Some Food for Thought

Over this holiday season I’ve been traveling around Tanzania with my sister who has been volunteering here as a health educator. Though she has been primarily working on HIV/AIDS issues, I of course have been more interested in how this particular African country has been dealing with waterborne diseases. And the fact of the matter is that – just as Tanzania’s economy is experiencing relatively solid growth while Mali is left watching on the sidelines - Tanzania is steadily improving its indicators of water and sanitation while my beloved Mali remains mired in stagnation and disease.

Statistics vary according to the respective methodologies of the World Health Organization, the Center for Disease Control, UNICEF, etc.; and public health statistics are notoriously difficult to measure in the hardly-functional states of sub-Saharan Africa. But the broad picture is clear; though health indicators in Tanzania remain generally abysmal, they are considerably less abysmal in Tanzania than in Mali. Here in Tanzania there is a significantly lower prevalence of diarrhea, giardia, dysentery and cholera; Tanzania has a lower prevalence of death by diarrheal disease, a lower infant mortality rate, a lower child mortality rate, and a slightly greater life expectancy overall.

And in many of the same reports, you will find that only 24 percent of Tanzanians have “access to adequate sanitation facilities” i.e. toilets or latrines. This statistic too is prone to wild estimation and subjectivity, but I think that it may be the most telling. A Westerner might look at this figure and read it to mean Tanzanian sanitation infrastructure is atrocious – I think that would be a fair statement – but they don’t know the meaning of atrocious until they read that only 1/6 of that fraction, a mere 4 percent of Malians have “access to adequate sanitation”. The blunt truth is that beyond the likes of Niger, Mauritania, Haiti, Afghanistan and the very nadir of the most-underdeveloped countries of the world, it is difficult to exceed the sheer disarray of sanitation in the Republic of Mali.

Confined to the realm of pure statistical analysis, one might be inclined to assume that that is the whole story; Tanzanians have more latrines and soak pits than Malians, latrines and soak pits reduce the chance of fecal contamination of the drinking water, therefore Tanzanians have less prevalence of giardia and dysentery and greater life expectancies than Malians. Q.E.D.

But there’s more to it than that. In addition to the existence of water and sanitation infrastructure of the lack thereof, the prevalence of diseases transmitted via the fecal-oral cycle is tied to sanitation practices. Loyal readers of this blog are probably familiar with the fact that Mali’s appalling prevalence of gastrointestinal disease is largely caused by the country’s traditions which entail that the people of that country clean their respective anuses with their respective left hands, they “wash” their hands before eating by mushing their left and right hands together in a tin can of water used by every member of the eating party, and then they eat from a communal food bowl with their respective right hands. Popular Tanzanian anal-cleansing and eating practices are not much better; they generally eat their corn ugali with their hands, very few ever adequately wash their hands with soap, and even fewer use toilet paper or a bidet.

However, there are a few subtle differences. Most notably, when Maasai herders “wash” their hands without soap, they don’t dip their hands into a container of increasingly-filthy water. Instead, the eating rituals of the Maasai culture involve the youngest boy bringing a pitcher of hot water to his elders and pouring it over their hands. Even if they’re not doing a very thorough job of washing their hands, at least they’re not making them even dirtier as the Miniankas are wont to do.

And even though the Maasai maintain the uncouth tradition of eating with their hands, they do not eat with their hands from a communal food bowl. You see, in addition to drinking tea and eating fried potato “chips”, Tanzanians adopted from their former British colonial overlords the practice of eating from individual plates. This – I believe – makes a world of a difference. Even if someone is going to eat ugali with fecal matter-tainted hands and unwittingly practice coprophagy, there is relatively little risk of contracting giardia, dysentery or cholera by ingesting one’s own fecal matter – if there are amoebas in your stools, then you already have amoebic dysentery. The only way to contract fecal-oral cycle-transmitted disease is to ingest someone else’s poo particles – a risk significantly downgraded by a culture that shifts from eating from one shared bowl of food to multiple, individualized bowls of food.

I can only assume that the hygienically-superior eating habits of Tanzanians and their hand-washing practices which at least are not counterproductive probably provide a partial explanation of why this society is significantly less mired in disease than the people of Mali. Of course, this hypothesis would be quite daunting to prove as 1) there is no control group; and 2) if compilations of data on disease prevalence are shaky and “access to adequate sanitation facilities” is much too subjective to ever be analyzed scientifically, any statistic like “the prevalence of adequate hygiene practices” is 100-percent subjective and therefore epidemiologically-useless.

Nevertheless, I suppose that the conclusions are quite clear: cultures that are receptive to amending their cultural practices at least stand a chance of improving their public health and their general standard of living. Conversely, cultures which exhibit little genuine interest in learning how to swim are more liable to sink. If the people of Mali want to sully their hands in each other’s filth and eat with their hands from the same food bowl, then they are going to remain forever mired in gastrointestinal disease.

Trench Peacefare

This one trick pony has expanded his repertoire. As loyal readers should know, the people of Mali suffer from completely unnecessarily high rates of giardia, dysentery and explosive diarrhea because the raw sewage from their “traditional latrines” flows out into the streets and the entire population is exposed to the dangerous pathogens which cause these illnesses and continue the positive feedback loop by making their way into other people’s mouths. Sewage is both a danger to public health and also a necessary byproduct of human life itself, and so this blog’s eponymous hero is busy spending the prime years of his youth and your tax dollars building modern latrines equipped with concrete floors and soak pits: a rudimentary septic tank technology appropriate for cultures in this harsh Sahelian climate with few financial resources and building materials.


In the flat center of Sanadougou where I live, the water table lies almost perfectly uniformly between 7.5 meters below ground level at the peak of hot season and 4 meters below ground level after the groundwater has been recharged by 4 months of rainy season. In the center of Sanadougou where about 3,800 of the 4,400 permanent residents live, development-minded villagers have been digging soak pits 1 meter deep and varying in diameter (usually about 1 to 1.5 meters) depending on the number of people in their households and the volume of wastewater generated by their respective nyegens. Since the pathogens originating in wastewater can usually seep up to half a meter through hard-packed soil and sedimentary rock, the water table should never come closer than 2.5 meters to the sewage generated by these modern latrines and thus the groundwater consumed through wells and pumps should be adequately protected from direct contamination by human fecal matter.

However, even within the demarcated borders of Sanadougou there are some places where the soak pit is an inappropriate technology. Namely, there is an outlying neighborhood called Filablena which is significantly lower in elevation than the rest of the town and sits around a couple of large seasonal ponds. Here the water table varies between 5 meters below ground level at the peak of rainy season and 1.5 meters below ground level after rainy season.


The wells here are so shallow, and with less rock they are cut into nothing but soft soil which is much more permeable and conducive to groundwater flows. The pressure in a well is somewhat less than within the soil, so the water levels of wells are slightly higher than the water table; in Filablena during rainy season, the well water surface is only slightly less than a meter below ground level.


If we built 1 meter deep soak pits here like we have in the rest of Sanadougou, soak pits would in fact exacerbate the water sanitation problem by directly polluting the groundwater with raw sewage. That contaminated groundwater would then eventually make its way to people’s wells from which they get the bulk of their drinking water. The absolute worst-case scenario would be that contaminated water makes its way into the seasonal ponds and – though it probably wouldn’t be as obvious as the ones which form behind "traditional latrines" – render them into gigantic seasonal cesspools.

In Filablena we are just beginning to introduce a specialized technology: the infiltration trench. An infiltration trench serves the same function as a soak pit in that it contains the wastewater emitted from “traditional latrines” underground so that it cannot serve as a fertile breeding environment for filth flies and mosquitoes and cockroaches and a vector for all sorts of disease. It has to be able to store roughly the same volume of wastewater as a soak pit, but in an environment where the water table is prohibitively high an infiltration trench must be dug at a much smaller depth. In truth, the volume of a soak pit is only really important so long as it briefly stores wastewater before in seeps into the surrounding soil and rock; what is much more important is the surface area which determines the rate of discharge into the ground where it is safe and isolated from human water and food supplies. Where there has not been a lot of room to maneuver, we have solved this problem by simply reducing the depth of our soak pits and increasing the diameter accordingly.

Infiltration trenches take that ideal of minimal depth and maximum surface area even further. First I found a group of Filablenakaw interested in rebuilding their nyegens, measured their dimensions and assigned them lengths of plastic piping between 4 and 6 meters in length. Then we took an afternoon and pierced holes in them; we took a dozen large nails and placed their ends in the fire until they became red hot, and with protective work gloves we held pliers to hold the hot nails and melted lines of holes down the length of the pipes. With these hole-ridden pipes, wastewater should flow out over a more evenly distributed area and facilitate more rapid and less concentrated wastewater seepage into the soil.


Instead of small circular pits, Filablenakaw have been digging 4- to 6-meter long trenches which begin about 20 centimeters and eventually expand to a maximum depth of no more than 50 centimeters. We fill them in with rocks in such a way that the plastic pipe is on a gradual incline downwards and wastewater flows all the way down. Then we fill them with more rocks to keep the pipe stable, and cover the end of the pipe with a large flat rock to protect it from closing up.


Eventually we’re going to cover the trenches all up with plastic sheeting and cover them with the dirt that was dug up in the first place so that the sewage is contained underground, people and animals can walk over them without falling in, and every year or so homeowners can open up their infiltration trenches to inspect them and clean them as necessary.

However, there are some negative aspects of this process which make the construction of an infiltration trench an unattractive option. The biggest down point of this technology is that burning holes in the plastic pipes produces noxious fumes and is fairly harmful to anyone who isn’t wearing a respirator – I covered my face with soaking wet handkerchiefs while doing this work, and even then I came down with really bad headaches. Infiltration trenches also require more than 6 times as much plastic piping and sheeting than your average soak pit – but the plastic materials are so cheap compared to the cement that goes into the nyegens that the cost of an infiltration trench cannot be prohibitively expensive to anyone who is building or revamping an entire nyegen. Nevertheless, in communities sitting atop extremely high water tables, infiltration trenches are the most practical, cost-effective technology available for sound wastewater management. It is unlikely that we will be able to completely sanitize Filablena's latrines with such infiltration trenches, but my hope is that the few models which we are building will serve as an example for the entire community to one day safely contain their waste underground and away from the rest of the water supply - insh'allah.

I Say I've Got a Real Solution...

I don’t think that you have any obligation to give to charity. I don’t think that people in Mali have any right to expect your generosity. I don’t believe in Socialism, I don’t believe in hand-outs, I don’t believe that just throwing money at the endemic disease and poverty in this country is going to make anything better. The vast majority of the time, I think that the best thing for Americans to do is to let the people of Africa solve their own problems themselves.

But every once in a while, someone like Etienne Dembele rides his motorcycle up to my gate. He wanted to know if I could help him find a certain “Madu Sogoba” – Dembele had heard that he builds toilets.

“Vous êtes arrivés à la vraie maison”, dit Monsieur Sogoba.

M. Etienne Dembele explained the situation. He hails from the village of Tounto – a 12 km ride from my own Sanadougou. Tounto is a settlement of some 4,000 people who are mostly simple millet farmers. They have a market, a small clinic, a primary school. Until recently they didn’t even have a secondary school – if the children of Tounto wanted to continue their studies to the 7th, 8th or 9th grade they had to wake before dawn at the call to prayer and walk the 12 km to le Diaramana Secondaire Cycle and back every schoolday. Dembele organized the parents of Tounto to petition le Bureau de la Mairie de la Commune, le Sous-Prefet de la Cercle, even their representatives in the national parliament and every NGO they could find to try to build them a secondary school. They all said no. So Dembele spent 4 years collecting funds from the people of Tounto itself and in the last year commissioned some local masons to build the school themselves.

If you’re not really familiar with the customary patterns of development in countries like Mali, the story of Etienne Dembele and le Tounto Secondaire Cycle is about as remarkable as they come.

However, there was one little problem; Monsieur Dembele was able to raise all the funds for a schoolhouse – but he came up short to build anything else. There is no well or pump in the schoolyard, so before class each day kids have to fetch drinking water from the clinic 1,000 meters away. This is a hassle, but it’s doable.

But more importantly, Dembele wasn’t able to raise enough funds to build latrines. So when the 7th, 8th and 9th-graders have to “go to the bathroom”, they have no choice but to just squat in the field next to the schoolhouse. The schoolhouse was built in a pretty open plain by the main road going through town, there aren’t even trees or bushes to hid behind, so these kids are more or less urinating and defecating in plain sight of each other and anyone else who happens to pass by on their motorcycle.

Since there’s no nearby water source, there aren’t even the customary plastic teapots that Malians typically use to wash their hands after they cleaned their butts. Maybe the kids can find some grass or leaves and wipe their hands off. But no matter how hard you wipe your hands with a couple of twigs they really can’t get all the poop or pee or diarrhea completely off their fingers, there will always be some residual germs. And then when they come back to the classroom they’re going to share their scarce textbooks and pencils with all the other students. And of course they’re going to share whatever germs they might have.

Etienne Dembele estimates that 75 percent of all of the students at this school come down with diarrhea over the course of the year, at least 65 percent come down with full-blown dysentery because they have to learn with classmates who cannot go to the bathroom in a sanitary fashion.

The Director of the Secondaire Cycle, Monsieur Fousseyni Sogoba is a generally cheerful young professional in his early 30s. But when he speaks of the lack of sanitary facilities at his school his face contorts into a raging scowl, “My students are children as young as 12, but in the highest grade they are as old as 16, 17 years. The female students are of marrying age, and in our Muslim society it is dishonorable for a woman to be seen undressed by a man who is not her husband. For them to urinate and defecate in the open is the greatest shame. The girls who have diarrhea are condemned.”

The epidemiological hazards of open defecation effect all students equally, but the shame factor hits schoolgirls the most. When girls feel disgraced by shitting in the field for the whole town to see, they simply stop going to go to school – this is especially true when puberty hits and they start menstruating. Though women slightly outnumber men in this society, girls make up less than 40 percent of the student body at Tounto Secondaire Cycle. They make up less than a third of all Secondaire Cycle graduates.

I agree with the Peace Corps philosophy of development which emphasizes those projects which consist of pure education, which require no financial expenditures. But in certain extreme situations, no progress can come about without some significant capital investment – this is one of them.

I told Monsieur Dembele that if he was really serious about building latrines, he had to find out the prices for all the materials we would need and to write up a budget. Two weeks later, he showed up at my gate once again - with a comprehensive budget, typewritten in French. Even after checking all the prices out myself there wasn't all that much to edit. I had never before witnessed this kind of gumption and initiative and professionalism in this country, and to tell you the truth I was downright dumbfounded.

So for the first time in more than a year in Mali, I have agreed to help a local activist fund his project.

Dembele and I have submitted a proposal to Peace Corps Washington to build two first-class latrines - one for boys and one for girls – and three hand-washing stations at the Secondaire Cycle. First the people of Tounto are going to pay a team of well-diggers to excavate the latrine pits. Then after the harvest the dugutigi is going to charge the men of the village out to the fields to gather 100 donkey cartloads of sand, 60 carts of gravel and 12 carts of porous sedimentary rocks. Once these are in place, we are going to Koutiala to buy all of the cement, rebar, plastic tubes, roofing, doors, etc. Tounto is going to pay a team of masons to build the latrines, and I am going to build the hand-washing stations.

Altogether, Tountokaw are paying for 29 percent of the overall cost in labor, transport and raw materials – the labor isn’t just being donated, they’re collecting 170,000 francs (~ $400) to pay the well-diggers and masons, and another 20,000 francs (~$48) to pay for the truck to carry it all from Koutiala to Tounto. The community’s contribution in cash is roughly equal to Mali’s per capita GDP.

And once construction is complete the village of Tounto is going to be responsible for cleaning and maintaining these latrines and hand-washing stations. Most likely the schoolchildren will be doing most of the cleaning themselves. UNICEF provides the school district with some soap, but it is nowhere near enough for these kids' hygienic needs and so parents will be responsible for paying for additional soap as part of the annual school fees. And of course, the teachers will be responsible for teaching and enforcing proper hygiene practices indefinitely.

Despite the drought and the fact that this is going to be a really bad year for all of Mali’s cash crops, the village of Tounto is ready to invest a significant amount of their scarce resources into improving the sanitation at their children’s school. I cannot emphasize enough that in a community as poor as Tounto, this effort is absolutely extraordinary. But they could use some help to pay for the cement, rebar, tin and plastic without which nothing that they contribute can be of any use.

And so, if you would like to donate to a cause which will prevent diarrhea and dysentery and help girls to have an equal opportunity in education, click here.

Update: Apparently so many people donated to fund this project that all of you donors cleaned up shop within 100 hours of it being posted on the Peace Corps website, before I could even bike into the city to post this on my blog. To all of those who contributed, from here in Mali I grant you a big "In'i che kosibe kosibe!!!!!" Thank you very very much!!!!!!

And to those who wanted to donate but didn't make it quickly enough, do not fear - all signs point that after the latrines are built in Tounto, there are plenty of other schools within biking distance of Sanadougou lacking in proper sanitary facilities. Stay tuned!!!!!


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There's a Mean New Sheriff in Town

Snoop Doggy Dogg is now five months old and he is the rowdiest, most playful puppy ever! He is so disproportionately shaped it is kind of hilarious – his legs and his midsection have yet to catch up with his head and his tail, so every time he sees me coming he gets so excited that he wags his tail so hard that his entire body wags back and forth to counter the momentum! Because when Snoop Doggy Dogg sees me coming he knows that we’re going to wrestle!!!

Snoop Dogg is not only the pokiest puppy ever in the whole wide world, but he is also as dumb as rocks. One of our favorite games is Snoop will try to chew my toes and I’ll kick him in the face and then he’ll try to chew my toes again and I’ll kick him in the face... We could play for hours and it’ll never get old. When our wrestling gets really intense Snoop will try to jump on my legs and knock me down, and so I’ll do the old “Boop – got your nose!” trick and hold him by the snout and if I pin his legs down with the other he doesn’t know what to do and he wriggles helplessly and whimpers.

As dumb as he might be, Snoop is actually quite artful when it comes to wrestling other doggies. The other four puppies in his litter have been distributed to human families throughout the neighborhood, so when we go for a walk and Snoop sees one of his brothers he goes ballistic and gallops down the street to pounce on them and knock them over into the death position.



Snoop fights dirty. One of his best moves is to wait until one of his brothers is squatting to take a poop and he’ll start galloping and with a running start he’ll leap and knock ‘em over! The other puppies don’t see it coming and are incapable of mounting a defense! For such a dumbass he’s a brilliant tactician.

So I was walking with Snoop down the road to my jatigi’s house, past the clinic where all the moms come to bring their shriveled little babies dehydrated from giardia diarrhea or amoebic dysentery, past the brand new schoolhouse and nyegens that the Japanese NGO just built and past the field where the kids run and play and defecate.

Karitie was right – the elementary schoolchildren continue to shit outside even when there are brand new, nice and clean nyegens open and available for their evacuating pleasure. And it’s really funny watching these kids try to hide themselves out of sight and pulling their pants down far enough to hide their little butts – they don’t want anyone to see that they’re taking a dump, and they’ll go out of their way to crouch down low in the field so that no one can see them, but they won’t walk 20 meters further to the nyegen where they could do their business behind closed doors. Often I will walk by and the kids will be shitting right next to the brand new nyegens. The issue isn’t that there aren’t enough nyegens per head or that they are improperly maintained (I have already taken care of that). The issue is that kids in Mali grow up the first four or five years of their lives naked from the waist down and their parents just let them shit wherever they feel like it, and when they start going to school at age six its difficult to get them to change gears and undo the most terrible of ingrained habits.

“Open defecation” – the technical term we sanitarians use for shitting in a field – is just about the worst behavior which kids could possibly conduct on the elementary school grounds in terms of disease transmission. This isn’t an issue of cultural relativism – it’s an issue of life and death. Sanadougou is a village where the 2nd highest cause of child mortality is diarrhea, a symptom of bacterial or parasitic infection which is transmitted by fecal contamination of water sources or the simple hand-to-mouth route. Allowing Malian kids to take a dump in the same field where their friends play soccer is like allowing prostitutes in Mozambique to sell sex without a condom, it’s like allowing American kindergarteners to bring a semiautomatic rifle to show-and-tell – this behavior is downright dangerous and it is irresponsible for adult members of this society to let it continue without punishment.

“I know it is very bad, that is why I teach the children to poop in the nyegens!” Karitie says.

“Well apparently your lessons haven’t been absorbed very well because your students are still shitting in the field.”

“We teachers have more important things to teach the children such as spelling and mathematics! You don’t have to teach class, so you should teach them that pooping in the field is bad.”

“Will you let me teach the first-graders a class on how to go to the bathroom?”

“No, now they must become literate. But from now on when you see children pooping in the field you should beat them! I, as Director of the Schools of the Commune of Sanadougou, grant you explicit permission to use corporal punishment to instill discipline.”

“NO!!! If I did that then the Peace Corps would like court-martial me or something.”

In truth, when I see these kids crapping in public I should beat them. However, I do not believe in using violence unless it is absolutely necessary and instead prefer to combat unsanitary behavior through the hard power of economic incentives and the soul power of satyagraha i.e. active non-violent resistance. Without a mechanism for negative reinforcement these hazardous habits will continue unabated, so I need to develop some non-violent means of associating the act of open defecation on the elementary school recreation field with the due consequences of filthiness and public humiliation. These negative repercussions need to be hammered in so deeply that the association between open defecation and shame is internalized and they will cease such atrocious behavior on their own.

I will never beat the kids in my village but I will let my puppy play with them. Forget about Pavlov’s dog – the schoolchildren of Sanadougou elementary are getting to know Madu’s dog!

It turns out that building a lifeguard chair on the field next to the schoolhouse is unnecessary because I have a perfectly expansive view of that field from my concession. While I’m working in the garden or even while I’m reclining under my gwa shoving mangoes into my face I can spot these evildoing dirty-bombers with ease.

Now I’m beginning to conduct an experiment in social psychology and public sanitation in which every time I see kids defecating out in the open, I rile up Snoop Doggy Dogg and get him in a playful wrestling mood. And I open the gate and lead him towards the schoolyard.

“See that little boy squatting in the field? He’s your new friend! He wants to play with you!”

Snoop then goes galloping into the sunset to show these kids some tough love – tough puppy love, that is!



Awwwwwwwwwwwwwww

Calling All Soapmakers!

As a Peace Corps Volunteer serving in Mali, I am doing my part to improve water sanitation on the village level. Due to the utter lack of infrastructure, the vast majority of Malians have nothing to wash with other than well water often contaminated with giardia, amoebas and other parasites transmitted via the fecal-oral cycle. This is among the reasons– and without a doubt the most easily preventable one – why juvenile diarrhea is endemic and 25 percent of all children in Mali die before age five. It is also the reason why I would like to enlist American pharmaceutical companies such as Unilever, Colgate-Palmolive, Jergens, Proctor & Gamble or Estée Lauder to help fund the construction of hand-washing stations at Mali’s public schools.

Here in Mali the most widely-practiced sanitary practice is that people wipe with their left hand and eat with the right. After going to the latrine and before eating people will rinse their hands with tin can full of water, but when one has fecal germs on their left hand and they just get it wet and mush it around with their right hand, and then they pass the can of now-filthy water to the next person to “wash” their hands, it kind of defeats the whole purpose. Add the fact that Malians eat with their right hands from a communal food bowl, and it is not very difficult to understand why giardia, amoebas, cholera and dysentery are so widely transmitted.

The most feasible, cost-effective means for Malians to mitigate disease transmission and improve health conditions is something quite simple: washing one’s hands with soap. It doesn’t sound very profound, but the Malian Ministry of Health has invested a good deal of its resources organizing adult education programs and broadcasting public service announcements to persuade her citizens to undertake this basic hygiene practice. It should be any easy task. Soap is cheap and readily available; most Malian women are in some way, shape or form involved in the collection of shea nuts or the cooking of shea nut butter which is used to make soap.

Malians use soap made from their shea nuts to wash clothes and dishes, but oddly enough very few people use it to wash their hands. Animist beliefs shared by many Muslims and Christians extol the benefits of washing one’s hands with only water to protect against malevolent spirits, and many people believe that using soap would render them vulnerable to sorcerers’ evil spells

Though a number of Malians are trying to do away with these superstitions and espouse modern sanitary measures. Karitie Sanogo teaches his first-grade students how to conduct basic hygiene practices like washing their hands. To Westerners this might sound like condescension, but when most adults believe in the black magical qualities of soap the fact is that the only way majority of Malian children will ever be taught to protect themselves from fecal-oral diseases is through the public school system. Sanogo explains that he tries in earnest to teach his first-grade students the virtues of soap, but it is difficult to instill modern hygiene in impressionable minds when they cannot even practice their lessons into their daily routine at school.

There are brand new latrines at the elementary school, but there is no place for the students and teachers to wash their hands when they are done. So the headmaster would like to construct a hand-washing station. A hand-washing station would consist of two plastic barrels with spigots raised to a reachable height for children by a concrete structure. Most importantly, each station would be made with a soap dish so that every time a child walks from the latrines back to class they would have an obvious and unavoidable opportunity to wash their hands with soap.

The most difficult aspect of projects like this is not their construction per se, but rather their financing. If I wanted to build just one or two of these hand-washing stations, I could acquire funds from U.S. A.I.D. or the U.S. Embassy. Though what I have in mind is on a somewhat larger scale. There is a program known as the Peace Corps Partnership which allows Volunteers to work on projects financed in whole or in part by private individuals, NGOs or corporations. In this sense capitalism is not just a means unto itself but can be used as a means to humanitarian ends.

I would like to petition one of the aforementioned corporations to establish a fund for Peace Corps Volunteers to construct hand-washing stations throughout Mali, or even Africa at large. Much of this shea butter cooked from Malian harvests is consumed locally, and in recent years Western companies have begun to purchase Malian shea nut butter to manufacture gourmet soap, moisturizing cream, shampoo and conditioner. I would like to argue that those companies which earn hundreds of millions of dollars of profits selling shea butter products have an ethical obligation to invest a negligible fraction of those profits into promoting the hygiene of those populations at the bottom of their supply chain.

Even from the rational self-interest of a profit-maximizing firm investment in hand-washing stations is beneficial in that they are meant to create a whole new generation of consumers of soap. The fact that tens of millions of people in Mali and elsewhere actively refrain from washing their hands with soap should be seen as a lost consumer base which can be captured with a bit of public education and investment in simple sanitation infrastructure. Even if the company does not sell its products in Malian markets, the good publicity which such a humanitarian campaign would engender could certainly help to establish a favorable reputation among socially-conscious consumers.

This is a win-win proposal which would benefit both soap producers and the people of Mali. So please, if you happen to work for a company that makes shea butter soap, shampoo or moisturizer, or if you know anyone who does, please drop me a line. There are a number of Peace Corps Volunteers in Mali who would like to put together a joint venture.

Upholding and Defending My Own Constitution

In more personal terms, upon my arrival the dugutigi (village chief) let it be known that I ate was to be adopted as a son by a teacher Karitie and his family who live down the road from me. This arrangement could not possibly be any better for yours truly. Karitie speaks fluent French, so he is able to teach me the nuances of Bambara quite well. Besides being the best cuisinière in town, his wife Durukas is also one of the most educated and informed women whom I have met thusfar in Mali – she is an advisor to the Mayor. Their sons Kam and Jafete and their daughter Diko act as my teachers as well; they are helping me navigate Malian youth culture, to fully appreciate American hip hop and Jamaican reggae, and with the their help I have received the worst haircut in my life – I should have known it was a bad sign when la coiffure muttered “I’ve never given a white boy a haircut before.” So in conclusion, I tried to make lemonade out of this lemon of a situation and I shaved my head.

… But I digress. So I reiterate that during the first three months at site I am supposed to take it slow and get a feel for the community in which I am living and working – I’m not just plopping down here and starting to dig wells willy-nilly. Even without constructing a new water pump, merely getting my own house in order and understanding what is going on here is difficult enough for the time being.

My number #1 priority at the time being is to carry out the first imperative of Mission Number 0079 and maintain the Constitution of Zachary Asher Mason. I reiterate that with all of the mosquitoes, flies, ants, beetles, termites, hookworms, roundworms, tapeworms, centipedes, millipedes, crickets, cockroaches, praying mantises, amoebas, giardia cysts, lizards and other organisms who would like to feed off of yours truly and my own supply of nourishment, this is no simple undertaking.

At this incipient stage of my existence as a member of Malian society, my modus operandi has been heavily influenced by the strategic thinking of George Kennan. As the Red Army had ensconced its dominion over Eastern Europe by the conclusion of hostilities in 1945, Kennan realized the futility of attempting to roll back the Communist bloc by sheer force and the dangers which such overreach could impose on America’s immediate national security interests. Likewise, I believe that I must first focus on the maintenance of my direct interests in surviving through September 2010, and even if I do nothing more than strive incessantly to preserve my own health and to contain the spread of water-borne diseases to my own person, the worst that can happen is that the strength of my example will rub off on my neighbors so they might improve their sanitary practices in kind.

The most difficult aspect of maintaining my own health is not the direct hazards of any non-humanoid organisms per se, but rather excluding myself from what water sanitation extension agents refer to as “the fecal-oral cycle”; in other words, how germs get from your poop to your mouth. In Mali, certain cultural practices make this mode of disease transmission rather facile.

As spelled out in the classic Sanitation Without Water – a must-read for anyone interested in the anthropology of anal cleansing,

“A basic distinction between people is that some are ‘washers’ and some are ‘wipers’. There words refer to how people clean themselves after they have excreted. Washers use water, wipers use some solid material like grass, leaves, paper, sticks, corncobs, mud balls or stones (Winblad and Kilama, 1985).”

The vast majority of Malians are what Winblad and Kilama would categorize as “washers”, and though most adults have had extensive practice with the plastic teapot method, from time to time even the most experienced washer inevitably gets a little bit of poo on his or her finger.

If everybody here ate from their own separate plate from their own separate utensils, this would be no big whup; but the traditional method for Malians to eat their meals is for everybody in the family and any guests to share from the same common food bowl – and everyone eats with their hands. And so it is not very difficult for the layman to understand why the fecal-oral cycle is such a common means of disease transmission, particularly for such illnesses which result in the symptom of messy diarrhea which will inevitably get all over one’s fingers such as cholera, dysentery, giardiasis and amebiasis.

The fecal-oral cycle could be easily discontinued if those who suffer from nasty diarrheal disorders were to wash their hands thoroughly with soap after taking a dump and again before eating from the communal food bowl. And that is why every time I sit down to eat from Durukas’ bowl of delicious rice with peanut butter sauce, yams or beans, I see to it that everyone eating with me washes their hands like it’s their job – because it actually is my job.

The very simple practice of washing one’s hands with soap is without parallel the easiest, cheapest, most effective means of reducing the transmission of potentially fatal diseases; however, many people are still reluctant to do so. As continued in the literary masterpiece Sanitation Without Water,

“In all cultures there are taboos surrounding defecation practices. Your enemy, if he gets hold of your faeces, can cause you great harm. Evil spirits may live in the pit… Religion may even lay down rules for cleaning after defecation (Winblad and Kilama, 1985).”

Many times when guests come to dine at Karitie and Durukas’ house, they are taken aback when I tell them to wash their hands with soap. It’s not an economic issue – everyone has soap to clean their clothes and their dishes, for soap is widely available and easily affordable. Pretty much every woman in Mali is involved in the collection of shea nuts and cooking them into shea nut butter soap.

Washing one’s hands with soap is more of a problem of superstition. You see, in Mali people are accustomed to washing their hands with only water, for soap is thought to wash away one’s luck. More specifically, I was told by one man who was reluctant to soap up his hands that if he did, then he would render himself vulnerable to the shubagaw – sorcerers who could then curse him with evil spells. He then lifted up his right hand curled in deformity, explaining that sorcerers wishing him ill transformed into bees and stung his hand to cause its present condition.

I cannot articulate in words just how frustrating it is to try to explain germ theory and disease transmission to someone who believes that sickness comes from magic spells.

So when put on the spot, I have to be blunt, "Today you were working with your father's cattle all day long. And the last time you took a dump, maybe a little bit of your poop got on your hands. You cannot see them, but there are little pieces of poop on your hands. If you dunk your hands in water, all you're doing is getting the little pieces of poop wet. I don't want to eat poop, so if you want to eat with me you have to wash your hands - with soap. I want to see bubbles."

I understand that it is a sensitive topic - nobody likes to talk about ingrained cultural practices regarding fecal matter when they are sitting down to eat. But my host family is on my side, so when push comes to shove they tell their guests that the village wanted a Water Sanitation volunteer for a reason, and that I am right - and that they should wash their hands with soap when they're dining with me or not.

I try my best not to be patronizing, especially with adults. But I don't want amoebas living in my gut, so sometimes spelling out the fecal-oral cycle in graphic detail is necessary when it comes to preserving and upholding my own constitution.