  Check back for reports and ruminations from the field.