Saturday, January 28, 2012

Life in Yako, Burkina Faso

Not much has changed in Yako since my last visit in 2010. It was great to get back together with the people at SEMUS, and with Dr. Soma who is the physician that provides the medical care at the HIV clinic that SEMUS runs. Thanks to the enthusiasm with which my volunteer colleague Sarah takes photographs, I can give you a better idea of what things look like around here. Above is the classic view on the highway that runs through Yako. We are at the north end of town looking south towards La Grand Mosqué near the center of town. The mosque had been recently repainted when I was here last, but that doesn't last long around here with the wind blasting sand from the Sahara for half the year. As you can see below, the building is in need of maintenance, like most things around here.

Unfortunately, the economy has not changed much over the last two years either. The country was very much affected by the recession in 2010 which resulted in job losses for migrant workers in Cote d'Ivoire and in the local mines. Especially in this part of the country, most people continue to live in very rural settings as subsistence farmers, and have to travel for considerable distances to obtain services. Transport continues to be primarily by walking, donkey cart, bicycle or at best a motorized bicycle, scooter or motorbike. It is not unusual for ill people to have to walk for 20 km in order to be seen at a clinic. Cars are fairly common in towns and on the main highway, but they are still very unusual in small remote villages. Many villages have no roads leading to them, only paths.Yako continues to be a blend of rural and urban. Sewers from homes with often drain directly out on to the road. This large pig seems to be quite content with the situation. He actually blended in very well and startled Sarah as it moved when we approached.
As I said, the people here continue to be warm and friendly. The children are very interested in us wherever we go, especially when there is candy involved but also when we are just out and about. The adults are just as interested, often stopping us to ask how we are, how long we will be staying, etc. Above, Sarah is in an animated discussion with a group of kids
This stable runs along the exterior wall of a cluster of homes. Houses here consist of one-room buildings connected together by walls that run along the periphery of the property. The rooms open to a central courtyard where most of the daily activity occurs. In town, most of the properties are gated, but in villages the entrance way is almost always open. Extended families, often polygamous, live in these settings. The rooms are for sleeping and storage, and most of the living is done outside. Wood continues to be the main energy choice, which means that the town is very smokey come dinner time.
This is a very typical neighbourhood in Yako's west end. Here the streets have more trees lining them, and the houses are set off the road. It kind of reminded me of the suburbs in Calgary when my children were little, and they were always out on the street playing with their friends.


This young fellow wasn't sure what to make of us. As you can see, he continued to play with his tire while we approached, but he wasn't about to take his eye off of us.
Kids. They're everywhere. The median age of the population of Burkina Faso is just over 15 years (high birth rate and short life span - life expectancy at birth here is around 55 years). Life here is almost completely focused on children and family. When a woman here is diagnosed with HIV infection, her first reaction is almost invariably "what will happen to my children?" There has been some international news coverage recently regarding the use of child labour and you will often see them involved in farm work, carrying goods, selling things and driving donkey carts, but they also play a lot, smile and laugh a great deal, are usually clean and well fed, and are closely supervised. The law here states that children cannot work until age 15, but the only way that will ever happen is through economic development and better access to resources, not through international public disapproval.

One of the very enjoyable things to do around here is the candy walk. I brought 300 candy treats and Sarah, who is much closer to the age of these children than I am and has a much better understanding of what kids like, brought (in addition to candy) stickers, a few small toys like cars and skipping rope (big hit!), and small Disney princess ink stamps. Every few days we will take stuff out to the streets like this one and start handing them out. Needless to say, bedlam ensues. Once the party starts, it keeps going, even when the treats run out. They love to have their photos taken and looking at them on the camera display screen.


At first, I wasn't sure how the parents would react to having us hand out treats. I realized very quickly, however, that the parents were watching their children closely and loved to see them having so much fun. It is very much the same kind of fun that we used to have as children when the ice cream truck would come through the neighbourhood on a hot summer day.
The parents often get involved in the fun. A great sport for the adults is to slowly bring their small children close to us, and watch the child's reactions as the eyes would get bigger and bigger, then the child would burst out crying in fear of our white faces. I must admit, it seems a little mean but it is also hilarious.

These families were at the municipal water fountain, filling up for the day. They were very welcoming, and asked us to take a photo. They were clearly proud of their neighbourhood, particularly the brand new small mosque across the street.
Life in Yako is much better for me this time around compared to 2010. It helps to know what you are getting in to and to be a bit better prepared. A very nice woman prepares our meals and her 22 year old daughter Saili serves them to us in the hostel at the SEMUS site. I also was looking forward to the warm reception that I knew I would receive. People know that we are here for development and support, and see this as hope for a better quality of life. Solidarity in the fight against poverty and all of its implications is a critical thing here - without it, survival itself would be impossible.

More on the work we are doing here in my next posts. Stay tuned and be patient - internet access has been very "iffy" (our access was cut off for all of last week).

Wednesday, January 18, 2012

So then what happened?




So 2 years later I'm back in Yako, Burkina Faso and getting back to work, helping to develop a plan that will hopefully allow our partners here to bring effective, community-based palliative and end of life care to the people who are confronting a life-limiting illness. Last time you heard from me, it was January 2010 and I was still trying to make sense of what I was observing, hoping that I would be able to make a difference. I have to admit, it continued to be overwhelming on a daily basis for the rest of my 3 week term, and most days I ended up feeling very much the same way as I did that night. Meanwhile, my colleague Dr. Pierre Allard who is an Ottawa-based palliative physician was going through a very similar process in Bobo Dioulasso, which is Burkina Faso's second largest city. We had very little opportunity to communicate until I was able to travel by bus (another story) for 8 hours just to spend some time in Bobo comparing notes. Together, we were able to suggest a long-term strategy that would allow the two non-governmental organizations that we were working with (SEMUS in Yako and REVS+ in Bobo) to work together with other community-based organizations to develop a Center of Excellence in Palliative Care that would be a model for the development of palliative care competencies, and that would allow Burkina to provide leadership for the rest of francophone Africa. The center would be based in 2 sites. One, based in Bobo Dioulasso would develop, the capacity to train health professionals, while the program centered in Yako would develop the competencies required to provide support in rural areas (80% of Burkinabe live in rural areas) who are living with AIDS. As part of the continuing Medical Outreach Program undertaken by the Canadian Medical Association, Pierre and I have returned to Burkina Faso to continue working with these agencies with the support of Uniterra, a development program undertaken by World University Services Canada and CECI (Centre d'Étude et de Coopération Internationale) with support from the Canadian International Development Agency. On this trip we have acquired a new partner in the form of Sarah Lowden, a financial adviser working with the Canadian Medical Association and a dynamic young woman with expertise in finance. Her day job is as an advisor with MD Management, a financial services subsidiary of the Canadian Medical Association. Over several months prior to our departure from Canada Sarah (who is an avid single gear cyclist from Montreal) raised approximately $10,000CAN in order to purchase new bicycles and several bicycle ambulances (more later) for SEMUS. She will be helping SEMUS enhance their accounting procedures and will be very valuable in developing further funding for our project.
After the usual living nightmare of travelling to Burkina over 30 hours and three different flights, we were met at the airport in Ouagadougou (minus Pierre`s luggage that had decided it wanted to spend a night in Paris) by Simon who took us directly to the Hotel Yibi. Here we were able to get straight to the task of feeling sorry for ourselves, then heading to bed. Nice place all things considered, with one of the best restaurants that I have encountered in this city, at a very reasonable price. Sarah is one of those people who cannot resist taking photos of their food (my wife Jacqueline is another one). The one below gives you an idea of the pleasant but not overstated poolside atmosphere. This was of course an extra special experience as my home city of Calgary was just entering a dismal, dark cold spell when I left on January 15th. Ouagadougou is a typical capital city for a developing nation with terrible pollution, abject poverty and huge disparity between rich and poor. Burkina Faso remains in the bottom four nations on the UN development index, with only nations in conflict below them. Still, there are very pleasant spaces here, and this is one of them.

One day to recover from the trip and to deal with some details and we left Ouaga for Yako. I was surprised at how good it felt to leave the city for the rural area. Although the poverty becomes even more intense, the pace slows, and people are much more relaxed. Pierre had never seen the northern region of Burkina during our first visit here, and it was great to be able to show him around and have him see first hand how things were here. By that time Sarah had become the official photographer, thanks to her more advanced skills and her much better quality of camera. The two photos at the top of this blog are from Yako (my blogging skills are obviously rusty after two years).