Deep Secrets

A blog post formed in my mind the way they often do, beginning with a feeling in response to some small experience, perhaps a vague hook or a title surfaces at some point, and then a few connections are made, linking this random experience to more common human threads of emotion.

I felt fairly prepared for my Sunday morning writing. And then I had a visitor from out of town. My friend was here for exactly one and a half  days before he ventured out on his own. I returned from school to find him sitting comfortably in the house, having arrived a mere 20 minutes before.

Remembering my own harrowing experience trying to get back home, I was a bit in awe. I began to wonder if I'd imagined the communication difficulties with the taxi-men.  I chalked it up to being white, being a woman. A million and ten reasons tried to surface explaining the disparity. Once he started telling me how he'd written everything down well, I recalled that it was I who wrote down the reference points, based on evidence gathered from my experiences gone wrong.  Because I'd learned that the taxi drivers call all of the rondpoints in Sotuba the rondpoint Sotuba, and because I'd learned that the Shell station was a pretty reliable reference point (you can't change the name of an established business with a 6m orange and yellow sign,) I was able to make a note with references that couldn't go wrong, no matter how little French or how much Bambara.  He wasn't necessarily more savvy than I, but just received better 'get home directions' than I had (or, at least this was the  way I chose to frame the story.)

It was helpful to remember this last part because sometimes living in Bamako can feel like a deep trove of well-buried secrets to uncover. Everything simple seems to require days of searching and asking questions. It began a month or so after arrival. I'd been having some health issues and one of the possible remedies was to renew my packet of the pill.

Taking contraceptives was never something that was talked about in my family, along with a long list of many other non-discussed life mile-stones. It is only recently that I have realized how many women take it for reasons other than preventing childbirth. All this time I thought I was alone.

Contraceptive use in Mali seemed like another one of those sticky issues. The country in general feels a bit more conservative than other countries, but I am not really sure if I am so truly in touch. The amount of tourists that has passed through here perhaps had an effect of loosening restrictions. At this point I am probably still working on stereotypes from the media and quarter-truths.

Regardless, I do feel that Mali is a male country and going into the pharmacy didn't prove me wrong. I'd made my way down to Mohamed V, having been told it was the pharmacy to go to if all the others didn't have what you needed. I should take a minute to mention this whole adventure might have been more easily solved if I'd just gone to the doctor- but, well, the Tale of Two Clinics is a blog post I still haven't committed to paper, though it's well formed in my head. I generally avoid doctors except in the most emergency of cases and this didn't seem to be that. Besides, I hadn't visited the illustrious Mohamed V.

The pharmacy is located in the middle of the grand marche, which translates into crowded streets, difficult parking and an overwhelming number of customers inside. The routine was pretty clear- a bunch of baskets lined the counter and one had only to place their prescription in the basket in order to secure a place in line. Then, just find an unclaimed portion of floor space to step back into and wait for your name. This was great, except I had a question, not a slip of paper. Actually, I had a slip of paper, too, handwritten by myself but it required explanation, and, of course, my question.

I hung out near the counter hoping to catch someone's eye and maybe have a conversation. My first attempt didn't go well as I had reversed two of the letters in what I thought was the brand name. It was close to a girl's name, but not exactly. The woman at the counter took a look at my paper and could only focus on a girl's name. The conversation couldn't get past that.

To my horror, the school chauffeur, who'd driven me down to Mohamed V, had also come in. He had good intentions and only wanted to help, but this was definitely not a matter I wanted to share. There's no such thing as HIPPA here. I spotted a sign hanging from the ceiling that suggested there was another area for consulting so I took my question down there. The man tried his best to help me, but he was a bit stymied by the girl's name as well. I'd written Melanie instead of Meliane.  In either case, I had already gone to one pharmacy where the pharmacist had been especially helpful by looking up the brand name in a book and he was able to find comparative medicines. I'd been hoping for something similar here. The blue book of pharmacists.

One man handed me off to another, supposedly more senior man who was a bit brusque- it was a busy Saturday morning. In the end, I lost my nerve to ask for exactly what I wanted, between his gruff demeanor, the chauffeur standing by and the waiting room full of men, I chose instead to just leave. Empty-handed. Great.

Back at the ranch, I did some googling. What I wanted to find was the name of the specific pill used in Bamako, if in fact, there was one. My research turned up several interesting articles by various NGO's and others studying the hows and whys of contraceptive use in Mali. Turns out many men buy the pill for their wife, although there were a number of secret pill users. I was also able to discover the name of a popular contraceptive. Armed with this new information, I set out for a pharmacy close to me- I figured if it was going to be helpful, it had to be convenient, too.

This pharmacy is just next door to a Marie Stopes, and so it seemed logical they would have something. I just wasn't speaking the right language yet. I handed the pharmacists my new slip of paper, this time written with the correct spelling of Meliane and the Malian version, Pilplan.

He came in seconds with a packet, which he offered to me saying, "Deux cents francs." I thought it wasn't possible I could have heard him right and so asked him to repeat. Sure enough, this box of contraceptive, which Trump has been trying to make ever harder for Americans to access, was 200 francs, something like 35 cents.

When I got home, I opened the box to find there was a 2 month supply inside. Which meant approximately 17 cents per month. And the 5 or so pills at the end of the pack were iron, not placebo. I had to appreciate the ingeniousness of it. Sometimes, Africa does it better.

It was such an easy transaction I wondered why it had taken so long and felt so complicated. Just like once I understood the clearest directions to get home, it seemed so obvious. Maybe not all secrets are buried so deep. Slowly, slowly Bamako is making sense. (But it's still way too dusty and hazy to breathe. I am not sure if there is any fix for that.)

When the glove fits...

Blogging for the past 6 years has revealed certain facts about my character which I would not have otherwise known (or maybe it is living in Congo for the past 6 years that has brought forth these qualities which were previously lying dormant in the winter worlds of my personality...) Because they are now forever documented on the web  (unless of course I request to have them removed- recent news here and an endlessly fascinating title here) I can easily link to proof of my obsession with medical/ illness stories and pharmaceutical remedies (completely refuting the fact that I have always claimed and previously thought myself to be a healthy individual with a nearly all natural life style- I'm sure I haven't even linked to all the previous posts describing our hospital and doctor experiences, but I am ready to pull the kid card and say whenever kids are involved, there are bound to be more doctor stories to tell.)

And so it is this time. Because along with my story telling, there is that aspect of faith changing. I constantly battle with myself about whether to believe in the medicine, the doctor, the whole process of invasion- or to just let time and nature take their healing course. I battle about treating symptoms as opposed to finding out the real cause and taking prescriptions as opposed to using herbs and teas and the medicinal properties of foods to do their job. A recent pharmacy find had left me feeling secretly delighted - a sore throat spray containing mint and clove oils reminiscent of an all natural, essential oil spray I had bought at my favorite supply store back when receiving mail items was still possible. Mohamed confirmed everything with his comment, "Tastes just like the old one," after an initial trial spray.

My inner battle began anew when Mohamed showed me his swollen finger- fat and unmovable 3 days after a nasty fall. While it didn't hurt, it was easy enough to take him in for a quick exam to be sure it wasn't fractured or broken. Since we are still in the luxurious position to have insurance, it seemed wise to take advantage of it. The exam left me feeling dubious- as it often does. The doctor poked and prodded, pulled and massaged. Mohamed winced and gasped and closed his eyes. Predictably, we were sent for x-rays.

One day and several hand scans later, we arrived back at the doctor's office. While Mohamed was supremely thrilled to have gotten a look at his bones, the x-rays showed no fracture and so we were still left with a swollen, impaired finger. While the doctor typed away on his desktop, I asked about the next step. What should we do now? He was ready with his prescription paper and pain medicine. "But, he doesn't really have any pain. That's not the problem. The problem is his finger has been swollen for 4 days and he can't  move it." I pointed out the obvious. It surely seemed to me the doctor was making things up as we went along. And I feel I should apologize in advance for not having faith in his ability. He mentioned something about massage therapy in a few days if the swelling didn't begin to go down and wrote a prescription to help with this.

I am sincere when I say I have no idea where my immediate disdain and disbelief of all things medical was born, but sure enough, it rose up like a fierce protecting dragon once again. Fine, I thought, we'll take the medicine, but that doesn't mean I actually have to give it to him. I vowed to look it up and find out exactly what farcical thing they were trying to prescribe now. I wanted to know why the finger was swollen, not just how to remove the symptom.

Perhaps my rebellious nature stems from the fact that there seems to be a remedy for everything (despite popular American belief, I am sure the cure for the common cold exists and can readily be found in any African drugstore.) Language probably also contributes to my inability to believe in the validity of the medicines. With my basic French, and their basic understanding of biology, I often find myself in vague and concerning conversations with friends that include phrases like "my blood is dirty" or "my heart hurts" or the ever alarming, slightly vague but oft present, "I thought I would die." There's a medicine for that- for all of those in fact. "Cleaning the blood," "calming the heart" and "saving you from imminent death."  It conjures up images of 1800's America to me-- the traveling salesmen with suitcases of snakeoil. And if none of those things work, there is always the nganga who can provide a natural healing alternative. However, if I have to go pharmaceutical, I want long, awkward prescriptions I can't pronounce and medical sounding diagnoses.

Consistent with my illogical and contradictory nature, I become immediately suspicious of those un-sayable cures and commence to googling the minute I am within range of connectivity. Imagine my surprise when I looked up Chymoral and found it is a medicine used for swelling in hand fractures. So specific. So exactly to the point. I admit to feeling a little bit of awe. The doctor never even appeared to be consulting a text or double checking anything. He just knew about this amazing hand fracture drug. I got to thinking about the million different ailments one could suffer from and the million different remedies that were out there- each fitting the other like a glove. Had he really committed all of this to memory?

Mohamed took a dose that night. In the morning, he surprised me at the kitchen sink by saying, "Look Ma, I have some improvement," as he bent his finger halfway. Maybe it was the medicine. Maybe it was just a natural improvement after 5 days of swelling. Most likely a combination of each. I'll never really know but I can't forget that sensation of wonderment- a hand fracture drug? really? And so I remain renewed in the most temporary sense. A drug for everything, why not?

Commercial district

Ever in search of clean water, I was on my way to buy more PUR packets for distribution to Vero. I thought that, since she has a tap of running water in her yard and I’ve seen some neighbors come to get water as well as the soda and pop she sells, if I could get her hooked on using the packets, it might benefit the whole neighborhood. (I’ve since come down from my lofty cloud but you know, it never hurts to dream.)

Albert has told me to come to the PSI office anytime and pick up a box. This office sits on a relatively nice, paved street. It is wide enough for two lanes of traffic and a row or so of pedestrians to manage without getting in each other’s way. However, those in the office inform me they are out of boxes and send me to the commerce district to ‘any pharmacy’ that will have some.

Rue de commerce is organized that way. All the pharmacies are in one cluster, then the hardware stores, and the fabric shops, etc. Everything grouped together by product. It turns out that none of the pharmacies had whole boxes available either, but what a series of adventures to discover this.

The streets themselves, adventure one. They quickly turned from fairly smooth and paved to swelling mounds of packed earth more reminiscent of a dirt bike race track than a ‘rue de commerce.’ Aside from the frequent ups and downs, there are people and pushcarts to avoid. Many of the carts are loaded with goods higher than my car. Up to four men might be struggling with one in order to get it to navigate the hills and valleys and avoid the outright ditches.

Second adventure- leaving the car. The streets are swarming with people, mostly men, sitting, watching, waiting. They have been eyeing me from a distance and I know they will be ready to pounce as soon as I step out of the car. I really don’t want to go into the ‘pharmacy’ I’ve happened to stop in front of. It is small and dirty and crowded. Outside a line of older men loiter with nothing to do except gaze in my direction. Inside, behind the counter the clerks are wearing face masks. In a corner a woman sits on the floor counting out pills into a small plastic baggie. On her lap is a basket full of unrecognizable remedies. The entire scene makes me feel like fleeing.
As expected, a young someone has attached himself to my elbow, completely intruding on my business. No pharmacy privacy act in effect here, that is for certain. He listens to my request so he will be ready to provide any small amount of assistance which I could easily perform for myself. Such as finding my way across the street to another pharmacy when this one does not have what I want.

Actually, although I consider it for a moment, I am happy enough to have him accompany me. I can hear the shouts of ‘Mondele! Mondele!” rise above the general din of the busy streets. It is a cry that always generates an initial, somewhat comical urge to run and hide. Everyone should have to feel this way at least once in their lives. Trapped inside your own skin, wanting to get out.

Someone tries to join us and I am satisfied to already be “taken,” having developed a slight preference for my guide. He leads me into another ‘pharmacy,’ this one more open and bright. I am nearly standing outside as I place my request. I appreciate the openness, having felt completely closed in within the dark, blue painted cement of the previous shop. My guide ‘translates’ my order, though we are all speaking French. I understand it to be part of his job, doing things for me that I can do for myself. I collect my purchase and he walks me back to my car, all the while questioning if I’ve been able to buy the quantity I was looking for and assuring me he would be happy to run off in search of more. No, I thank him and tell him I am finished for this day. I give him the obligatory tip- too much but still just about one dollar- and settle back into the car for adventure number three.

How do I get out of here? The commerce area is a veritable maze of shops and people, push carts and animals. Somewhere in here is the Grande Marche and I know several of the roads will lead to that dead end. A small group of men have begun to bang on the window, demanding money and so I choose to drive straight off rather than execute a timely turn. I always believe the people on the street to be much faster than my car could ever go. It is better to just get out rather than wait for them to gain force in numbers.

My desired path is cut off by a huge lake of water. Another man overtakes the window, jogging along, tapping and talking. I make all decisions by instinct (l’aide de Dieu) and crack the window slightly to hear him. He is friendly, encouraging and helpful. He gets me turned around, provides directions de sortie, and wishes me bon journee, with a fairly beautiful smile.