Life in Koutiala: Malian Flintstones

Ibrehima stands roughly six feet tall; he is muscular but thin. His face is a series of sharp angles that are so pronounced that most people describe him as the “one with the angular face.” He walks with a confident swagger, arms swinging at his sides in a manner that could almost be mistaken for dancing—dancing being something he does incredibly well. He seems to have two moods, a serious and a funny one. In his serious mood, he is a bit intense, doesn’t smile, and becomes much more direct than the vast majority of his Malian countrymen. The angles in his face, sharpened by the intensity, make him look like someone you wouldn’t want to meet in a dark alley. When I was training him in the vaccination clinic, he turned to me one day, and said rather sharply, “You write your numbers wrong.” He began enumerating the differences in the ways Americans and Malians write their numbers. It was clear that I needed to change my style of writing. But in his funny mood, a huge smile spreads across his face, easing the lines, and revealing a large gap between his two front teeth. His manner relaxes, and he becomes quite witty. His laughter is contagious and he is a pleasure to be around.

Yaya is about 5’9’’ with a round face and cheeks that are high and a bit chubby. He smiles the vast majority of the time, in a manner that smacks of an excited, cartoon squirrel. He is a bit timid and sometimes downright nervous (enhancing the squirrel image). At the end of stating his opinion, he almost always ends with a nervous, “ou bien” (or…well?), providing space for someone to change or correct what he has just said. During the summer, he had to step up to the responsibility of being the nurse-in-charge during a couple days, because our other senior nurses were on vacation. The first day of these new duties, his face beamed with pride for having been selected for the responsibility, and he ran back and forth between nursing areas with a manner both excited and nervous. He laughs frequently, but isn’t the first in a crowd to crack a joke. He checks in regularly with the nursing director to find out her opinion of his performance. In addition to his duties as a nurse in the wards, he also works in the OR with us. He does a good job, but is slowed down because he wants to follow, thoroughly, the step-by-step process he was taught. I really enjoy Yaya, but he definitely gives off the impression of having been the kid that got picked on in school.

The two are inseparable.

I wouldn’t have picked it in a million years. The jock and the nerd as best friends. It is one of those funny realities of African life and friendship. They live rather close to one another, and according to their own statements, if they aren’t at the hospital, they are hanging out together. You wouldn’t have picked them out as your Fred and Barney, but they’ve got friendship loyalty down.

Awhile back, Yaya invited me to come drink tea at his place. Tea drinking is the major “hang-out” activity in Mali (possibly the “only” hang-out activity). It’s kind of like the American coffee-house scene...but not quite. They have these little charcoal stoves that they put the teapot on. They add loose tea leaves and lots of sugar. The rounds of tea are served in shot glasses (because it is that strong). More water is added to the pot, and another round is prepared. Each time, the tea becomes more sweet and less bitter. Three rounds (the normal use for one bag of tea leaves) can take a couple of hours to complete, if you drag it out. In between the thirty second intervals of downing tea, you are left with nothing but the heat, hopefully some shade, and lots of time to talk. It might be the incredible amounts of caffeine, but truthfully, I find the whole process intoxicating and completely enjoyable.

However, every time Yaya and I tried to get together, we were interrupted by something or other. So we finally set a firm date for a Sunday. He called me about 4 times in the days leading up to the “tea party” to make sure that I was doing well and to let me know he hoped we wouldn’t be interrupted this time. Ibrehima called me once, the day of, and said, “You didn’t forget did you?” “No,” I assured him. “Good. See you soon.” Click.

So Sunday, after eating lunch with Terry and Barry (missionary couple) and overstaying at their place, I rushed up to Yaya’s place. He rents a room on a compound. It is a room in a cement building with a door to the outside; this is where he sleeps and keeps all his worldly belongings (Much of your living is done in the courtyard of the compound, or out in the street under a tree.) The land-lady does his cooking for him, and overall it seems to be a good arrangement. When I pulled up, Ibrehima, Yaya, and Yaya’s younger brother (who now lives with him) were all sitting under a tree in the street by the compound.

I greeted them all, pulled up a chair, and was almost immediately served a glass of tea. I sipped some, and said, “Hmm… it’s the second round already.” Ibrehima, with a big smile, explained that the first round had been on time, and I was not. Touché. After this gentle ribbing, we settled into easy conversation under the shade of the tree. We were about 4 meters from a garbage pile that had the drain from an outhouse (the drain was for the water used for showering and for washing the floor for the outhouse…not excrement, I think...) running right through it. The wind was from the other direction, so it ruined the scenery but the smell didn’t come our way, until the local herd of pigs got chased out of a nearby millet field and began to dig through the garbage.

Ibrehima was a bit tired, but was being a good sport. He had worked all night and still hadn’t slept. We talked everything from the weather, to crops, to the differences in Malian and American dating. It was this last topic that kept coming back to the conversation, until finally Yaya blurted out his news. He was engaged as of the previous weekend, and his fiancée happened to be visiting Koutiala at the time. And it was then that I knew this visit was going to take on a different form. We had already had about 6 rounds of tea, so it was time to bring that to an end. The guys took turns going to their homes to change, and when they were ready, we took off to visit Yaya’s fiancée.

She was staying at the home of one of the pastors in town, so we headed over there. I wasn’t at all sure how all this was supposed to “go down.” Men and women rarely show affection for each other in public (and public being in front of any other person), so it wasn’t like they were going to sit there and hold hands while we all chatted. I figured that Ibrehima and I would be some sort of go-between, since that seems to be a big cultural tradition.

We pulled into the pastor’s compound, and walked up to greet the men who were all sitting in a circle. It was dark, but the night sky was clear, and the stars were incredible. (I’ve become a huge fan of sitting out under the stars, in the pitch dark, having relaxed conversation.) About the time we sat down, the cumulative effect of the 6 glasses of tea took hold, and I felt like I should be running, not sitting. But as jittery as I felt, Yaya was by far worse. He was visibly nervous. We made small talk with the pastor and his friends. I ask the pastor about some recent happenings, and about that time, Yaya’s fiancée emerged to greet us.

She started on the far side of the circle, greeting the pastor and his friends first. Then she approached the back of Ibrehima’s chair, kneeled, and whispered greetings to him. When she came to the back of my chair, I twisted around to look at her. Even staring at her, I couldn’t hear what she was saying. I understand the basics of the Bambara greetings now, but that didn’t help me. Luckily, it is standard practice for beginners to answer “No problems” to every question. (Granted, using this method, I have inadvertently told my fair share number of people that there are “no problems” with my wife and kids.) I greeted her back, and then she slipped behind Yaya’s chair, knelt, and spent the next couple minutes whispering to him. Then she backed away into the shadows; Yaya turned around, face beaming.

Now, normally I try to be chill and just roll with the cultural punches. Blame it on the caffeine, but that night, I just didn’t roll. In my head, I was like, “This is ridiculous.” We came all the way here, dragging poor, tired Ibrehima along, for 2 minutes of conversation!? I at least expected her to sit and chat for awhile. It is no wonder they act like perfect strangers at their weddings. I also really struggled with her subservient role. She was just doing what is culturally appropriate—showing respect to the friends of her fiancée. (Something that many guys have told me is important in selecting a future wife—that she respect their friends. It seems almost the inverse in the States—the friends must respect the fiancée.) I can handle the polite curtsy that the girls do when shaking hands with me, but being knelt before is a little much for me. I’m not a far-left feminist, but I think there is quite a bit to be said for elevating the position of women in a society. The whole thing just struck me as weird.

But we weren’t finished yet. Ibrehima still had his role to play. And that is why it pays to have a dedicated and culturally-wise friend in this culture. About two minutes after Anne (the fiancée) left, Ibrehima dismissed himself to go to the restroom. But instead of returning to the main circle, I could his shadowy figure talking with another young man who lived on the compound. Soon they were sitting against a wall of the house, a good 15 meters from where we were, and they were joined by more young men. I was pretty sure that he had just brilliantly acted out his role as the “go-between,” using tactics perfected from years of watching other people do the same. (That’s only conjecture based on my observations; they could be wrong, but seem to fit with the little that I know.)

Another five minutes of awkward small talk past, and then it was clear that Ibrehima had opened a door of opportunity for us. We politely dismissed ourselves from the group, and went over to greet the other guys. We sat down and were, immediately, much more at ease. I knew all three of the other guys that were sitting with us, and our conversation picked up a more lively pace. I leaned over, grabbed Yaya’s wrist, and pretended that I was taking his pulse. “Yup,” I said, “his heart is beating way too fast. I think we are going to get him out of here, for his health.” This elicited a howling chorus of laughter. (I’d love to congratulate myself on my comedic genius, but Malians love to laugh and will crack up at even the worst attempts at humor.) After more joking and laughing, Ibrehima brought his role to its completion. He asked one of the guys if Anne was still around, and if could she come and sit and talk with the group for a moment.

Sure enough, that worked, and she soon joined our little circle. But despite being a much more laid-back environment, she was still very reserved and shy. I tried to ask her a couple questions (like, where she grew up, etc), but what little response I got was in mumbled French that I could barely hear. I’m apparently very intimidating!

After about 20 minutes, Ibrehima looked like he was going to fall asleep on the bench, so we began to say our good-byes. We drove off, Yaya leading the way, and a very tired Ibrehima on the back of my moto. Yaya had gotten his opportunity to introduce me to his fiancée and to spend a little time with her; the giant smile on his face said it all. And Ibrehima, well, exhausted as he was, he had played well his role as best-friend/go-between/opportunity-creator. I was really impressed by his loyalty and self-sacrifice for his friend. I realize that in the grand scheme of things, it wasn’t a huge thing, but that night in my reflection, it seemed like the stuff that movies are made of; the stuff that is enviable in all the great “dynamic-duos”; the stuff we all long for—someone to love us and be loyal to us. It got me wondering how many times I’ve allowed my tiredness (or busyness) to get in the way of being loyal to my friends, or being there for them when they needed me.

Funny how that works so differently here. Often in the States, when one guy gets engaged, his time is swallowed up in his relationship with his fiancée, and he will get less “guy-time” to hang out with his good friends. Here, an engagement means that you are all the more dependent on your friendships. No judgment call on that, just an observation of difference.

It has become (almost) cliché to talk about how people in the third-world are so much better at relationships than we in the West. I’m not convinced that such a broad statement is accurate; I think it is more nuanced than that. For example, I would argue that Westerners, though far from perfect, generally have better male-female relationships in terms of equality, general friendship, and in marriage. (Our rampant sexuality and divorce rate suggests we still have a long way to go.)

Instead of being about who is better about “relationships” as a whole, it seems to be about the priority of our values that affect relationships. I personally, think it is very important to hold honesty in a high priority, whereas Malians might tend to tell you what you want to hear, so as not to create tension. But we have volumes to learn about loyalty, patience, and acceptance from our Malian friends. We all, in our fallenness, seem to get these priorities out of whack at times—elevating one too far above others, to the detriment of our relationships. We do well to learn from one another—even in those moments when you want to say, “Are you kidding me right now? This is ridiculous.”

Daouda Update

This is our little guy that we've had so much trouble with. He arrived with an old burn, that had caused his lip to scar all the way to his collar bone. So his mouth was open all the time and his left eye was pulled open all the time. (Other pictures in previous posts.)

We are almost done with him. We did a skin graft last week, but it looks like not all of it took, so we'll probably need to do a little more. He is really fed up with the hospital and with us in general--never knowing what the new day holds. Friday, he was in a good mood, so he came to my office. What you can't see in this picture is the candy in his hands just below the level of the shot. (Hence the smile.) Continue to pray for him--he still has a road of healing ahead of him.

Abana!

Yesterday was the last day of Aruna's chemotherapy (for the Burkitt's Lymphoma). We had been telling him all day that this was the last time he had to get an IV, but he didn't seem to be very excited. (I think his mind was still on the IV for the moment.)

This morning, I went in to take out his IV. After finishing, I said, "Aruna, abana." Bambara for "it's finished." He looked back at me and asked, with a face full of question and excitement, "abana?" (Is it really finished?) "Abana," I said. And with a huge smile he yelled, "Abana!"

It was so cute and funny that I went and grabbed Brett. The two of them started a little cheer. Below is a short video clip. (Unfortunately, the blog doesn't allow it to be super clear, but hopefully, you'll enjoy it anyways.)

I sat down with a pastor and Aruna's father yesterday. Brett and I felt like it was important for the father to know that we had done all of this work for Aruna because of our love for the Lord and His command to love others. I explained that to the father (with the pastor translating into Bambara). I told him that he was a great father for always comforting Aruna during his treatments and for bringing him back week after week, even during harvest season. And then I shared with him the thought that God is a Good Father and that He has given us gift. I let the pastor continue on with a short Gospel presentation. When he finished, Aruna's dad responded in a very touching way.

He said that when they came to the hospital, he had already lost all hope for his son. But when he walked onto the hospital, he said he could feel that God's hand was in the place. He said he could see it in the way we cared for his son and in the way our team worked together. He also said that before coming to the hospital, he had never heard of Jesus, since he is from a remote village. We have little radios that play dramatized Bible stories, and he said that he had been listening to those. He concluded with the fact that things were obviously different here and that he really needed to think about it all.

Continue to pray for Aruna and his father, Mumuni.

Pediatric Cases #2

I thought I'd post a few photos of what we've been doing in Pediatrics lately. [And I should have grabbed some photos of our severe malnutrition patients, but these will suffice.]

Let me introduce you to Daouda (David in Bambara). This is truly one of the bravest little kids I've ever met. He's not a big fan of me right now (lots of shots and dressing changes lately...) despite my constant efforts to keep him hooked up with candy and coloring books.

Because of his deformity, he had to wear this ski-hood every time he went out into public. You can imagine how warm this was.

When he was four, Daouda was burned. The resulting scar pulled his lower lip down to his collar bone. This severely limited the movement in his neck, and held his mouth constantly open. It also pulled on his left eye and ear.

This is a picture of Daouda a couple days after surgery. You can see we were able to free up his lip. Though the scarring is still extensive, his mobility has been largely returned. Please continue to pray for Daouda. He currently has an infection in his surgical wounds that threatens to undo much of what we accomplished.

Above is Aruna. He had Burkitt's Lymphoma. We have completed several rounds of chemotherapy for him. At first, Brett and I (with minimal chemotherapy experience between us) had big pow-wows to figure out how to do his chemo and his management afterwards. We've now gotten much more proficient. The last two rounds of chemo I've done all by myself, including the spinal taps. The tumor is completely gone, and we have only a few rounds left to guard against relapse. In the first picture, Aruna at admission. The second picture is Aruna now. His facial bones are slightly displaced because of how large the tumor got (and we are hopeful that the bones will remodel a bit and you'll soon not be able to tell.), but the tumor is gone.

I snapped the picture above right before the family left the hospital, and of course, I forgot to get the kid's name. He was many of our severe malaria cases, but he was particularly bad. He had cerebral malaria and despite our best treatments he was in a state of constant seizing and didn't appear to be getting any better. I was on-call one night, and I went to look at him. He looked terrible; he was tachycardiac, his oxygen saturation was around 80% (normal healthy people should be between 95-100%) even with 5 liters oxgen (the max we can give), and his respirations were irregular and shallow. I figured he would be leaving us in a matter of a couple hours. I called Ecle (A-klay) the Malian charge-nurse, and explained my assessment. I asked if we could talk to the family.

We took the dad into the nursing office, and through Ecle, I explained the situation. In Mali, you don't say someone is dying, because this could be interpreted as cursing the patient. So I said that the child was "VERY sick," and that without a miracle from the Lord, there wouldn't be a whole lot of hope. After I explained all this, and it was translated, I asked the dad if we could pray for him. He agreed, and I asked for one of the nurses to pray for him in Bambara. Everyone was a bit reserved, but Ecle finally spoke up and led out in prayer. I'm not sure what he prayed, but the day this kid was leaving, I grabbed Ecle, took him to the bedside, and said, "This is your miracle kid. Proof that the Lord is responsive to our prayers." I also brought Mama Germaine, one of our older, "motherly" nurses who has a direct but gentle way of explaining things to the bedside and told her to express to the family my personal feeling that this kid was a miracle, and that they needed to thank Jesus for His work.

And what would another pediatric case update be without a picture of Miriam. She has gone home with her caretaker, Elizabeth. She made a recent visit to the hospital to see us. She is still cubby and now she is regrowing hair. Above she is pictured with Elizabeth (her temporary caretaker) and her "adopted brother" Abou. (You can see "before" pictures under the post "Medicine in Koutiala: Case Updates.") Continue to pray for Miriam and her safety. In another month or so, she is scheduled to return to her grandmother (who got her into this mess in the first place...).

Follow-up on Malaria Post

I'm currently reading the book, "The Shackled Continent," by Robert Guest. This passage, I thought, went well with what I had written last week about malaria:

"One problem that Africans are almost powerless to solve, at least in the short term, is that most medical research is done in rich countries for the benefit of rich people. The fattest profits are to be made tackling chronic conditions that affect lots of Wsesterners, such as heart disease and cancer. The ills of the poor are neglected: of the 1,223 drugs introduced between 1975 and 1996, only thirteen were aimed at tropical diseases. In 1998, the world spent $70 billion on health research, but only $300 million of this was directed at developing an AIDS vaccine, and a mere $100 million was devoted to fighting malaria." (pg. 202)

Medicine in Koutiala: Malaria Bites

I was working late in the office one evening, when my phone rang. “On a besoin de toi, tout de suite au Rea,” (“we need you, stat, in reanimation”) said a voice on the other end. “J’arrive,” I replied, rising, hanging up, and throwing my stethoscope over my neck. I jogged down to the Rea to see what was going on. I could hear the kid breathing before I entered the room. A four-year old boy lay on the bed, chocking on his own spit and vomit, after having just seized. I grabbed a suction machine and tried to clear his airway. After four or five passes, the rasping and bubbling in his throat cleared. I positioned his head and neck to allow him to breathe more clearly. Even with these interventions, his breathing was labored and you could feel the rattle through his chest from the stuff he had aspirated into his lungs.

While another nurse attached monitoring equipment, another helped me ask questions of the parents. The child had been sick for four days and this was his third seizure. Malaria. Not good, I thought myself, you don’t want to fool around with malaria. (It’s not that my diagnostic skills are that good, it is just that 99% of kids coming in right now are malaria cases.) But encouraged by our recent string of victories, I was still very calm. The monitoring equipment seemed to be malfunctioning, so I asked the nurse to go get a new machine. She left, and I pulled the lower lid of the kid’s eye down to look at the conjunctiva. (The third-world version of a quick blood-count.) Where normally you find a rosy red inner eye lid, I saw a pale white. “Oxygene!” I yelled. I sent one nurse running for oxygen and the other for IV start supplies.

In an instant, I went from calm to significantly panicked. Before either of the other nurses came back, I saw the boy’s chest start to move irregularly. Then a pause, and a gasp. I jammed my fingers into his neck to feel his pulse. Bump, Bump…Bump…….Bump……Bump………. The word I screamed in my head at that moment was very unsanctified, very not-missionary; but I hardly know a word that is more sufficient to express my feelings on this disease.

I pulled the sheet over the little kid’s face, and turned to look at the stone-like faces of his mother and father. Sorry, I half-said, half-whispered. Without making a sound, the mother got up and left. The father lingered a moment. I had one of the nurses translate my condolences, and then explained that the malaria had progressed too fast and there was nothing we could do. He nodded solemnly and then walked out.

I made final arrangements with the nurses and then walked out. At first I wanted to play the “what-if” game. What if I had started the IV sooner? What if I had gotten oxygen sooner? I should have looked at his eyes sooner. What if… But my background in critical care medicine has taught me that this is never productive, nor does it represent any form of reality. So I tried hard to stop. I called Brett (the pediatrician), played the what-if game a bit more, and stopped when he spoke the same words that I knew to be true. “The kid just got to us too late.”

And then I got mad.

And I’m still angry. At first, I couldn’t find one direction to point my anger. I wanted to yell at the parents for waiting so long, for not even getting some kind of treatment. I wanted to tell the government that they had done a crappy job at educating their people. I wanted to write the UN and tell them to ship an army here, because we are getting flogged by this disease. But the parents looked poor to me, so I knew that they had waited part because of financial pressure, part from lack of education, and more than likely, they lived in an outlying village and it had taken some time to get to the hospital. The government is already providing free medicine for malaria, and though it is far from perfect, it’s doing a decent job as far as governments go. And the UN…well, whatever…it just doesn’t feel very productive to get mad at the UN.

But I’m still angry. The next day, we lost two more. A little later, I watched two parents throw themselves on the floor in tears as their seven-year-old, their only child, passed away moments after they laid him on our hospital bed. (First Malian man I’ve ever seen cry.) This past week, we’ve had at least two or three new cases a day that we admit. (That’s a lot, considering that pediatrics isn’t even technically open. And that’s not counting the ones seen in outpatient clinic who are sick but well enough to go home on meds.) Some of them get better, some we lose. And all of a sudden this mysterious, tropical disease has an ugly face to go with its name for me.

Isaac, who before the opening of the hospital worked in a rural clinic, told me that during this season every year it is not that strange to have at least one death a day in the village from malaria. Brett has asked, more than once, out loud, “How do any children survive here?” I wonder the same thing. It’s no wonder that some parents stay a bit aloof of their young children. (They often don’t cry at deaths, first because they are so over-exposed to death and second because Islamic teaching says that if a child dies it is Allah’s will; to cry is to tell Allah that you disagree with his will. This is not true of every family.)

The problems are multifaceted. The first is a lack of education. Malians seem to be unaware that their malaria problems have a season. During the dry season, we don’t see malaria, but with the rains come the mosquitoes. So in May, when your kid vomits, you relax and figure it is just a stomach bug. If they vomit in September, you should load them on the moto and get to the nearest hospital. That doesn’t seem clear to them. The seasonal-ness of malaria here may also be part of the problem. If kids were exposed to small numbers of parasites during the whole year, they might form antibodies better. Instead they go through a period of little or no exposure, and then are hit with a wave of parasites.

Medicines are also problematic. The government gives out a very good malaria treatment. However, it comes in pill form. The pills work well, if they are started in time, and the kids keep them down. A frequent symptom of malaria is nausea and vomiting. Some parents don’t even have access to these pills. Others try traditional treatments first. Still others try single-drug syrups or injectable quinine, which can work, but malaria often develops resistance to single-drug therapies. The very best treatment (in country) is expensive and is only sold in a box set for adults (making it much more expensive). We offer this treatment much cheaper because we share the vials among our multiple pediatric patients. (i.e. making it possible for the kids to get just the doses they need instead of having to buy a box set that they won’t use all of.) So when a child comes down with severe malaria, parents often waste precious time getting them the very best treatment because they try other options first.

And then, frankly, the reality is that malaria doesn’t exist in first-world countries. We wiped it out with the use of DDT and other extreme measures. We have, however, placed bans on DDT as it no longer affects us. (And I’m not necessarily advocating the use of DDT here.) And this is where my frustration and anger have found roost. How is it that we know so little about this disease in the West?! (And truthfully, care less.) Between 100-300 million people (mostly children) die every year from malaria. 36 million people die from starvation every year. Contrast that with the 25 million HIV-related deaths BETWEEN 1981 and 2006! We hear a ton about HIV (and rightfully so…) but hear little about malaria, even though malaria kills 100 times the number of people! Or, do I dare say it? Yup, the number of world-wide abortions every year is estimated at 46 million. Not saying that HIV and abortion aren’t worthwhile concerns, but it seems like if we wanted the most bang for our buck, we’d go after malaria. I wonder why we have so separated ourselves from this disease. (Grain of salt…statistics taken from Wikipedia.)

I feel a certain moral-outrage about this disease. It is a smear on the face of our world. It is a symptom of our world, corrupted by our sin. It is made worse by our complacency. I’m ashamed that I didn’t know more about it before now. Do what you want…but I’ve asked the Lord to never allow me to become complacent about this disease. As long as He allows me the privilege, I’ll be here kicking back.

Life in Koutiala: Get out of town

It had been a long few weeks. Isaac had been sick with some typhoid/malaria combination and that had left me on-call for anesthesia for a couple weeks straight. Then I added in Pediatric call starting September 2nd, so I was having lots of long days and late nights. So I was quite ready to wind-down into my weekend with no call, and when Paul proposed a trip to the village, I was all over it.

It was, as I’m learning, a typical Malian invitation. I was leaving the hospital just as he was arriving for his night shift. I stopped to talk with him, and the conversation switched to the weekend. He started talking about how he and Eclesiate were going to the village in which Ecle (A-klay; for short) grew up—Zamblala. And then—and this is the problem—some comment or question led me to believe I was invited to come along. But I don’t even remember what it was. It was definitely not a direct question, like “Do you want to come along?” It was way more subtle than that. So subtle, in fact, that driving away, I really began to wonder if I was really invited or whether I had just invited myself. Either way, I figured, their reaction to my “acceptance” (or self-invitation) had been positive.

That evening I ran my trip past some seasoned veterans in efforts to keep unexpected adventures to a minimum. They told me quite a bit about the town. One of the few places in Mali that is predominately Christian, as opposed to predominately Muslim; quite a friendly little town; take your own water; etc. Olive, a 30-year veteran of Mali living, wondered why the two guys were heading back to the village. Probably a young lady was involved, she mused. She recommended being prepared to spend the night. She called Ecle to make sure the road was good since I had agreed to drive. (Don’t worry, Jessica, the road was in really good condition and I took it nice and slow!)

The next morning I was up and preparing when the guys called to tell me they would be ready at 8:30. I threw together a bare-bones overnight bag. Change of clothes, toothbrush, deodorant, diarrhea medication… trying to fit all into a small little backpack. (I really dislike being the “white guy with all the luggage.) I took off, feeling quite ready to leave Koutiala. (I haven’t left Koutiala since arriving here in Mali, except for my wedding trip to Bamako and my vacation to Bobo. I was beginning to feel very confined.)

When I pulled up to pick up Paul and Ecle, I immediately knew something was not as I had expected. They were both dressed in their matching wedding shirts (from the previous wedding). They climbed in and we took off, while Ecle explained that the real reason for the trip to the village today was a wedding of his “big brother.” (Quotes because I think the guy was probably more like a distant cousin…) Sweet…thanks for the heads up, guys. And again, that nagging question, did I invite myself on this trip? Since weddings are more open-invite affairs here, I’ve learned to be a bit more comfortable going with friends to weddings without an invitation in hand, but inviting myself to the wedding of someone I don’t even know, is still a bit uncomfortable.

Luckily, I had packed a boubou (traditional West African formal wear) in case we had spent the night, much better attire for a wedding than my t-shirt. And I decided to trust in the unfailing hospitality of my hosts (self-invited or not). So we turned on the radio and enjoyed the ride. I had the guys help me rehearse my Bambara greetings, since there would be very few French speakers in the village. I’ll admit that my Bambara is terrible. In the hurry to acclimate and get to work, I spent all my energy working on learning other things. It is pretty pathetic that after 4 months in the country I can’t even properly greet people in Bambara (goes against everything I believe…really), but finally, it is starting to come.

After 15 kilometers on paved road, we pulled off onto a dirt, donkey-cart path and went another 10 kilometers. The road was narrow and surrounded by shrubs and millet and corn fields, but the surface was even and the going was smooth. We had to stop several times to figure out how to get around an on-coming donkey cart. And the best was when we came around a corner and stopped suddenly in front of an on-coming cattle plow-team, led by a boy that couldn’t be more than 7. It took him a full five minutes to get the team off the road, being less than 1/8 the size of even one of the cows. We probably should have helped, but we were too busy laughing and digging out my camera to take a picture of him pushing and pulling with all his might on the stubborn beasts.

[This picture made possible by me sitting in my car laughing, instead of helping the poor kid!]

Pulling up to the village, we had to drive over the narrow dam that has created rice fields for the village. The village itself is little collections of houses, interspersed with huge mango trees and fields of corn, millet, and cotton. Healthy looking chickens, pigs, and goats were everywhere. I’m not an expert on village living, but I would say this village was doing well for itself.

We parked the car in front of the compound of Ecle’s grandfather. The compound is a large, walled-in area that has houses for the grandfather and his sons. There were easily 80 people in the compound that morning. And the greeting began. And the greeting continued. This is what we did for the vast majority of the morning. We greeted, we sat for the appropriate length of time in their presence, and then we were off to the next family. We traveled the village on foot, meeting countless people, visiting the schools, the small health clinic, and the church. At each place, there was the rush to find chairs for us, to properly welcome us.

After our first few stops, Paul and Ecle began to explain that the village was very on-edge that morning because the bride had not shown up. (She was from a village a ways away.) Normally she should have come the day before, in order to have been there for the all-night party. They had thrown the party anyways, but preparations for the wedding were at a stand-still that morning. Some imagined an accident, others that the parents of the bride were playing some trick to get more gifts and money from the groom. A delegation had been sent to find her.

This was eliciting complaints from everyone, at every stop. Some of the concern was for the groom—the shame and disappointment of a failed wedding. Some of it—coming from the women—was over when to start preparing the food. And some was over the delay of an anticipated event. These events are clearly a highlight of life in the village, and people wanted to get on with the party. Paul and Ecle, who had worked all night, wanted to get on with it so that they could get home and sleep.

It was while walking around the village, visiting, greeting, and guessing with Ecle and Paul what had happened to the bride that the reality of my situation washed over me. I would occasionally get a similar feeling in Utah. It would come when I was driving on the interstate with a clear view of the mountains, I would suddenly catch my breath, and it would wash over me again—their grandeur, their majestic beauty—as if I was seeing them again for the first time. It was the same here. I looked at the blue sky lit up with a blazing sun, the palms and mango trees framed with white clouds, and the red dirt of paths and mud huts. And I felt like I should pinch myself. “I’m in Africa,” I thought. I’ve dreamed of this all my life, and here I am. I felt very blessed.

Around noon, the bride finally arrived. The story I heard is that a car was supposed to bring her to the village, but there were too many people wanting to go, so they had to take two trips. So they left the bride and her attendant and took the other people first. Very funny, but strangely not surprising.

We retired to Ecle’s compound. We sat in the shade of a room and talked for a while, not knowing when the wedding would start. And here I observed yet another fascinating thing about village life. All of a sudden, Paul and Ecle got up and said that it was time to go to the church. No one had come in to announce this. There was no ringing of bells or PA announcement, no phone calls, no text messages. I can only assume they heard people talking about it outside. We took off for the church and were some of the first to arrive, but less than two minutes later, the whole village was there. Much like the beats in music that they hear and I don’t, there is some kind of rhythm in the village life that I just am not tuned into.

We all entered the church just as the rain began to fall. And it came hard. The racket made it hard to hear the service, but Paul, sitting right next to me, was translating most of it into French for me, and he seemed to be able to understand enough of what was going on.

The ceremony was shorter than the one in Bamako. And after the service, we all made mad dashes back to the village for cover. Paul, Ecle and I ate in a back room of one of the houses. The food was excellent. A rice-and-sauce dish with pork and noodles with chicken. We ate and then brewed tea to drink. The rain continued to fall hard. I began to have fears that the road would wash out and that’d we would be stranded.

The rain slowed towards the evening and so we said our goodbyes, picked our way through the mud to the car, and took off. The road was very muddy on the way back, but still very much intact. We made it back without problems, and I dropped the guys off at their home. I thanked them for a great day, and they promised we’d do it again soon. I look forward to it.

[Ecle and I eating dinner.]

[Ecle and Paul]