Male Circumcision is Not Genital Mutilation

One evening I was dining with my anthropologist friend Natalie and I expressed just how viscerally and zealously I abhor the African practice of female genital mutilation. As a male champion of women’s rights and a lover of the female form I believe that there is no reason to hack off a pubescent girl’s clitoris and/or labia other than to make the act of intercourse painful, to deprive women of their inherent sexual freedom and to oppress them as a permanently subservient class. I think that female genital mutilation is such a patently wrong act, a reification of misogynist and phallocentric violence that should be prohibited and criminalized. Anyone who practices female genital mutilation is a menace to society, and our police forces should lock them up behind bars.

Natalie threw a wrench into my crusade for the sanctity of the clitoris; “But Zac, aren’t you Jewish?”

“Yeah, so? What’s that have to do with anything?”

She looked down in the direction under the table and cleared her throat.


At that moment I realized the hypocrisy of my zeal. I was so humbled and dressed down that I concluded that when speaking of subjects as delicate as a culture’s practices pertaining to the sexual organs – especially those of cultures that are not one’s one – perhaps one should generally abstain from casting matters in sweeping judgments of “right” and “wrong”. I’m not saying that one shouldn’t criticize the genital practices of foreign cultures; sometimes one must. But perhaps we should limit our analysis to those things that we can prove at least somewhat scientifically and avoid subjective critiques of metaphysics and postmodern gender theory.

My friend Natalie isn’t the only one who thinks that my righteous indignation against genital mutilation should apply to both genders. There is in fact a growing faction of feminists, human rights activists and lovers of the natural male form want to broaden the definition of assault to include those who circumcise the foreskin. The self-proclaimed “Intactivists” advocate for the preservation of “genital integrity” and an end to the practice of male circumcision – or “male genital mutilation” as they prefer to call it.


One such group known as the Bay Area Intactivists values the foreskin as a nerve-rich portion of the male genital organ. From their perspective, male circumcision is means of denying to a male and his future partner(s) the potential for maximum sexual satisfaction.


Other groups such as Intact America are organizing the opposition to male circumcision from comparatively more scientific, rationally more compelling grounds. If you read their literature, you get the sense that they represent a faction within the American medical community who oppose the practice under the logic that 1. the act of circumcision can be painful; 2. it can lead to infections and other harmful complications, and 3. removing the foreskin is not medically necessary.


Now the combined Intactivists of San Francisco have garnered enough signatures to put a referendum on the ballot which extend the definition of assault to those who circumcise males under the age of 18. If the proposition passes, the circumcising of a male’s foreskin would be a misdemeanor offense punishable by up to a $1,000 fine or up to one year in jail. The consent of the underage male in question would be irrelevant; a male could only consent to having his foreskin removed if he is a legal adult. There would be no religious exemptions.

The movement to utilize the compelling force of criminal law to prohibit male circumcision is not without foundation. After all, since federal legislation was passed in 1996, Section 116 of the U.S. Code has defined whomever “circumcises, excises, or infibulates the whole or any part of the labia majora or labia minora or clitoris of another person who has not attained the age of 18 years” as a perpetrator of assault. The Intactivists make a reverse-sexist argument that by creating a set of legal protections for women – but not extending those same protections to men – the continued legality of male circumcision is a violation of the Equal Protection Clause.

As much as this blogger disagrees with the claims of the Intactivists, I am equally critical of the campaign by the Anti-Defamation League and the American Civil Liberties Union who are arguing against the San Francisco ballot measure in terms of religious freedom. If a federal judge were to strike down a municipal ordinance banning male circumcision because it is a violation of the Jewish people’s freedom to exercise our religion, then that same judge would have to uphold the right of West African Muslims to practice female genital mutilation on the same grounds. This would be an argument of cultural relativism; e.g. “Yes, it is a barbaric practice, but we live in a barbaric society in which cruelty and torture are woven into the fabric of our culture.” This is not the argument that the defenders of male circumcision ought to take.

If defenders of circumcision are going to make a valid argument based on moral logic and reason, one must contend why the practice itself is not just a tolerable tradition with religious significance but actually a positive good with secular and tangible benefits. And moreoever, it doesn't hurt to deconstruct the logic for the argument against circumcision.

From what I gather after a comprehensive reading of their literature, the moral logic of the Intactivist movement runs as following:

1. Female circumcision is a cruel, inhumane practice which can cause disease and pain over the course of the victim’s lifetime. (Given)
2. The only reason why cultures practice female circumcision is to make the act of sexual intercourse excruciatingly painful and undesirable. (Given)
3. Therefore, female circumcision is a form of assault (1, 2)
4. Gender is only a social construct, there is no substantive difference between men and women, in fact, the binary characterization of human beings as either men or women is a form of gendered chauvinism. (Given)
5. Therefore, male circumcision is also a cruel, inhumane practice (1, 4)
6. Therefore, the only reason why Western culture practices male circumcision is to make the act of sexual intercourse excruciatingly painful and undesirable (2, 4)
7. Therefore, male circumcision is a form of assault (5, 6) Q.E.D.

The crucial fallacy in this logical argument is postulate number 4. Though traditional gender roles and identities might be a mere social construction, it is more than fair to say that there is, in fact, at least one significant difference between the vast majority of individuals born as males or female; generally speaking, males are endowed with penises and females are endowed with vaginas. In light of this fundamental distinction, the removal of the clitoris and/or the labia should be banned while the removal of the foreskin should remain legal because there is in fact a very compelling case to be made that male circumcision and female “circumcision” are two very different operations performed on two very different organs which ought to be distinguished as such under law.

Intactivists’ Sophistry #1: “Surgically removing part of a baby boy’s penis causes pain.”

If one were to practice circumcision with the same crude instruments and techniques as say, the Dogon tribe of Mali, then it is indeed an unnecessary painful procedure. The Dogons gather all of the uncircumcised boys 12 years old and up and to have the village blacksmith remove the boys’ foreskins with a homemade blade which is not very sharp by Western standards – and they perform the operation without any sort of anesthetic. Perhaps this argument over pain might be valid if Jews in America were to practice circumcision in a way similar to the Dogons; if that were the case, maybe circumcision should be prohibited under law.

The modern Diasporic Jews of America, however, have developed a method of circumcising our boys at the age of eight days when the nerves of the appendage are not as sensitive as a pubescent boy and we utilize various means of anesthesia which all but eliminate pain. The most effective of these is nerve-block applied locally with a shot to the penis – a remarkably effective anesthetic which renders the applied area completely numb. Rabbinical student Josh Stanton and Dr. Anne Epstein write: “While the idea of an injection to the penis sets teeth on end, it is as close to pain-free as we can get in this sort of minor surgery… It hardly hurts.”

Just about any operation involving the cutting of flesh – even an operation as minor as a tonsillectomy or the removal of an ingrown toenail – would be painful without anesthesia. But if the prick of a needle was reason to ban a medical procedure on the basis of pain, then banning circumcision would make no more sense than banning tetanus or polio vaccinations. In this day and age of modern anesthetics, the contention that circumcision should be banned because the procedure causes pain holds little ground.

Intactivists’ Sophistry #2: “Male circumcision creates immediate health risks and can lead to serious complications.”

Indeed, a botched circumcision could lead to an infection of the penis or worse. In cultures that perform this operation with crude tools and unsanitary conditions – such as the Dogon blacksmiths with their homemade iron blades – yes, the removal of a boy’s foreskin does sometimes lead to more serious complications including not only local infections but hemorrhage, scarring, difficulty urinating, loss of part or all of the penis, and even death. According to the Center for Disease Control, between 2% and 8% of all circumcisions performed in African cultures lead to an infection or more serious complications.

However, such fears are essentially unwarranted in the developed West because we utilize modern medical practices, the doctors and mohels who perform circumcisions are rigorously trained, and we perform the operation in a sanitary environment. Even if the most basic aspect of male circumcision remains the same, the cleanliness of our foreskin-cutting arenas, our medical instruments and our practices make a world of a difference. Local infection is still nevertheless possible – but then again, even having your bellybutton pierced can lead to an infection if it is not done by the right person in the right place the right way.

Whether an adequately trained, certified mohel conducts a circumcision in a synagogue or if a bona fide doctor circumcises a baby boy in a hospital, the risk of immediate health risks with serious complications is extremely small. According to the CDC, the rate of complications due to male circumcision in the United States is around 0.2% of all cases – in other words, just about negligible.

Indeed, the medical Intactivists are correct when they argue that male circumcision can cause infections – there is that 1 case in 500 in which the circumcision does lead to a complication – but that fact cannot be adequately evaluated in isolation. In a study of circumcised boys in Washington State conducted over the course of a decade, it was found that for every circumcision complication there were 6 urinary tract infections prevented. Circumcision also reduces the chance of contracting human papillomavirus (and thereby penile cancer), genital herpes and HIV.

Intactivists’ Sophistry #3: “Male circumcision is unnecessary” because “Claims that circumcision prevents HIV have repeatedly been proven to be exaggerated or false. Only abstinence or safe sex, including the use of condoms, can prevent the spread of sexually transmitted diseases including HIV/AIDS.”

At this point in the evolution of homo sapiens, the continued possession of a foreskin actually poses a risk to the health of males and those who have sex with them. The main reason why not circumcising a boy creates a health risk is that this vestigial structure creates a cavity which can retain smegma which can sit and fester, inviting bacterial and viral infection. Uncircumcised males are more likely to contract and transmit HIV than those who are circumcised, largely because the smegma which can be retained in the foreskin allows for the transmission of the virus to and from vaginal fluids. In addition, the foreskin has considerable surface area which renders the penis more susceptible to minor trauma and ulcerative disease – thus increasing the chance of transmitting the HIV virus.

A 2000 study of the relationship between male circumcision and heterosexual transmission of HIV in Africa noted “a substantial protective effect of male circumcision on risk for HIV infection”; finding that the risk of HIV infection in circumcised men was 44% lower than those who were uncircumcised. The strongest association between circumcision or lack thereof and HIV infection rates was found in high risk populations (e.g. patients at STD clinics) for whom the adjusted relative risk was 71% lower for those who had been circumcised. Another study conducted in 2003 found that the risk of HIV infection in circumcised men was 42% lower than their uncircumcised counterparts.

More macro-level epidemiological studies indicate that the practice of circumcision is not limited to the individual men but also the population as a whole; after all, if a man has contracted HIV due to his smegma-retaining foreskin, he is then liable to transmit the virus to his sexual partner(s), who are then liable to transmit the virus to their sexual partners, etc. African and Asian countries in which less than 20% of the male population has been circumcised have HIV infection rates several times greater than comparable African and Asian countries in which more than 80% of the male population has been circumcised. Of course, there are many other variable including religious mores and sexual norms which also vary among these countries, but the link between relatively high rates of circumcision and relatively low rates of HIV infection is so strong that the value of the practice as a significant factor in reducing disease transmission cannot be ignored.

I have heard a number of objections to this kind of analysis; namely that such studies have only been performed in underdeveloped Third World nations and not the developed West. These skeptics contend that since Americans and Europeans have better hygiene than the typical African, since we generally practice monogamy, wear condoms and bathe regularly we do not need to bother with circumcision.

Such First World-centrics are faulty in their reasoning, particularly because the studies linking the lack of circumcision to higher rates of HIV infection found the greatest correlation in the most at risk populations – precisely those persons in the United States who are the most likely to have sex with multiple or even concurrent partners, those who do not wear condoms, and those who have the worst hygiene. The mere fact that one might reside in the Global North does not separate that person from the basic facts of virology which tend to be associated with the Global South. Likewise, if circumcision has been found to be an effective method of minimizing the HIV epidemic amongst homo sapiens in sub-Saharan Africa, absent any fundamental anatomical or physiological distinction between Americans and Africans, there is only reason to conclude that that practice remains effective amongst homo sapiens in the United States.

I have also heard the argument made that circumcision is unnecessary for homosexual men, because the studies cited above have only demonstrated a link between circumcision and reduced prevalence of HIV amongst heterosexual men. This Intactivist argument maintains that for a parent to decide that they will circumcise their boy to protect him from HIV and AIDS is to make a heteronormative assumption that their child is in fact straight, and that if their boy turns out to be gay then they will be deprived of sexual satisfaction due to a societal bias towards heterosexuality.

This Intactivist sophistry is not only spurious in its logic but quite dangerous in its potential for giving homosexuals a false sense of security. Though the possession of a foreskin is most likely to transmit disease via the mixing of smegma and vaginal fluids – which is exclusive to heterosexual intercourse, that is not the only reason why possession of the foreskin increases the chance of disease transmission. Disease can also be transmitted because the foreskin is more easily susceptible to tearing. One must also take bisexuality into consideration; an uncircumcised man could very easily receive the HIV virus by trading fluids with an HIV+ woman and later on transmit the virus to a male sexual partner (or the other way around) explicitly due to his possession of his original foreskin.

Read Intact America’s sophistry again: “Only abstinence or safe sex, including the use of condoms, can prevent the spread of sexually transmitted diseases including HIV/AIDS.” This is more or less the logic of abstinence-only sex education; “if you don’t have sex, then you can’t get a sexually-transmitted disease; therefore don't wear a condom”; “if you always wear a condom, then you can’t get a sexually-transmitted disease; therefore you don’t need to be circumcised.” The problem with this logic is that uncircumcised men do have sex, sometimes they use condoms, sometimes they don’t, sometimes they have sex with a condom but the condom breaks, etc. Even the highest-quality prophylactics can fail - that is why instead of relying on the effectiveness of one or two disease prevention methods, it is best to employ as many as possible.

Intact America is telling the truth when its literature states that circumcision is not the only way to prevent the transmission of HIV, that abstaining from sex or practicing safe sex are alternative ways of preventing disease transmission. But they're not telling the whole truth. “Male circumcision is unnecessary”; indeed, for a practitioner of celibacy there might not be much of a benefit, but for everyone else it remains a very sound, particularly effective means of reducing the transmission of disease. There is no silver bullet which can by itself inoculate an individual from HIV/AIDS, no one is claiming that circumcision can by itself rid the world of this deadly epidemic. Rather, medical proponents of circumcision are contending that it is but one of many practices which ought to be maintained – along with fidelity to one’s partner, safe sex, regular testing – in order to defend oneself from STD transmission.

Likewise, the Intactivist movement is making a grave mistake in trying to ban male circumcision under the guise of public health; their pseudo-scientific case to ban the practice is so full of misleading language, cherry-picked half-truths and outright falsehoods that it cannot be taken seriously. Perhaps there are other reasons why a parent might reasonably decide to opt to not circumcise their male child – religious, sexual, aesthetic or otherwise – but the health of the child is not one of them. Male circumcision is not genital mutilation; it is a sound medical procedure which is safe, which does not cause undue pain, and it is still a very effective component of our society's efforts to maintain men's health and curb the spread of disease in America and throughout the world.

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.

Eating With My Hands

To preclude accusations of “cultural imperialism” the educational philosophy of the Peace Corps is all but one of cultural relativism. We are supposed to teach the people of developing countries about which new varieties of sorghum offer the highest yields, how to start a business and manage their accounts, sometimes we work in the classroom as math and science teachers – but we’re supposed to teach only objective truths and we’re explicitly not supposed to tender criticism of our host country’s indigenous culture. Understandably, few self-respecting nations which have lived through the humiliation of Colonialism – particularly those nations which have suffered under the yoke of French overlords who appointed themselves mission civilatrice and sought to discredit and dismantle the beliefs of tribal heritage – would now petition the United States to come and tell them that their culture is wrong.

However, maintaining a position of absolute political correctness is impossible when the prevailing practices in a given field are in fact objectively wrong. When Malians greet me “bo swa” at 8 in the morning, when bus drivers have filled their car beyond the legal maximum capacity and tell me to cough up more cash so they can bribe the police, when people ask for leaves from my lemon tree so they don’t feel guilty about not buying real medicine for their child in a malarial coma, it would be a disservice for me to just go along with the prevailing practices of this culture and not criticize the way people live in this country to their faces. Of course a liberal would argue that all of the above are the muddling of Western modernity, so all of this present-day African nonsense can be attributed to the corrupting influence of French colonial rule. But some of the most self-defeating customs which people follow here were established long before there even was such thing as a France, it would be obtuse for thinking people to subscribe to the absolutely non-judgmental broadmindedness of mushy-headed liberalism and tell themselves “it’s not wrong, it’s just different.”


Perhaps the most difficult custom for a mushy-headed liberal to digest is the way that Malians eat – because it is an objective truth that the traditional way of eating is one of the most significant vectors of disease transmission in this society. Malians by and large eat their food with their hands, and so long as they are eating with family or friends they eat with their hands from a single communal food bowl. Most Malian men tend to livestock and spread their manure over the fields, almost everyone wipes their butt all women wipe their children’s with their left hand; somehow or another over the course of the day their hands are likely to come into contact with fecal matter. Hardly anyone ever washes their hands with soap, so when Malians eat with their hands from the communal food bowl they share and consume each other’s fecal germs. Hence the primary reason why giardia, dysentery and all other forms of severe diarrhea are endemic in this culture is the purely cultural factor of how one brings food to one’s mouth.

When I arrived in Mali for Peace Corps Training, the language and cultural teachers collected me and my fellow trainees into groups of six, sat us around big aluminum bowls of zamé: fried rice with chunks of beef, cabbage, hot peppers and onions. The object of our lesson that day was to learn to eat our lunch with our hands. This task was not so daunting for a dedicated multiculturalist such as myself; I had spent a month in Sri Lanka where I learned the Indian subcontinent’s method of folding one’s four fingers into a V-shape to scoop up a mouthful of rice and sauce and pushing it towards one’s mouth with the thumb – the Sri Lankan finger scoop method could be so refined that at the end of a meal an apt practitioner should have their palm perfectly clean. In my prior experience, eating with my hands was something exotic and worldly.

“Exotic” – yes, but “worldly” is not the first word that usually comes to mind as a Westerner watches Malians eating with their hands. Unlike the Sri Lankans and their graceful finger scoop, a Malian is wont to grab a heaping handful of rice with their right hand, squeeze it in their palm, open their mouth as wide as they can and place their palm to their bottom lip as they shove the handful of rice into their gaping gullet, then thrust the entirety of their four fingers deep into their mouth so they can suck off every last drop of sauce. If they are the staple dish of grayish-green millet goop called toh, Malians will cup their hand a little more as they dip the millet goop balls into a separate bowl of sticky sauce made from baobab leaves, dried fish and peanut oil – the sucking of the fingers remains the same. All of this is done as quickly as possible with no conversation between wolfing down handfuls of food, because the faster one eats the more they can consume. After they have eaten their fill, a Malian licks his or her saucy hand clean in a manner not unlike that of a cat preening the fur on their head.

I went with the flow as I tried to integrate into the family of Karitie Sanogo and Durcas Dembele and their Minianka subgroup of the Bambara tribe. I found eating with my hand sloppy, and it was quite impractical if I was eating lunch alone and trying to read a book. But when I sat down with a group of men around the communal food bowl, I thought “When in Rome…” and shoveled away. I feared that eating with a fork or a spoon would set this hairy, light-skinned Jewish boy apart as an even more distinct Other.

Cheap aluminum forks and spoons are widely available at any sizeable market for no more than the price of a small box of tea, so there were some times though when I wondered how Malians had never developed the custom of eating with utensils by their own initiative. On special occasions Durcas would cook spaghetti seasoned with a bit of tomato paste and a heaping volume of peanut oil, and since food here is served directly from the kitchen with no time to cool off people would begin to dig in while the oil on the spaghetti was still scalding hot. The oil would be so hot that even the old men with their thickly-calloused hands would be wincing at the touch. And long strands of spaghetti are not designed to be eaten manually; every time the men around me would reach down for another painful handful they struggled to shove eight inches of floppy, steaming noodles into their mouths – at least half of the spaghetti strands would be dangling out of their mouths as they chewed, splattering hot burning oil all over their faces and all over their clothing. All of the men seemed to be in such pain and discomfort that it was hard to believe that any of them really enjoyed eating this impractical delicacy.

After a few experiences with this nonsense, the third time that Durcas prepared spaghetti I came equipped with a fork and showed them a much more efficient way of twirling it into practical, bite-sized portions. “You see, not long after the Italians learned how to make spaghetti they invented these things called forks so that they could it without burning their hands and making a mess with the sauce.”

“Maybe they eat with forks in Italy” I was reprimanded, “but here in Mali we eat with our hands.”

“Suite yourself” I thought, and twirled my spaghetti with a fork as all the other men in the family continued scalding their hands.

So long as we weren’t eating spaghetti covered in scalding-hot oil, I thought that eating manually from the communal food bowl didn’t have to be a bad thing, for I could use every meal as a forum to inculcate proper hygiene by washing my hands with soap and water and insisting that every man I ate with do the same. This should be no minor formality in a society of people who wash after defecating by sticking their left hand up their asshole, scrape their rectum with an extra-long pinky nail, and then flush their asshole clean with water from a plastic teapot. Malian culture stresses that anal cleansing is to be conducted exclusively with the left hand – “the good hand”, and that one eats with only the hand on the right – “the rice hand”. But all of this business about separating the right hand from the left comes to naught only a few seconds after anal cleansing when Malians “wash” both hands with only water from that same plastic teapot which was up their asshole only moments ago. Before eating from the communal food bowl, they will pass a calabash or tin can full of water around in a circle starting with the eldest so that everyone can mush their left and right hands together in the increasingly-filthy water. In this culture where just about everyone is completely ignorant of modern germ theory, people think this is actually a hygienic practice.

The fact of the matter is that the prevalent Malian “hand-washing” practices is one of the primary reasons why the population of Mali suffers from more giardia and dysentery than almost any other culture in the world, it goes a long way in explaining why 2 out of 5 children in this country die before the age of 5 and why life expectancy is only 45 years for men, 48 for women. If a circle of men are mushing their shitty hands together in the same calabash of water then after the calabash has gone around everyone has the fecal matter of other men on his hands. And if these men are then eating with their hands from the same bowl of rice or toh, over the course of a meal they are most likely consuming each other’s fecal matter. The Minianka village in which I have lived for two years is an unwittingly coprophagic culture, for a person to eat with their hands from a communal food bowl without having adequately washed their hands is to directly subject other people to the consumption of human feces.

I don’t think that it is going too far out on a limb to say that traditional Minianka eating habits are not just distasteful to the cultural norms to which I am accustomed but objectively wrong. Let’s say that I had in my possession a syringe containing Ebola – wouldn’t it be immoral for me to inject it into an innocent bystander and infect them with the deadly virus? Or if someone knew that they were infected with HIV, wouldn’t it be immoral for them to exchange bodily fluids with another person and subject them to that deadly disease? Knowing that the consumption of human feces is a surefire way to make someone sick, wouldn’t it be wrong to furtively slip a fresh stool from a cholera patient into someone else’s milkshake? How about if someone with dysentery wipes their ass with their hand and then puts his hand in someone else’s rice bowl? Even if someone has yet to be diagnosed with a particular malady, in this day and age when (at least in the Western world) people understand how diseases are transmitted it is unambiguously wrong to engage in practices known to spread serious illness. Ignorance might obviate moral culpability, but it does not change the fundamental wrongness of a practice which inflicts harm upon others.

Where the Peace Corps Volunteer comes into the equation to break the cycle of disease and poverty is to simply eat with the people and still live up to our own standards of cleanliness. Accepting the fact that the Minianka villagers of Sanadougou crouch around a communal food bowl to eat with their hands, I made my point of washing my hands with soap before eating and insisting that all the other men eating with me do the same. I even bought this nifty plastic contraption to replace the calabash so that everyone could wash their hands with a clean, non-toilet plastic teapot over a receptacle without dirtying their hands in other people’s filth. I was eating with the Director of the elementary school Karitie Sanogo and two bachelor teachers Lazar Balo and Boubacar Coulibaly – if there was anyone in this society who could understand proper hygiene it should be this literate elite – and even if they preferred to not wash their hands with soap they grudgingly obliged to accommodate this foreigner’s eccentric ways.


That is not to say that I didn’t have any trouble getting my eating partners to wash their hands. Karitie and the teachers were generally cooperative, but they would have guests come to eat from the food bowl on a regular basis. When we passed the soap and water around the circle, guests would usually just rinse their hands with the water and mush them together like usual. I would nag them about the soap, and they would usually retort, “In our country, we don’t wash our hands with soap – we wash our hands with water.”

“I know – and that’s why so many people in your country die from dysentery. In my country, no one ever gets sick with dysentery – it just doesn’t happen because we wash our hands with water and soap.”

Some men simply refused. “SHUBAGAW!!!” they hollered – “evil sorcerers”. Though they publicly identify themselves as Muslims or Christians, the people in Sanadougou cling tenaciously to their animist superstitions; not knowing anything about germs or viruses, they believe that illness and disease come from these evil sorcerers' black magic spells. And according to ancient lore, washing your hands with water protects oneself from such malevolent witchcraft – soap, however, negates water’s protective powers and renders one vulnerable to sorcerers and their evil ways. Grown adults seriously believe in this twaddle, to such an extent that they would raise the tone of the conversation into a shouting match.

“NO!!! I REFUSE to use soap!!! EVIL SORCERERS!!!”

“Evil sorcerers ARE NOT REAL!!! THEY DON’T EXIST!!!

At this point in the conversation, Karitie would look his guest sternly in the eye and lash them in Minianka “If you’re going to eat with the American, you have to wash your hands with soap. Just do it.”

In a society where old men are considered to be a depository of all knowledge and wisdom, people thought it was downright subversive for 24-year-old me to tell a 50-year-old cekoroba how to wash his hands. This went for anyone. Even on the occasion when the chief of the village or the Mayor of the entire Commune would come to eat with Karitie and me, without batting an eyelash I directed the upper crust of society to scrub their hands with soap. And they were duly offended. No one likes to be told that they’ve been eating shit their entire life – let alone by a foreigner half their age.

I ate like this for about a year, getting in fights with Karitie’s houseguests and winning so long as Karitie was there himself to provide the moral support. But on some occasions he would be gone on business and I would be eating alone with the teachers Lazar and Boubacar – neither of which had any desire to be cursed by evil wizards any more than the next guy, they were only washing their hands to humor their boss. One night Lazar looked me defiantly in the eye, mushed his hands in a pot of water and plunged them into the bowl full of rice, “You can’t make me wash my hands with soap.”

“You’re right. And I can’t eat with you, because I don’t want to eat rice with your shit all over it.” I got up and walked home to cook dinner by myself. Durcas was so thoroughly insulted that I had walked away from her afternoon’s work that she gave Lazar an earful; from then on before eating he would dip his hands into the soap dish while casting me the stink eye.

I put up with this shit for quite a while, but after a year of struggling to convince my eating partners about the merits of soap from time to time I would still find myself running to the nyegen with giardia. I was filtering and treating every drop of water that went into my body, so the only way I could possibly be getting giardia was from the food I was eating. I began to watch the other men eating from the food bowl more closely, and I realized that that a lot of them were merely feigning to apply soap; most dinner guests – and Lazar of course – were meekly touching the bar of soap with the tip of their forefinger and calling it a day. Apparently they thought that hand-washing with soap was just some sort of Tubab eating ritual (though it isn’t – we don’t eat with our hands from any sort of communal anything). No matter how many times I tried to explain how soap actually has chemical properties which detach particulate matter from one’s skin and kill the microorganisms which cause diarrhea, they thought that I was just spouting off American mythology equivalent to their own folklore about witches and wizards. No matter how hard I tried, it seemed that science, reason and the moral power of example had no use on these people – and that for me to eat with my hands from a food bowl meant that I would inevitably be eating other people’s feces.

I thought long and hard about this. Eating from the communal food bowl was more than just a ritual in Minianka society. Even though conversation has nothing to do with it, eating together with another person is the most basic social activity which I could partake with another Minianka man as a sign of friendship and camaraderie. To be a part of this society meant eating with the same food as them, to eat from a food bowl with another is to treat them as one’s equal. To eat alone would be interpreted as a strong demonstration that I truly wished to set myself apart from this society.

I called to seek the wisdom and sagacity of my elders, and my dad recounted a conversation we had had when I was a senior in high school driving around New England looking at colleges. I had made a point of checking out schools where Greek life was small to nonexistent, because I didn’t want to be faced with the choice of either joining a fraternity or having no social life.

“Don’t worry about it, Zac, even if you go to Dartmouth or Cornell that doesn’t mean you have to join the Deltas. There are better ways of creating lasting bonds with friends than running some dehumanizing hazing gauntlet.”

“If I did want to join a fraternity, what would I have to do in order to pledge?”

“Let’s put it this way: if you’re invited to join a secret society and you’re told you have to eat a brother’s feces, just say nothing more and walk away. If you have to eat someone’s shit in order to be a member of a society, there can’t be any compelling reason for you to be a part of it.”

Thus I concluded that I could no longer eat from the communal food bowl.

I came to Karitie and Durcas’ house one day with my own plastic bowl and explained that from that day onwards I could only eat alone. They really didn’t know what to make of it – no one had ever done or said anything like this before. I didn’t have the heart to explain to them the real reason why I couldn’t eat from the men’s bowl, I feared they would interpret it as a grave insult and they would disregard anything else I had to say. So I offered a little white lie that my doctor told me I needed to lose weight and that I should start exercising portion control: “It’s not that I don’t like eating your rice and peanut butter sauce, it’s that I love it so much that if you put the whole bowl in front of me I’m going to eat the whole thing!”

But Karitie and Durcas are intelligent people. Eventually they figured it out.

For the rest of the year, guests to their food bowl would make a stink about me eating alone. People would accuse me of being an elitist or a racist; they would ask “You think you’re better than us?” I didn’t want to make a big deal of it, but in regards to the very significant matter of hygiene I certainly did think so – I knew so, it was a fact.

And eventually I realized that since I was eating by myself, and conversation has nothing to do with the Malian eating ritual anyway, I might as well bring a book or magazine with me to read while I ate from my private food bowl. But it was difficult to turn the pages when I had peanut butter sauce all over my right hand, so I started bringing a spoon with me to all of my meals. Eventually I dropped the eating with my hands business altogether, because I had discovered a much cleaner, more efficient and hygienic manner of bringing food to my mouth.

The more I thought about it, there is really no compelling reason for me or for anyone else to eat with their hands, that it’s simply a primitive practice employed by those cultures who have yet to embrace modern sanitation. Hand-washing with soap is a harm-reduction practice which can reduce the spread of disease among cultures that eat with their hands much like if heroin addicts were to shoot up with clean needles instead of sharing them – but the harm can be eliminated if people would stop shooting heroin altogether. I resolved to never eat with my hands again.

Once I started eating with utensils again, Durcas remarked that I was “eating like a Tubab.”

“No matter how long you look at it, a tree stump will never turn into a crocodile”, I replied. The one and only proverb in the Bambara language means that some things just don’t change.

And eventually I noticed that Karitie, Lazar and Boubacar had given up on washing their hands with soap. It was plainly obvious that they had been going through that charade the whole time to humor me – not because they were actually serious about adopting this practice. Despite a whole year of my lectures about the giardia, the fecal-oral cycle and disease prevention, the most educated men in the entire community were still content to be ingesting each other’s fecal matter.

“No matter how long you look at it, a tree stump will never turn into a crocodile”, Karitie said.

I was really disappointed with this outcome, both with my host family and with myself. I interpreted it as my greatest failure in two years of Peace Corps service.

The people of this village requested a Peace Corps Volunteer to help them build the capacity to improve their water and sanitation, so the United States government decided to take this former lifeguard with three years experience testing and chlorinating the pool water, they trained me to build concrete wells, latrines and wastewater receptacles, and sent me to Sanadougou. With the help of the Water Committee and my expert mason counterpart, we secured roughly $6,000 in USAID , NGO and private donor grants to build 112 latrines, 96 soak pits, 3 infiltration trenches and 6 top-well platforms in families’ homes, we built a row of latrines at the secondary school, we built a row of latrines at le Bureau de la Mairie, we even repaired and reorganized a broken solar water pump-to-tap system so that the people of Sanadougou could enjoy clean, potable drinking water. After all the work that we did, Sanadougou is now a visibly cleaner place. Though I have no way of compiling exact statistics, our work to improve this community’s infrastructure should lead to a significant decrease in the transmission of diarrheal diseases.

Though as I prepare ready to leave for America, I fear that all my work has come to naught because I wasn’t able to make a dent in Sanadougou’s eating habits. The World Health Organization estimates that if people would only wash their hands with soap it would reduce the incidence of diarrheal disease by 43 percent. Even if Engineers Without Borders were to expand the solar pump-to-tap system and bring running water directly to every family’s kitchen, even if some charity were to give the people of Sanadougou a lifetime supply of bottled Evian so long as people keep on eating the way that they do now they are still going to be consuming each other’s shit. Until people in Mali are willing to change their habits, giardia and dysentery are going to forever remain facts of life and children in this town are still going to die from simple bouts of diarrhea.

The fact of the matter is that sometimes tree stumps do, in fact, turn into crocodiles. There’s a word for this phenomenon: “progress”. Hundreds of years ago, the disparate Slavic tribes from which I am descended, the Franks, Teutons, Angles and Celts all lived in earthen huts, they farmed the little food they had with simple hand tools made of iron and wood, they lived in poverty not unlike that of the present-day Miniankas. They didn’t have toilets, they didn’t have toilet paper, and they ate their potatoes with their hands, so the tribes of Europe suffered from endemic giardia and dysentery and they had a life expectancy about as low as that of the Miniankas today. But sometime around the 10th century the French and Italian nobility popularized a simple technology which made eating all the more cleaner: the fork. It took a few more centuries for the peasants and lowly serfs to follow in kind, but eventually all the people of Europe adopted this new custom which not only made eating easier and more pleasurable but also reduced the incidence of disease.

There was also a time in the not-so-distant past when Europeans didn’t quite understand disease transmission either; they thought that sickness was spread by the Devil, the cold and the wind. There was a time when angry mobs massacred Jews by the hundreds because they could think of no other explanation for why the plague had come to their city, they burned so-called witches at the stake for causing outbreaks of cholera – very few Westerners took the time to question whether the spread of disease had anything to do with the complete and utter lack of sanitation in the cities where people lived amongst and ate and drank their own filth.

Now America, Europe, Japan, Australia and all the countries of the developed West have established a culture in which it is absolutely unacceptable for people to eat most foods with our hands, we all eat from our own separate bowls and separate plates with our own separate sets of utensils. And even though a surprising number of Westerners are not conscientious about washing their hands on their way out of the bathroom, we have developed our cultural habits to the point where even if you invite someone over for dinner and they did have microscopic pathogens crawling all over their hands, it wouldn’t really matter because at no point over the course of the meal is your guest ever going to put their hands in your food. As a result, giardia, dysentery and cholera are all but nonexistent in Western societies, it would be a freak occurrence if a child were to die from diarrhea, and we can expect to live to a ripe old age in our late 70s. It is only a rare occasion when someone falls so sick that they cannot work, and since we are so much healthier and more productive we have so much more wealth and a superior standard of living.

When I try to explain this to Malians, they typically respond along the lines of “Well, you Americans are healthy because you have so much money and you can buy so much more medicine” – they think that every time we contract dysentery we just pop some expensive pills and that’s the end of it. I insist that Americans don’t ever contract dysentery to begin with and few will believe me – gastrointestinal disease is simply accepted as a fact of life in these parts. More worldly Malians might understand that everyone in America has flush toilets and tap water in their home, but they can still attribute that to our superior wealth – it seems that no one is willing to be critical enough of their own culture to realize that maybe our superior health has more to do with our superior hygiene and superior methods of disease prevention, and that they could improve their own health if only they adopt new methods of eating.

The people of Mali have a choice; either they can overcome the pagan superstitions about evil sorcerers and start washing their hands with soap, or they can start eating from separate food bowls, or they can start eating with forks or spoons or chopsticks or spatulas or flat-nosed screwdrivers - anything besides the hands; even better, they can adopt some combination of all of the above. Or they can continue what they’re doing and forever remain mired in this endless cycle of disease. This kind of change is not something that white-skinned NGO workers can do for them – changing the habits and customs of Malian culture is something that only Malians can do for themselves. And when they do take this great leap forward, the people of Mali will finally understand that development is not just about building roads and factories but that it is also about changing behavior, that positive change doesn’t require massive foreign aid and that it can be done on the cheap or for free, and that the future of their society truly rests in their own hands.

Enter the Poopopticon

The best course I ever took in college was Professor Bumiller’s Regulating Citizenship. The syllabus itself wasn’t every impressive– it was mostly composed of elementary political writings of Locke, de Tocqueville, Thoreau and Martin Luther King which I had read in high school. But what made this course so enlightening was the format and location of our class: once a week ten “outside” students from Amherst College drove down Route 9 to meet with ten “inside” students in the visiting room of the Hampshire County Jail.

The “inside” students were not hardened criminals but guys who happened to have been given a bad deck in life and royally screwed up, but they deserved a second chance. “Camp Hampshire” – as it was affectionately known by those who had made it through the meaner penal regimen at State – provided a community-based rehabilitation program, offering residents drug counseling, psychotherapy, G.E.D. certification, training in carpentry, quilting, and seeing-eye dog training. Through the course of their stay residents were incrementally allowed more and more freedom of movement, culminating in the final stage when they resided in quarters outside the sealed gates of the central compound and could essentially walk in and out as they pleased and vans would drive them off the facility grounds so they could work part-time jobs. The overriding purpose of this entire scheme was to “re-socialize” those whom society had apparently failed the first time around, so that the next time graduates of the Hampshire County could re-enter conventional society with marketable skills, find a decent job and conduct themselves in a lawful manner.

The most tantalizing class was the day when we discussed Michel Foucault’s Discipline and Punishment, namely, his analysis of Jeremy Bentham's ideal reformatory: the Panopticon. According to this scheme lawbreakers should be reside in a ring of transparent cells ringed around a central guard tower so that guards could monitor all prisoners at all times. Every sinner would be conditioned into good behavior by the sight of the ever-present guard tower, for it would always be much too obvious to the prisoner that his every behavior could be monitored. Whether or not there was actually a guard in the tower conducting surveillance at any given moment was irrelevant – the individual prisoner could never know. And so he would have to assume that he was in fact being watched in perpetuity as though by the all-seeing eyes of God. The convicted criminal would thus have no choice but to adopt self-discipline and learn to conduct himself with upright character and morality at all times.

Foucault and Mill were quite relevant to the daily lives of every single “inside” student, for though they enjoyed a liberal degree of freedom at the Hampshire County, they were self-disciplined into good behavior by omnipresent video cameras which were linked to live-feeds into the central guards’ surveillance room. An “inside” student pointed at the silver orb hanging from the ceiling,

“We know what da Panopticon is all about! Here we gotta stand in line cuz we is bein’ surveillanced every single minute of every single goddamn day!”

This experiment in academia has proved to actually be quite useful in my real-life experience as a Peace Corps Volunteer trying to promote water sanitation in Mali. Here the biggest public health issue I’m dealing with isn’t a crime as defined by any legal code, but an act so heinous that it is treated with the palatable euphemism “open defecation”; i.e. children shitting all over the public school grounds.

Every single day when I walk to Karitie and Durcas’ house for lunch, I walk past the Première Cycle. The sanitary infrastructure on this schoolyard is actually quite impressive for a rural town in Mali; there is an India/Mali pump so that the students and teachers can drink clean, filtered water at all times, and there are three sets of latrines – one of them brand spanking new. The kids know how to get their water from the pump – sort of – but it is quite apparent that they do not quite grasp what they are supposed to do with these latrines. In one hour I sat with Durcas under her gwa and counted 14 kids who actually ventured inside the nyegens and do their business, 11 children who defecated in back of the nyegens, and 8 of them who just dropped their pants and shamelessly pissed in the middle of the schoolyard.

“Durcas, this just doesn’t make any sense. It actually takes more effort for these kids to walk behind the nyegens than it does for them to walk inside the nyegens. Why on Earth do they insist on expending more energy to shit and piss outside?”

“Je ne sais pas! You have done everything that you can possibly do to tame these nasty children. You have organized the student government to properly clean the inside of the nyegens on a weekly basis…”

“ – But the problem here is what kids are doing outside the nyegens that’s so unsanitary.”

“You have even trained your puppy Snoop to tackle nasty children he sees pooping…”

“ – But ever since Snoop maimed Bobacar’s sheepling in the fields I’ve had to keep him chained up all day.”

“Then there is nothing more that you can do.”

“But there is! I’ve been trying to get Karitie to let me teach his students just one class on how to go to the bathroom – but he still won’t let me… Speaking of the Devil, here he comes right now! Karitie!”

“Oui?”

“Watching these kids shit so near the water pump day in and day out is simply intolerable. What do I have to do for you to let me teach these kids a lesson in proper defecation?”

“I have already told you that you should beat these nasty, nasty children. Here in Mali when children are misbehaving that is what we do – we rip a switch from the tree and spank their butt until they cry! Unless you teach my students that there is a price that comes with pooping outside, and that that price is a very painful beating, I refuse to let you step foot in my classrooms.”

“I still don’t want to tell these kids that I, personally am going to beat them – some of these 8 and 9-year-olds are my best friends in this entire village! I’m sure there is some way that we can compromise...”

So that afternoon I put on my General Patton face and went from class to class to lead a stern conversation on personal hygiene and sanitation. I greeted all the students, greeted their teachers and after a little small talk abruptly broke the ice; “I have to poop” and squatted down in front of the blackboard as though I were going to do it right there in front of the class. “Do you think that this is a good place for pooping?”

“NO!!!” (Asking questions always catches the kids off guard, they are so used to being lectured at)

“OK then… How about I poop here behind the teacher’s desk? No one can see me!”

“NO!!!”

“Is it ever OK for me to poop or pee inside the classroom?”

“NO!!!”

“Why not?”

“It is DIRTY!!!”

“That is correct! Pooping or peeing in public places with lots of people is the dirtiest thing in the world! And that is why I am very mad . Today I watched 19 children poop and pee outside the nyegens. Do you think that pooping and peeing outside in the schoolyard is OK?”

“NO!!!”

“Do you know what diseases you can get from people pooping and peeing outside?”

Answers included “Malaria!”, “Headache!”, “Coughing!” even “AIDS!”

“Close… but not quite. Who here has heard of dysentery, cholera or schistosomiasis?”

This very unscientific survey made me think that absolutely no one in the subpopulation of Sanadougou most likely to fall ill to these wretched maladies had heard of them previously. That was a very frightening thought. So for each class I drew a diagram of the water pump on the schoolyard all the way down to the water table.



“Here is a schoolgirl named Aminata Sogoba. She is drinking water from the water pump. Do any of you know how other students might make Aminata sick?..

Pooping and peeing outside in the schoolyard, of course!”

So I drew a highly exaggerated diagram of how diseases are transmitted via open defecation and urination – the Bambara language doesn’t take very well to metaphors or similes, so I had to make my diagram as straightforwardly literal as possible.



“…So you see, when Aminata drinks water contaminated with Bakary’s poop she has a good chance of getting sick with giardia or dysentery or even cholera and she might even die because Bakary took a dump too close to the water supply. Who here has had diarrhea in the past month?”

Everyone raises their hand.

“There’s a good chance that you had diarrhea because your classmates have been pooping all over the schoolyard and their poop somehow got into your mouth. Either their poop went directly into the drinking water, or it got on a soccer ball – which someone picked up with their hands – and then they picked up a pencil – and then you shared that pencil – and then you put your finger in your mouth. Every time that children poop out in the schoolyard it gives you a greater chance of getting sick… So does anyone here want to get a really bad case of diarrhea again?”

“NO!!!”

"Does anyone want to get other people's poop in their mouth?"

"NO!!!"

“So what do you think we should do with dirty children who poop outside and put nasty disease seeds in the drinking water?”

“YOU SHOULD BEAT THEM!!!”

“You all should know that Karitie says that I should beat children who dirty the schoolyard with their poop. But I will not, I cannot do that. There are 428 of you and only 8 teachers and 1 of me – we adults can’t watch you when we have to work. Though since all of you go to school here, and it is you the students’ responsibility to fill the water jugs with clean drinking water and to clean the nyegens, it is now the job of each and every one of you to make sure that no one poops outside... You’re going to have to learn to discipline yourselves! So what are you going to do the next time you see kids pooping in the schoolyard?”

“I WILL PUNCH THEM!!!”
“I WILL KNOCK THEM DOWN!!!”
“SPANK THEIR BEHIND!!!”
“SMACK THEIR FACE!!!”
“SIT ON THEIR HEAD UNTIL THEY CRY!!!”

“Wow… that sounds like pretty awful punishment… and you all have wonderful imaginations. Though violence is horrible, and I do not encourage you to ever hurt anyone - but pooping near the water pump is even worse because it hurts many more people in ways that you cannot see. I would prefer that the next time you see kids pooping outside you teach them why they are spreading diseases and threatening other people's lives... But remember, Monsieur le Directeur thinks that kids who poop next to the water pump he drinks from every day should be beaten..."

"So in conclusion, next time that you have to poop or pee, where must you go?”

“IN THE NYEGENS!!!”

“Thank you, my good friends. May Allah grant you a day of peace and happiness.”

After visiting all eight classrooms in the Sanadougou Première Cycle; 1) I finally got the break I had sought for so long to teach these kids about water sanitation and fecal-orally-transmitted diseases; 2) Karitie got the warning he wanted that open defecation in the schoolyard shall result in corporal punishment; 3) Not once did I ever have to say that I would personally conduct any of these beatings. I was able to draw from these students own mouths that not only is shitting and pissing in the schoolyard absolutely intolerable, that it is an epidemiological hazard and a personal offense to the entire student body and faculty, and – the icing on the cake – that the students themselves would personally beat their peers who threatened them with disease and even death by depositing their waste in the vicinity of the drinking water pump. I think that this compromise worked out fairly well.

And of course the best way to judge a utilitarian policy would of course to measure its tangible results. Before my discussions on water sanitation roughly 2 out of every 3 students were shitting and pissing outside on the streets, in the schoolyard, next to the nyegens, anywhere but inside the nyegens. But since I introduced this strict new waste management policy and cooperative disciplinary regime, open defecation has come to a screeching halt. In the two weeks since neither Karitie nor Durcas nor I have yet to see another child drop their pants in the open.

They seem to have internalized the discipline of sanitary defecation out of fear of peer punishment as though they were policed by the all-seeing eyes of Allah.

Evolution

Eating in Mali is – like all other basic life functions – tremendously more difficult and infinitely more times likelier to get you sick. There is an entire ceremony to every meal; the men sit around their communal food bowl on the ground and the women sit around theirs. Starting with the oldest man, the men pass around a tin can full of water to “wash” their hands i.e. dunking them in a basin of increasingly dirtier and dirtier water. The eldest man says a prayer, and in unison all the men plunge their right hands into the food bowl which is usually full of either toh or rice. Everyone squeezes their clump of food and shoves their entire hand into their mouth up to the knuckles to ingest every last morsel. If there are any pieces of meat or vegetables in the sauce, they are usually left in the middle for it is considered rude to gobble up the solid matter – in fact, it is considered polite to grab the chunks of sheep tripe and toss them towards the other side of the food bowl and insist that their guest eats the good stuff. “A dun, a dun” No one talks, the men just stuff their faces until they can eat no more, at which point one licks their hand clean, says “Barika” (thank you) to each and every person sitting around the bowl, and walks away.

Only after the last man can eat no more, the women and children may begin this procession on their own. Often a family only owns one bowl, so the women and children essentially eat leftovers for every meal. And anything the women and children don’t eat goes to the dogs and the cats. The animals know that they are served last, so they put up a fight to not be forgotten.

It goes without saying that Malian men have everything going against them when they try dating American women.

All of this pomp and ceremony notwithstanding, eating in Mali is really animalistic. I say this not because we are eating with our hands and without conversation, but because the whole time we are surrounded by very hungry animals. Dogs have learned to wait for their human masters, but cats have no patience and so we have to put a grass basket on top of them while we eat. But the one species which no one in this country has ever figured out how to keep from the communal food bowl is the chicken... Until now.

I fucking hate chickens. They are the worst animals ever. They are not cute, they are not cuddly, and they do not ever appreciate the company of humans. Chickens cannot be tamed, they have no respect for their human masters, they are dirty, filthy animals which eat carrion and garbage and they carry all sorts of parasites like worms and giardia cysts and amoebas which they can transmit to people. The only reason why God put these obnoxious creatures on this Earth was so that humans could chop their heads off, pluck their feathers and slow roast them over a fire with a garlic-pepper glaze so that we could savor the flavor their succulent breasts and chew the dark meat on their haunches.

Having lived amongst locally-raised, organic, free-range chickens for almost a year now, I can personally attest to the value of factory farms. By letting these awful beasts enjoy their natural liberty and walk wherever they like means that they too swarm around the communal food bowl when tigadegana is served. I have to swat cocks away with my left hand while I eat with my right, and these persistent fuckers cannot take no for an answer and try to make a run for my rice and peanut butter sauce over and over again. I don’t care what miniscule emotions might be felt in these vermin’s pea-sized reptilian brains – it is within the rational interests of human beings to cut off chickens’ beaks, cut off their claws, and force-feed them cornmeal in 12” x 12” chain-link cages so they become delicious sacks of plump white meat via minimal interaction with man.

A week ago something ticked as I was trying in vain to eat my tigadegana while simultaneously swatting away ravenous chickens. I had had enough.

“Ça, c’est absolument ridicule! J’en avais assez!” I proclaimed, stormed over to a small wooden table, brought it back to the circle of men and put it under the food bowl.

Karitie apparently thought this was a pretty ingenious idea, “If you raise the food on a table, … then chickens can’t reach it! Why haven’t we thought of this before?”

And from that day on, we have always eaten from a table.

And the world will never be the same.

My Augean Stables

In previous episodes of this adventure serial, our hero was inspired by his kitty cat digging cat holes in his litter box to dig a big deep hole in back of his nyegen. The American reader who has lived all of his or her life micturating and stircumating into a porcelain toilet flowing into a septic tank or a municipal sewer system might not understand the import of this action, but as a brief primer let me introduce you to the mechanics of a pit latrine.


First, I must emphasize the not-so-obvious reality that in some parts of the world a pit latrine is considered newfangled technology. In the year 2009 there remain many societies in which few people have bothered to build any sort of infrastructure to dispose of human waste in a sanitary matter. What that means is that everyone in a small village poops in the woods, in the fields, or on certain designated rocks or directly into the water. In more densely populated towns and cities, that means that people just pull down their pants and shit in the street where other people are selling and selling food. Oftentimes if a society lacking in sanitation infrastructure is located near a pond, a lake, a stream or a river, that means that everyone in this rural society disposes of their solid and liquid waste in the very same body of water which also serves as either their own or another human community's sole supply of drinking water - putting that society at grave risk of cholera outbreaks. This is the absolute nadir of public sanitation.

There are other cultures which have collectively decided that defecation out in the open, in and near water and food supplies is a hazard to public health if not humiliating to everyone in that society. And so they have developed their sanitation practices somewhat and built designated areas which are reserved exclusively for the depositing of feces and urine. In the Bambara and Minianka cultures of Mali families often build their own structure known as a bokeyuro – euphemistically, a “traditional nyegen”, but literally, a “pooping place”. It is what it sounds like; an area demarcated by a mud brick wall inside which people poop. The chief advantages of a bokeyuro over open defecation are that 1) fecal matter is controlled to some degree – people are no longer shitting all over the place, but rather in one place; 2) it spares its users the indignity of shitting in the street for all the world to see. The primary disadvantage of having everyone in a family of 35 shitting in one place is that it very quickly becomes full of shit – and a concentrated smorgasbord for filth flies, cockroaches, pigs and every disease vector which enjoys eating human feces.

The bokeyuro and its close relative, the sugunyekeyuro – “peeing place” – are not confined to undeveloped rural villages; I have been to a number of sketchy bars and restaurants in densely-populated urban areas where – upon asking for the nyegen – I have been shown to a seemingly empty room. Seeing no toilet seat, no urinal, no chamber pot or even a hole in the ground, I was at first confused as to what I was supposed to do. But after noticing a foul-smelling puddle on the floor it became quite apparent that the standard protocol in this establishment was to just do as one likes so long as it’s confined to this one closed container – and to leave the mess for someone else to clean up. The only aspect of a “traditional nyegen” which could be fairly called a virtue is that at least no one can see the user as they suffer the indignity of using it.

After many generations of building and managing “traditional nyegens”, proprietors of bokeyuros became disillusioned with the fact that they had to sweep up floors full of shit and piss every day. And so they discovered that if you dig a hole in that designated shitting place and bury a clay pot up to its brim, the pot fills up more slowly and one does not have to sweep up shit so often, and moreover the chamber pot can be closed with a lid. Eventually this semi-buried chamber pot evolved into what is known as a “pit latrine”, which is exactly what it sounds like – a hole in the ground on top of which people squat and poop, though a hole which leads to an underground pit which is so voluminous that it can store many months if not multiple years’ worth of fecal matter. Due to the fact that the shit is safely stored underground, a pit latrine is the simplest technology to contain and concentrate human solid waste in order to reduce fecal-oral disease transmission. In Mali the pit latrine is called a nyegen, and especially in rural villages a nyegen is more often than not constructed out of logs, dried mud and mud bricks.




Though a major step up from open defecation, a "traditional nyegen" has many faults to its design. The first and most significant is that the vast majority of nyegens are built out of mud - which is a perfectly adequate construction material so long as you don’t mind seeing your nyegen disintegrate under the heavy rains and having to rebuild it all over again every year. When I was living in Sinsina last rainy season I woke up during a torrential downpour one night and came out with my raincoat and headlamp prepared for a nocturnal stircumation - when I realized that the nyegen which I had struggled so hard learning to use over the past month had collapsed into the pit. It wasn’t a very fun night.

Most nyegens are not closed properly - if at all. Just as all of that fecal matter is concentrated in one place, so is the stench – and all of the insects and vermin which are attracted by it. And if flies are feasting upon human waste, they can transmit those pathogens equally well if they are from waste on top of a soccer field, the central market square or from inside an unclosed nyegen.

Pit latrines without proper coverings are also hazardous to small house pets. One Peace Corps Volunteer who failed to properly cover her nyegen suffered the fate of curious kitten peering into the hole and falling into the pit. She tried hoisting down a bucket, but the kitten could not be made to understand that it was supposed to climb in. Every time that the Volunteer crouched down over the hole she would hear her kitten mewing – and she knew that she was peeing all over it – until the mews became weaker and weaker and the poor critter eventually died of starvation.

Moreover, the greatest weakness of a latrine is that the latrine pit is ultimately going to fill up without some sort of outlet. This does not necessarily have to happen, for if a given latrine is seldom used and it also serves as a food source for a considerable population of worms, flies, cockroaches and dung beetles, the mass of the pit’s contents could technically decompose faster than it accumulates. But more often than not it is the other way around. Even a latrine pit is used only for the disposal of solid waste, eventually there is going to be a big stinking mass of human feces and someone has to perform the unenviable task of jumping into that latrine pit and shoveling out its contents. This job is so objectionable and yet so necessary in a society with pit latrines that Indian civilization created an entire caste of persons – the Dalits – who are born to the foul and dangerous occupation of shoveling other people’s shit.

Latrine pits fill up particularly fast if they are misused for the disposal of wastewaters which stifle aerobic decomposition and turn the nyegen into a stinking cesspool which serves as a breeding ground for pathogens, is never going to evaporate, and is difficult to remove. It’s most likely no big deal if a little bit of pee trickles into the poop pit because while squatting you had to #1 and #2 at the same time; it only becomes a problem if this happens to a great extent on a regular basis. What’s really bad is if a family dumps their average weekly 1,600 liters of greywater produced from washing persons, dishes and clothing into the latrine pit – in which case it is going to fill up in no time at all.

One means of significantly reducing the quantity of mass inside a latrine pit and requiring less-frequent shoveling sessions is to separate the solid waste from the liquid waste. Malian cultures which developed mud nyegens found this out pretty quickly, which is why just about every nyegen in this country is made with a second hole on the bottom of one of the mud brick walls which allows wastewater to flow out. These outflow holes work just fine in terms of reducing unpleasant latrine-emptying labor. However, simple outflow holes kind of defeat the entire purpose of containing disease-spreading pathogens, for even if the squatting hole is aptly closed there is now raw, untreated sewage lying in the open where it is accessible to every species of disease vector known to mankind.


Some families - especially those who live in the outskirts of town next to their fields and gardens -simply place their nyegen in a remote corner of their concession so that their wastewater can flow out to a lightly-trafficked part of their living space. My host family’s nyegen water empties out in back of their house where no one has to see or smell it. The agglomerate of mud and sewage which has been generated in back of the nyegen after years of use also serves as their pigs’ favorite location for recreation, so every time the mucky sow and her piglets trot by we get a whiff of general nastiness (this is also serves as a prime reason to never eat pork in this country).


Though when I walk into the center of town where the concessions are closer together and there is no field or garden into which the wastewater can flow out, every family’s greywater and urine flows directly into the street where everybody walks, their children play and their animals roam. To say that the streets of Sanadougou are "foul" or “disgusting” would be a gross understatement.

On a typical day when I have to walk to the center of town and buy some sugar at the butigi, this is what the streets look like:


If you’ve never before lived in Mali or a similar underdeveloped country, you might be wondering: “What the Hell are those big crater-looking things on either side of the road?” Those, my friends, are puddles of human liquid waste.


Ewwwwwwww....


Ewwwwwwwwwwwwwwww....


Ewwwwwwwwwwwwwwwwwwwwwwww.....

Sometimes people will dig a little hole to “contain” their wastewater so that instead of spilling all over the street it sits in a relatively smaller, fetid and actually more hazardous cesspool.


Ewwwwwwwwwwwwwwwwwwwwwyuckkkkkkkkkwwwwwwwwww….


Ewwwwwwwwwwwwgrossssssswwwwwwwwwwwwwwwwwwwwwww…
Oftentimes people use their wastewater ditches for garbage disposal too.


Ewwwwwwwwwwwwwwwwwwrrrrrretttttttcchhhhhhhhhgagggggggggggggggggggggg…


Some of these nasty puddles are really, really big. Karitie Sanogo stands in the background for perspective.


Ewwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwww......

Even my Minianka neighbors who believe that diseases come from wizards and evil spirits understand that these wastewater puddles are really, really bad because they serve as breeding grounds for filth flies and mosquitoes. They believe that the wizards turn into flies and buzz over to place their curses in other people’s food. The Miniankas are like ¾ of the way there…


The worst part about standing wastewater is that it threatens the health of everyone in the community – not just those who produced this uncontained pee and greywater. Let’s say that the Sogoba family is currently sharing a really bad case of amoebic dysentery; most of their diarrhea fell down into the nyegen pit, but little Bakary missed the hole and splattered all over the floor and so his mother washed the floor down with water and it flowed out the drainage hole into the street. A female filth fly is hungry and thirsty, so she sticks her proboscis into the Traorés’ effluent of human waste – while she’s at it, she will stick her front two legs into the water and pick up whatever unicellular amoeba have been previously evacuated by the Traoré family.

Let’s say the Dembele family does everything right; they get their drinking water from the hand pump in the village square, they filter their water and treat it with chlorine bleach, they wash their hands with soap after going to the bathroom and before eating. As the family gathers around the communal food bowl for dinner, the female fly which was just drinking from the Traorés’ cesspool swoops down and lands in the Dembeles’ tigadegana. Now the Dembele’s peanut butter sauce is spiced with a dash of Bakary Traoré’s diarrhea with a few young amoebas to boot. Now the Traorés and the Dembeles all have amoebic dysentery! This is why improving sanitation on the household level alone does not suffice to improve a family’s health – sanitation campaigns must be conducted on the community scale.

So this is where I, Zachary Mason a.k.a. Madu Sogoba, Peace Corps Volunteer, come into the picture. Before anything else, after being roused into action by the hardest-working man in the sanitation business, my kitty cat of soul James Brown, I took the initiative of spending a week in back of my nyegen digging a big fat hole. As this was the first time that anyone in Sanadougou had ever seen a white person doing manual labor, the week that I dug that hole behind my nyegen was a major spectacle.

However, what sets the hole in back of my nyegen apart from the couple-inch craters which my neighbors have made to create stinking cesspools of slime is that there’s a more planning and a little bit of industrial-age materials involved in my creation.

What I have made here is the pinnacle of water sanitation technology appropriate for a rural Malian village: a soak pit - or in the local vernacular, a wuluwuludinge. Instead of any old hole, it’s a hole filled with rocks with a plastic tube leading from the outflow hole in the nyegen. It’s not quite finished - but that’s the point; over time I’m going to fill it completely with more rocks, cover it with sturdy black plastic, line the plastic tube with cement, and cover the entire thing up with mud so that looks no less wholesome than the rest of my garden. But in the meantime it serves as an excellent teaching tool for all of the people who walk by and ask me “what the Hell is that?” I invite all of the curious onlookers into my concession to inspect my new wuluwuludinge, show them what its purpose is and how it works, and offer to help them build one behind their own nyegen(s).

A soak pit really isn’t all that complicated. The purpose of this contraption is to thoroughly contain human wastewater so that it flows directly underground with absolute minimal interaction between other humans, livestock, and disease-transmitting insects. If one were to put a plastic pipe directly between the nyegen and the ground without a storage cavity, the water would not be able to seep quickly enough into the soil. Thus a soak pit serves as rudimentary septic tank; the first thing that it does is provide sufficient volume for the wastewater produced by a given family to sit in a contained location, and as the wastewater sits there, donné donné it will seep into the soil surrounding it. The pit should be filled not with concrete rubble or mud bricks but only with sedimentary rocks which can be permeated with water and still maintain their form. And every couple of years the owner of a soak pit should open it up, let the rocks out in the sun for a day to dry and clean them off so that they remain permeable.

My water sanitation how-to books say that soak pits can also be built in rural villages with indigenous materials; if there is bamboo available it can be hallowed to serve the same function as the plastic pipe, and then instead of plastic sheeting the hole can be covered with straw, corn husks or leaves. If available locally, bamboo and agricultural refuse is available, these materials could be economically-preferable to plastic piping and sheeting because it can be absolutely free of charge; however, organic materials eventually rot and need to be replaced – whereas plastic is relatively durable.

So not only am I teaching people about the merits and joys of soak pits – I’m also in the process of organizing a project to build a preliminary stage of 30 of these babies throughout the village of Sanadougou. The scheme Peace Corps has for project funding is that the local community has to pay at least 30 percent of the total project cost (which can be paid in raw materials, tools and services as well as cash) and USAID funds up to 70 percent. I had a series of meetings with my boss, the dugutigi of Sanadougou and his posse of old men and le Bureau de la Mairie, and we worked out a deal that if individual families can provide for all of the rocks, sand, and either pay for or provide in-kind all of the skilled and unskilled labor that goes into the making of a soak pit, then the American people will chip in for all of the plastic piping and sheeting.

What’s more, we’re going to throw in a brand new, cement-floored nyegen! One can certainly build a soak pit in back of a traditional Malian mud nyegen, but when the rains come all of that mud on the floor is going to rapidly fill up the pit and clog the pipe. There are about a dozen latrines in this village made with at least cement floors, and for those all that we need to do is make sure there’s a cover over the hole and dig a soak pit in the back and its disease-transmitting days are effectively over. But if we’re going to build a soak pit in back of Sanadougou’s more numerous mud nyegens we are going to have to remake the flooring with cement if not rebuild the nyegen from scratch.

And thus my job nowadays entails walking down Sanadougou's filthy streets, stopping to chat with my fellow villagers and talking to them about their nyegens and wastewater, to measure the dimensions of what needs to be dug, and let them know about an offer they can't refuse: you get off your butt and provide the labor, rocks and sand, and then the American people will provide you with $80 worth of cement, rebar and plastic and we're going to build a brand new cement nyegen which they'll never have to rebuild it again. There will be no sewage spewing out into the streets, filth flies and mosquitoes will have less stagnant water to lay their eggs in, and maybe just maybe pathogens will be reduced to such an extent that you will be able to discern a measurable improvement in their families' health. I think that's a pretty good deal.

After 8 weeks of canvassing and meeting with dozens upon dozens of families, however, results have been quite underwhelming. One guy down the street has dug 3 holes and filled 2 of them with rocks, another guy on my street has accumulated a pile of rocks in front of his nyegen, and after shaming them into action my host brothers have made a half-assed effort at digging a hole. A lot of people seem to be completely indifferent to the fact that their children are playing in, their livestock are drinking from, and they are inevitably ingesting their own and other people's wastewater.

I was trying to persuade one family which just so happens to supplement their farming income with a "pharmacy"; a mud hovel with bootleg Chinese manufactured medications which are in all likelihood nothing but sugar pills. They also have among the worst, most disgusting cesspools in the entire village (their twin nyegenji puddles are pictured above). Time and time again they would laugh me off, "Oh Tubabuke, don't you see that we have so many better things to do like drinking tea and selling medicine?"

They didn't even give me direct eye contact until I started talking dollars and cents. Walking by one day I mentioned to the pharmacist "I've got a headache and I would really like to buy some medicine - but I'm going to buy my pills from the other pharmacist down the street because his sewage isn't spilling out into the street and so his medicine is probably a lot cleaner". As I continued along my way I could hear the gears churning in his head...

Despite the lack of worldly-physical action, in spirit everyone seems to be behind me. I'm told every day "May Allah help you in your good work!"

"Allah-u-akbar; however, He's not going to clean up our village. But you can give me a hand..."