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.

A Banna!

As emotionally drained, cynical and pessimistic as I have become over the past two years, saying goodbye to my village was harder than I had expected. I suppose that once you have spent enough time in one place that you know every turn in the road, every person knows your name and you know every skeleton in every last one of their closets (well, if they had closets), especially if there is just one dog living in that place who knows and loves you as their master, even a dump of mud hovels, cesspools and garbage piles like Sanadougou can win a place in your heart with all the affection of home.

To bid adieu I slaughtered a goat and had my host family cook it over rice to feed all of my friends une petite fête. I even boiled a big pot of ginger juice and threw down for a bottle of whiskey for my Christian, animist and laxer Muslim friends to spike their spicy namakuji – after all of these years of hiding whiskey shots alone in the privacy of my gwa, it turned out that Sidiki was the only teetotaler among them.

“American boissons are delicious!” Alu told me “…much more delicious than the rubbing alcohol we usually drink on special fêtes!”

“Oh Alu, if only you had told me earlier we could have gotten drunk and lost our eyesight together!”

In this culture where talking during meals is often shunned, my Malian guests were confused as I stood up during the feast of goat meat and rice to give a little speech. Since the painfully-literal Bambara language does not allow for much rhetorical flourish, I could really only give a run-of-the-mill summation of the work we did together – though I tried my best to paraphrase Ralph Waldo Emerson:

To laugh often and love much:
To win respect of intelligent people
And the affection of children;
To earn the approbation of honest critics
And endure the betrayal of false friends;
To appreciate beauty;
To find the best in others;
To give one's self;
To leave the world a little better,
Whether by a healthy child,
A garden patch,
Or redeemed social condition;
To have played and laughed with enthusiasm
And sung with exultation;
To know even one life has breathed easier
Because you have lived...
This is to have succeeded.

My impromptu translation into this tongue devoid of metaphor or simile was absolutely nonsensical. I left a roomful of men scratching their heads wondering what in damnation I was rambling about. But then Abdoulaye Sogoba – the charmingly wise dugutigi – took the floor to save me from further embarrassment.

“What Madu is trying to say is that he did a lot of big work in Sanadougou. When he came here, this town was filthy. Now this town is still filthy – but it is a little less filthy than when he first arrived.”

The old men gave that thought a few moments to stew. Then they all started to speak up about my deeds – I assume that since Sanadougoukaw referred to me in the third person they were speaking amongst themselves;

“Before Madu came to Sanadougou, my nyegen was just mud and the sewage ran down to the well. But now, my nyegen is cemented and the sewage goes underground. And my well is clean.”

“Madu built soak pits at every nyegen on the road I live on. Now I can walk down the road without stepping in poop!”

Abel the pastor was emphatic; “Madu cleaned up the entire neighborhood of Filablena around the church, so now my church is a clean place to worship."

“… And he built nyegens at the Tonto schoolhouse, so now the girls will be able to go to school!”

“… And now we can do work at le Bureau de la Mairie without having to walk home every time we have to go to the toilet!’

“… And he fixed all the water system so now the robinets work again!”

Karitie recalled my foray into discipline at his Premiere Cycle; “Before Madu came to this town my students were shitting and pissing all over the place. But after Madu chased after the vile defecators and threatened to eat them, they will think twice the next time they try to poop in the schoolyard. They will be scared of being caught and eaten by the crazy white man.”

“Do not forget what he did in the garden”, said Moustapha, “Madu was not even a farmer in Ameriki, but he came here to Mali and farmed in his garden. He made a well and an underground pipe! And he showed me how to grow new squashes with cornhusks and pee! And he gave me a pack of pumpkin seeds so I can grow big Ameriki squashes!”

“But now Madu is leaving, and all of this work cleaning Sanadougou will end.”

“No, no, no! You have it all wrong!” I intoned, “Yes, I planted some seeds and tormented dirty little kids, but I really didn’t do all that much work cleaning up this town. Every time we built a nyegen, you found all the rocks, you found all the sand, you dug all of the holes, mixed all the cement and did all the hardest work! You the people of Sanadougou built 112 nyegens, 96 soak pits, 3 infiltration trenches and 6 top-well platforms! You paid Sidiki to do all the fine masonry! You didn’t need me to improve this town. You’ve had this power all along… you just needed somebody to come here and let you know it!”

“Madu is right” Sidiki said “he did not come here to do things for us. He taught us how to do things on our own.”

The old men murmured amongst themselves for a while in some obscure Minianka that I could not understand. The conclave then turned to me and Abdoulaye translated their deliberations:

“Madu, you must hold onto the voice of Sanadougou. You must always remember that even though you are a Mason in America, in Mali you will always be a Sogoba.”

Sidiki – the master mason – disagreed. “Before in Ameriki, Mason was just your name. When you arrived, while I passed all of my skills on to you, you were but an apprentice. But now a mason is who you are! You are a mason in your own right!”

When I look at Mali the rearview mirror, I feel accomplished in what I have done there. I leave as my legacy a bulk of physical evidence that I once lived in the village of Sanadougou, and my creations should last for a considerable amount of time. And I would like to think that if just one case of giardia is averted, if just one person is spared a painful trip to the nyegen, then I have succeeded.

But the most important thing that I have done here was not the construction of any concrete edifice that without proper maintenance will crumble into dust. I came to this realization long ago while riding on a bush taxi with a troupe of Minianka strangers. I was passing the ride reading a history of the Apollo Program. This endeavor captured the people’s imagination not just because of any tangible achievement but because of its intent; President Kennedy didn’t set the United States on course to send men to the Moon to conduct any military pursuit or to conduct any significant scientific research. What made Apollo 11 such a world-historical event was simply that Neil Armstrong and Buzz Aldrin disembarked from their space shuttle and hopped around on the lunar terrain. What mattered most was simply that they were there.

My Minianka fellow travelers rode this dilapidated bush taxi every week to sell their peanuts to market. They way they stared at this pale-skinned, hairy stranger wearing aviator sunglasses and an Indiana Jones hat, I might as well have been an alien from outer space. “Vous êtes d'où?”, one of them inquired – they assumed that I was French.

“N be bo Ameriki”, I replied. They understood that I was a peculiar outsider.

“E be mun ke?”, “E be Mali la muna?” they asked. “What are you doing?” “Why are you here?”

“N be yan o la an be se ka sigi yan ni Mali mogo san fila.” – I’m here to live with you for two years; no ulterior motive, no intentions of profit or gain. I just left the land of plenty to live amongst you the poor and sick and miserable as an end unto itself. I don’t intend on necessarily solving any of your problems, I’m really just here to do my thing.

“You white people are very strange.”

And thus I realized that my greatest accomplishment was simply that I disembarked from a plane and hopped around this alien landscape for two years – quite a considerable amount of time. Simply by doing my thing and broadcasting it to the world, I think that the understanding of Mali’s culture amongst the villagers of Vista and Amherst has multiplied a thousand-fold. Seriously, before I went there, how many of you could find Mali on a map? How many of you even knew that Mali was a country? Maybe a number of you even feel a sense of attachment to this far away land.

And if I left anything behind in Sanadougou, I would like to think that it would be the memory of that strange hairy man who lived amongst them and who flouted all social norms and went around sharing honest criticism of the way that we lived. I hope that they remember that it was only a child who told the emperor that he had no clothes, that it was only because that disrespectful punk told the chief of the village and his elder council that they were living amongst their own shit that they embarked on a comprehensive campaign to develop their municipal water infrastructure. More than anything, I hope that I might have taught at least one person the value of deconstructing the way things are – because only then can we have the perspective and will necessary to change it.

Though I might have spent a good portion of my time ragging on this culture and all of its present failings, I hope that you understand that it has not been out of spite. Lovers of law criticize the law because they want to make it more just, lovers of fine cuisine criticize their dinner because they wish to improve the recipe and make it more delicious. People who can call a dump of mud hovels, cesspools and garbage piles like Sanadougou home should tender criticism because they wish for it to one day become a place where gastrointestinal disease is as rare as the Malagasy Giant Jumping Rat, where wholesome food is as abundant as at the Trader Joe’s produce section, and where the Miniankas are so prosperous and healthy that they can live a life defined by music, dancing, and a whole line of brand new fart jokes that will never grow old.

My hopes might be sound fanciful, they might not ever manifest into reality, but there is only reason to keep on trying. After all, the Sun is but a morning star. And tomorrow is another day.