We finished up the medical clinic and loaded up the cars to go on a mobile mission.

Dolee is a community with whom we have worked for years.  We built a school, cereal bank and well.  One of the matrones from here was sick and could not attend the recent training so we wanted to visit the community for several reasons.

We arrived late and they greeted us with a dance.

We called the pregnant women first.  There were eleven of them.  The first was the grandaughter of the matrone and had delivered four children, but hemorrhaged severely after each.  She was at high risk of dying in childbirth on her next delivery in about a month.  Dr. Skankey explained to her mother the necessary things to do and medications to administer, but advised her to go to the maternity in Ingall.  She said she had been there in the last month, but htey had told her nothing and given her no medicine or vitamins.  We have heard this again and again.  It appears the local personnel do not have adequate training to help these women.  The good news is that Ingall has been promised a new doctor and we are hoping to work with him to improve the conditions.

After evaluating eleven pregnant women and seeing several at risk, making references and recommendations, we called a community meeting to ask them about their opinions of the most prevalent health problems and what they are doing themselves to improve their health.  We talked about the sources of fevers, diarrhea  and malaria and related them to hand washing and protection from mosquitos with nets.

We emphasized the importance of the Nomad Foundation’s goal of putting skills in their own hands to improve their own lives.

After consulting 28 patients on mattresses under the trees,  moving to avoid the hot sun and stay in the shade, with Linda keeping order, Louine dispensing medicine, me explaining it and of course Dr. Skankey and Achicha talking to the patients we left for the next camp–totally exhausted.

We next went to Tedbouk, our most remote Wodaabe community, but with one of our most dynamic matrones, Miriam.   A desolate place with high winds.

Linda donned her Wodaabe skirt…

Achicha helped Hannah don a turban.

And we were ready to see patients.  Again we said pregnant women first.  We had a challenge with our first patient.  She was bofido.  This is a time of life when a young married woman is pregnant with her first child.  She goes home to live with her mother and wears only black with no color or jewelry.  She is not allowed to interact with any men but her brothers or father.  She is to be totally reserved.  So when she came in to be seen she refused to talk or be examined–a puzzling situation.  Eventually with her mother there to negotiate we were able to examine her and found no serious problems.

One of the main reasons for the mission was to train the midwives with actual patients–showing them how to determine due date, position of the baby, if the mother is anemic and taking blood pressure.

As the treatments went on more experienced mom’s got more co-operative

…and we were deluged with patients.  Linda kept the kids busy by distributing balloons and enlisted Sidi and one of our guards to teach them how to blow them up.

When we left we had not seen even half and so promised to send Ali back in a week to see the rest.

The treating of patients has taken a back stage to the training program–I have not been too present to take photos as I am always involved in the training program.  We have also noticed that our patient load is lighter than past missions.  We were puzzling over this until we started getting reports from the bush that because of the presence of the clinic all the time, we have improved the general health in the region and the need for care during the missions has gone down–I guess the ultimate goal is to make ourselves unnecessary.  I think we have taken a step in this direction.  Even though we have a higher level of experience when we bring in American doctors, we know that the clinic can operate on its own and can take big strides in improving general health in the region.  We are pretty proud of that.

Louine runs the pharmacy with the help of Linda–both have worked really hard, not only filling perscriptions and fitting glasses, but preparing the medicine to replenish the matrone’s supplies to take back to the camp.

Ali checking in patients with the medicine chest and pharmacy in the background.

Sidi with our friend Tambola’s mother who is being treated for malaria.  Her son travels alot in the modern sense, runs a travel agency and lives mostly in Niamey.  Yesterday we treated the mother of another Tuareg friend who lives in Tucson and Mexico.  No matter where a Tuareg ends up he usually has family here in the homeland in the bush where the true nomads live: the pasturelands of the Cure Saleé: Tamesna.