The Pulse

Peace Corps Senegal | Health | January 2014 | Volume 1 Issue 2

www.pcsenegal.org

[Contents]

03 Where are the Nets?

/ Sarah Legare

05 Senegal Does Bugs:

Entomology in the Peace Corps

/ Sarah Legare and Rita Weiss

07 The Malnutrition Beast

/ Katie Richards

07 Recent Nutrition Trainings

/ Katie Richards

09 Building a Poste de Santé, and

Notes on Project Planning

/ Venchele Saint-Dic

11 Calendar of Events

The Pulse

Content Editor Katherine Jenson

Layout Editor Hannah Mills

Contributors Sarah Legare Katie Richards Venchele Saint-Dic Rita Weiss

The Pulse is a quarterly health sector newsletter published by volunteers of Peace Corps Senegal. All articles published in The Pulse are the sole view of their authors and do not represent the views of the United States Government or the Peace Corps.

Front Cover Photo: Family eating nutritional porridge, by Katie Richards.

Contents Photo: Unloading bed nets in Kolda, by Courtney Ruble

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Where are the Nets? / Sarah Legare It can be tough to keep track of mosquito net distributions, how they work, and where to get nets, especially when plans change and rumors fly. For those reasons, here’s an update on the net situation. There are currently four channels for the distribution of long-lasting insecticide-treated bed nets.

1. UNIVERSAL COVERAGE How: These campaigns involve a census of every household, double-check of the census results, a few days of giving out nets, follow-up home visits, and education and media events. The whole process usually lasts a few months. What: Ideally, Universal Coverage will provide a bed net for every sleeping space in the country. This may mean that several people share the same net, but it includes mats laid out on the floor for kids or anywhere else that people regularly sleep. When & Where: From 2008 - 2012, the whole country was covered via this process, and we’re in the midst of round 2. It started in Kedougou in 2013, Kolda just received nets, and the regions of Tambacounda, Sedhiou, Kaffrine, Kaolack, Diourbel, and Fatick are tentatively scheduled for 2014. The rest of the country has yet to go on the schedule, but should be completed in 2015 pending resource availability and no major strategy changes.

Why: Malaria risk for the whole population goes way down when everyone sleeps under a net every night! 2. HEALTH STRUCTURES How: Pregnant women who go in for a prenatal visit can receive a net for free. When someone goes to a health structure for a consultation of any kind, they can purchase a net for 500cfa. What: This channel is designed to keep nets moving out to those who need them between Universal Coverage campaigns. When & Where: If the health structure has nets in stock, they should be available to any person at any time across Senegal. While pregnant women may be offered a net, everyone else needs to ask! Why: Pregnant women are at high risk for malaria, so it’s especially important that they sleep under nets every night. People may also need more nets than are provided by Universal Coverage, or to replace damaged ones.

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3. COMMUNITY-BASED ORGANIZATIONS AND BUSINESSES How: Interested organizations and businesses are selected by local administrators to sell bed nets for 500cfa to anyone who wants to buy one. What: For areas that are far from health structures or as a backup when other sources are out of stock, this channel spreads the availability of nets beyond health facilities. When & Where: Select businesses are selling nets throughout the country, and community-based organizations in the Louga and Ziguinchor regions. 2013 was a test for this channel, and it is expected to be expanded this year. Why: The stock of bed nets available in health structures is sometimes not enough to provide for everyone in need, and expecting everyone who needs a net to go to a health structure for a consultation may not be realistic. In addition, through this channel,

organizations in charge of administering water sources will be able to sell nets to migrants who pass through to water their livestock. 4. SCHOOLS How: Nets are given for free to children enrolled in select classes at elementary schools. This year, kids in each of 2 grade levels were given nets. What: This channel is designed to get nets to kids and to educate them about malaria prevention. When & Where: As with community-based organizations, the school channel was piloted in 2013 in Louga and Ziguinchor and should be expanded in 2014 and 2015. Why: Like pregnant women, children are at higher risk of malaria and its complications, so making sure they’re protected with bed nets is a priority. Bringing nets to schools is also an opportunity to educate students.

Sarah Legare is the Malaria Coordinator in Dakar. She can be contacted at 30TUsklegare@gmail.comU30T. For additional malaria resources, visit the Stomp Out Malaria website at 30TUhttp://stompoutmalaria.org/U30T and the Google Drive folder at 30TUhttp://tinyurl.com/malaria-initiativeU30T. Or, contact your local Malaria Boot Camp graduates, Health APCD Mamadou Diaw, or Country Director Chris Hedrick!

Photos: Bed net distribution in Kolda by PCV Courtney Ruble.

Senegal Does Bugs: Entomology in the Peace Corps / Sarah Legare and Rita Weiss Have you seen mysterious vials in your regional house lately? If so, they’re probably filled with mosquitoes that a fellow PCV has captured and is sending to Dakar to be analyzed in a lab. In a ground-breaking partnership with the Centers for Disease Control and Prevention (CDC), President’s Malaria Initiative, University Cheikh Anta Diop (UCAD) in Dakar, and the Section Lutte Anti-Parasite (SLAP), Senegal PCVs are the feet on the ground for some great research. While there is already some data on how many and which types of mosquitoes are buzzing around Senegal, it’s been a long time since officials had a complete picture. Knowing more about local mosquitos helps us to fight malaria more efficiently. With the help of PCVs, researchers and administrators will be able to tell how many mosquitos could potentially be carrying malaria, how many actually are, and whether insecticide resistance exists in their population. Fourteen PCVs, trained last June, are now collecting mosquitoes from huts in their villages every month and sending them to a vector parasite lab at UCAD. Third-year PCV Rita Weiss works in the UCAD lab alongside faculty, staff, and students. Rita started full-time at the lab in November as a data manager to help organize, explain, and publish research. The opportunity to partner with the CDC and University attracted Rita to the position, and she’s excited to dive in to the work. “I hope to work with statisticians and entomologists locally and remotely to help improve the organization and presentation of data in the entomology lab,” she says. So far, she’s been setting up a server for data sharing, analyzing data, and helping with mosquito larvae mapping in Dakar’s suburbs. After organizing the data, Rita can calculate statistics like density of mosquitoes per night per person, or she can find out where the highest malaria risk exists. In the coming months, she’ll be headed out to the field. Researchers from the lab regularly visit field laboratories in Richard Toll, Velingara, Nioro, Guinguineo, Kolda, Kaffrine, Koumpentoum, Koungheul, and MalemHodar, which each has different experiments running. Rita is also looking forward to becoming a resource for PC Senegal and all of you. If you’ve got questions, give her a call. While Peace Corps’ participation in this research is new, the research itself has been going on for several years. UCAD is West Africa’s oldest university and is internationally renowned as one of the top research institutions in the region. Its student body comprises 60,000 students from all over the world. It maintains two teaching hospitals and partnerships with numerous institutions, including the Pasteur Institute, which does molecular testing for the entomology lab.

Photo 3: Dr. Ngayo Sy shows mosquito habitats at SLAP to PCVS

Photo 2: PCVs learn about capturing and identifying mosquitos from Moussa Diagne of SLAP during a training in Thies in June

Photo 1: PCVs identify mosquito larvae in Thiès with Dr. Ngayo Sy of SLAP

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In 2006, the CDC partnered with UCAD and the Senegalese government in the national fight against malaria, and has been supporting the nation’s entomology research ever since. Although there is one CDC advisor in Senegal, most coordination is done through their headquarters in Atlanta. A few times a year, CDC entomologist Dr. Ellen Dotson visits Senegal and follows up on local research and initiatives. During her last trip in October, she coordinated with UCAD’s field and lab researchers and also took a 5-day tour to PCVs’ mosquito collection sites. Her tour included visits to Bambey, Tamba, Kaffrine, Kaolack, Fatick, and Kebemer. She didn’t have time to visit everyone involved, but for those she did see, she brought supplies and support for the work.

All the PCVs involved in the entomology project are now part of a network connecting them to high-level initiatives and research led by the CDC. Senegal is the first Peace Corps program to participate in a partnership like this, and it has the potential to change the way that agencies like the CDC are able to access information, opening doors to areas where PCVs live that would otherwise be too remote to visit.

There will be another training planned in the coming months for PCVs interested in participating. A big thank you and congratulations to all the PCVs already involved!

Sarah Legare is the Malaria Coordinator in Dakar. She can be contacted at sklegare@gmail.com.

Rita Weiss is a Malaria Entomology Lab Data Manager in Dakar. She can be contacted at weissritaj@gmail.com.

Photos: SLAP training in Thies June 2013, by Sarah Legare.

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The Malnutrition Beast / Katie Richards Transitioning from the rainy season into the cool season represents a particularly prosperous time in Senegal. Farmers have recently harvested their grains (millet, peanuts, sorghum, beans, rice, fonio, etc.) and gardeners are benefiting from the cooler days that translate into a few less watering cans in order to produce successful vegetable crops. However, despite this seasonal prosperity, malnutrition still represents a significant problem in Senegal – as many might notice from a lack of produce in their lunch bowls. Between 2012 and 2013, it was estimated that 19% of children in Senegal under the age of five suffer from growth retardation due to malnutrition and about 6% suffer from severe malnutrition. Worldwide each year, five million deaths are attributed to malnutrition, including 61% of diarrhea deaths and 57% of malaria deaths.

As a sustainable agriculture volunteer working alongside community gardens and the Master Farm within my village, I admittedly struggled with incorporating nutrition into my extension work. It only seemed intuitive, however, that nutrition and agriculture should be taught hand-in-hand. Everything our bodies require, from vegetables to meat, depends directly on healthy soil. So, why did I struggle to incorporate nutrition in my work? Malnutrition seemed too gargantuan a topic to tackle. How could I possibly teach villagers about these tiny things called vitamins and minerals, and the impact they have on the body? How could I possibly persuade them to eat the crops of their gardens or fields, when selling them for a brand new Tabaski outfit was so much more appealing?

But that is exactly the point…we, as Peace Corps Volunteers, cannot and should not think of tackling the looming beast, but should instead consider clipping the beast’s sharp nails. We should consider small actions that will have an eventual impact on the beast that is malnutrition.

With this realization I found my motivation to extend for a third year working in nutrition programming with Peace Corps Senegal. We need to make the topic of malnutrition easy to approach from the volunteer perspective. As we integrate ourselves into our communities, we sit and drink tea for hours, we help with cooking and childcare, and we observe existing nutrition behaviors and obstacles within our communities. From our observations and research, we can take small steps and extend messages. We can help to incorporate bissap sauce into the rice bowl more frequently, or promote the nutritional value of traditional millet-based foods as opposed to the coveted rice, or demonstrate intercropping multiple vegetables into a small garden bed within the compound.

RECENT NUTRITION TRAININGS

This past September 2013, Peace Corps Senegal hosted a nutrition training in Toubacouta for Master Farmers, health counterparts, and volunteers from the Kaolack region of Senegal (also called the “peanut basin” after its staple cash crop). The training introduced its participants to the importance of proper nutrition and methods for promoting good nutrition through farming and gardening activities. Participants and training facilitators discussed early childhood nutrition and maternal nutrition as well as malnutrition and its symptoms. The training highlighted the influence of field and gardening work on nutrition, including approaches such as crop diversification and the incorporation of multiple fruit tree species in a field. Overall, thirteen Master Farmers, thirteen health counterparts, and ten PCVs came away with concrete action plans to improve nutrition in their local communities.

These nutrition trainings will be extended to the northern and southern regions of Senegal in February and March. We hope to continue to improve the training model and invite discussion to strengthen collaboration between the health and agriculture sectors. We envision these trainings including demonstrations of multiple agricultural techniques (e.g. intercropping multiple crops in a small garden bed) to health workers, and education for farmers about child and adult nutrition. We hope that this training will encourage health workers and agriculture experts to improve nutrition in their communities through simple messages and collaborative actions.

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So, in your next organized training, open field day, garden project, women’s group meeting, or even in your family compound, consider how a small message about nutrition might be incorporated. An estimated one out of every ten children in Senegal suffers from moderate or severe growth retardation due to malnutrition. During this season especially, families have options and variety that should be taken advantage of. If you would like to be more involved in nutrition work, consider applying to the nutrition trainings tailored to introducing the connection between nutrition and agriculture to both volunteers as well as our local counterparts. In addition, consider checking out the nutrition drive (a part of the Google drive) that can provide you with basic information on nutrition as well as ideas for extending that information to a variety of demographics.

Katie Richards is the Nutrition Capacity Building Coordinator in Dakar. She can be contacted at katierichards0@gmail.com.

Photo: A family eating nutritional porridge, by Katie Richards.

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Building a Poste de Santé / Venchele Saint-Dic

When I first arrived in Dassilame Soce a year ago, I recognized a pressing need in my community for a new and equipped poste de santé. The village is located in the Toubacouta zone and has an estimated population of 1240 habitants. After conquering my fear of the transition to an environment different than my own, I was eager to start working on potential health projects. My task as a Peace Corps volunteer seemed elusive until I began an assessment of the key community members’ roles in my village. Obviously, I did not know where to start, but I was confident that forming relationships with these influential leaders was the best way to begin my journey.

As part of my integration routine over my first three months, I began to introduce myself to the influential individuals in the three villages covered by the case de santé. I made a poster identifying their roles in their communities, so that I could ask the appropriate people for assistance when I had questions. I visited the case de santé every other day so I could make observations of the needs of my community. After holding several meetings with the health committee and the village, I began developing action plans for making our projects sustainable. These meetings, along with my observations, confirmed that my community needed a new poste de santé. I also researched and inquired about NGOs with my APCD so that I could gain insights on the organizations that intervene in my region.

One day my ASC informed me of a conference on education and environment in Djinack Bara, in the Saloum islands of Toubacouta, which was going to take place on June 16-17th. I had completed one month in my service and decided to take a leap of faith because I thought this would be a great networking opportunity. Many administrative authorities, religious leaders and village chiefs attended the event. I had the opportunity to meet the coordinator of a European NGO who had built a poste de santé and a school on the island. After several negotiations over the next two months, I made a compelling argument of the benefits they would gain from including my community in their projects. For example, I knew that this NGO wanted to establish its name in the broader Senegalese community, but its projects were confined to the islands and lacked visibility – this was one of the details I used to build the case for a poste de santé in my village.

The project was finally approved in July 2012 and construction began in October 2012. During the whole process, meetings were held with the village to explain their contributions to the project in bringing sand and water for the construction. We are about to paint the building for its inauguration in the next few months. This will be followed by the training of the new matrones, the installment of medical equipment, and the monitoring and evaluation of the project.

Photos: Former health hut (left) and new poste de santé (right) from Venchele’s blog (see byline for URL).

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VENCHELE’S NOTES ON PROJECT PLANNING

Building relationships is key . It is important to build relationships with the influential members of your community. This can be done by having meetings with them or by drinking tea with them, and you can get a general idea of the person’s commitment to your cause. It is equally important to keep local authorities aware of your activities. The local authorities often interact with donor partners or NGOs intervening in your region. It further boosts your PCV credibility and engages the community members in the design, planning and decision-making process of your projects.

Do your research. Prior to holding meetings with NGOs, ask your APCD whether he has information on organizations who work in your region. He may not know but he can guide you to resources. Find out on the NGO’s website whether the organization’s objectives match your community’s goals for your projects. Even if their goals are slightly different, there likely exists some common ground. All in all, you aim to create a favorable outcome for both parties.

Language proficiency is not necessary. Although the language barrier and translation can be tough to deal with during the first few months of service, you can use someone you work with, such as your counterpart or a friend, to act as a facilitator in meetings. This shows community involvement and ensures that all parties are on the same page to create sustainable projects.

Draft a compelling argument. Try to come up with at least five reasons this organization should include your village in their projects. Think in terms of what makes your situation unique and the benefits they can gain from the collaboration (e.g. increasing their presence). One book which could be helpful in this process is called How to Win Friends and Influence People by Dale Carnegie.

Attend community events. You can stay in the loop of these events by talking to the local authorities in your region. It is an added benefit to talk to them every three to six months to give them an update of the activities you are undertaking in your community. If not possible, sending them an email about these updates can turn out to be advantageous in future initiatives.

Be clear about your role as a PCV. For any construction projects, make sure that the community handles financial logistics with the coordinator of the NGO. This also means allowing the community to select masons who will be responsible for the construction. If this isn’t done from the beginning, it might create uncomfortable dynamics with your community. Financial matters rest in the hands of the NGO.

Community Involvement. Engage your community as much as possible in the planning and designing of your projects. I find it best to wait to inform community members in a meeting about a project until it has been finalized with the NGO. This will hopefully result in your developing sustainable projects. As a sidenote, NGOs are impressed when you can show that your community was involved in the decision-making process of your action plans.

Venchele Saint-Dic is a Preventative Health Educator in Dassilame Soce, Toubacouta Zone, Fatick Region. Venchele is happy to assist volunteers in developing sustainable projects even after the end of her service: contact her at vencheles23@gmail.com. Visit her blog at http://venchelepeacecorpshealth.blogspot.com/.

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[Calendar of Events]

January 15 – April 15

January 20 Martin Luther King Day (Peace Corps Office closed)

January 28 – February 9 Malaria Boot Camp (Sarah Legare)

February 1 Northern Summit, Linguère (Gordon Day)

February 2 – 4 Monitoring and Reporting Training, Thiès (Vanessa Dickey)

February 3 – 7 West Africa Beekeeping Training, The Gambia (contact your APCD)

February 5 – 7 Health and CED COS Conference, Thiès (Vanessa Dickey)

February 7 – 9 Kolda Regional Fair (Lauren Seibert)

February 8 – 12 Work Zone Coordinator Training and Plan Presentations, Thiès (Zoe Williams, Chris Hedrick)

February 10 – 12 Peer Support Network Training, Thiès (Marsha Hedrick)

February 11 – 12 SeneGAD conference, Thiès (Annie Bigwood)

February 13 – 14 All Volunteer Conference, Thiès (Vanessa Dickey)

February 15 – 17 West Africa Intramural Softball Tournament, Dakar (Whitney Jenkins)

February 17 Presidents’ Day (Peace Corps Office closed)

February 24 – 26 Nutrition Agriculture Training in Tambacounda (Katie Richards)

February 24 – 28 Grassroots Soccer Skillz Girl Training, Thiès (Sabrina Fortney, Claire Cravero)

March 5 – May 9 Health and CED PST, Thiès (Vanessa Dickey)

March 24 Kolda Youth Empowerment Camp (Sophie Danner)

March 31 DEADLINE FOR THE PULSE ISSUE 3 SUBMISSIONS

April 4 Senegalese Independence Day (Peace Corps Office closed)

April 15 Publication date for The Pulse: Issue 3

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Peace Corps Senegal www.pcsenegal.org

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