Annie's pre-natal consultation in Mali*

When I returned from America in July I saw Annie for the first time in over 1 1/2 months (due to COS conference and my sejour home) and I immediately noticed that her belly - though not the rest of her - had grown significantly.  While it is culturally inappropriate in Mali to reference a woman's pregnancy (for fear of jinxing the pregnancy) I asked Annie about her bump to which she laughed and said there was a baby waiting inside to come out!  She said she needed to go to the health clinic to receive a tetanus booster and her pre-natal consultation and I asked if I could tag along.  Vaccinations are issued each Tuesday (for babies and expectant mothers) at our local health clinic 2 km away so we decided to go the Tuesday before I left. 

Tuesday morning I saw Annie buzzing around the compound with more haste than usual.  The cooking/preparing/pounding of the millet for meals rotates every two days between the three wives in the compound (Esayi's wife Annie and his two younger brothers' wives Aminata and Kadia) and  though Annie would have preferred to go to the clinic on a day when she wasn't cooking- the task the most time sensitive, and consuming, since a whole family of bellies depends on it - the vaccination day fell on both of the following Tuesdays and so we were obliged to choose one of them.  Also, harvest will pick up soon so Annie wanted to get the trip out of the way before she is needed more in the fields. 

Annie walking to the health clinic with her knitting in hand

Walking to the clinic Annie worked on her knitting as I struggled to keep up while wearing a skirt and avoiding mud puddles.  Along the way we picked up women heading in the same direction for their baby's vaccination (4 weeks - 9 months) but most didn't move as quickly as Annie so they would fall behind.  Upon arrival, Annie sat down on the edge of the concrete platform between the mid-wife's consultation room and the vaccinator's area to wait for the mid-wife to usher her inside.  She situated herself directly in front of the door leading to the mid-wife's office to avoid confusion as to who got there first.  Annie, like myself, doesn't put up with line cutters!

The door finally opened after waiting for 1/2 hour and Annie and I went inside .  The mid-wife then spent 10 minutes looking for papers on her unorganized desk and the notebook in which she enters all the names of the women who come to receive her services (she delivers it to the health center in San at the end of each month).  The mid-wife's toddler daughter was running around the room picking up stethoscopes and jumping on the scale and I felt myself sighing and shaking my head as I saw Annie waiting patiently.  Even though Annie is paying for this service she doesn't feel she has a voice to express dissatisfaction when the care provided is inadequate and untimely - and who would she complain to anyways?  After Annie signed her name in the now located notebook the mid-wife directed us to the pharmacist (a room just outside the size of a closet where items like birth control pills, condoms, multi-vitamins and iron supplements are sold).  Annie paid the man 1,750 CFA (about $3.50 USD) to receive three papers (and other supplements) - two papers to track the baby's vaccinations once it is born (one for Annie and one for the health records/donor agencies that subsidize the clinics) and one to track her own shots, weight and height.  Annie also received a malaria prophylaxis, iron supplements, a mosquito net, her pre-natal consultation and a tetanus booster.  When her baby receives all of its vaccinations (after 9 months) she'll receive another mosquito net.  Back in the mid-wife's office Annie was weighed and her height taken (49 kg=108 lb. and 1.5 meters=5 feet).  She said this was a 9 kg increase from her last pregnancy (baby Christine) during which she got very ill. 

The mid-wife's desk - you can tell she had a hard time finding Annie's papers!

 

Mosquito nets

After finishing up with the mid-wife Annie and I headed over to the vaccinator's room and Annie worried to me that he wouldn't have time for her.  I reassured her that all expectant mothers are taken ahead of the baby vaccinations (over 40 women were waiting for their baby's vaccination) and that all we needed to worry about was if there were enough vaccinations.  There were and Diabité took us in not long after.  While Annie collected her papers and knitting, I purchased bread and onion sauce for 50 CFA (about 10 cents) from an entrepreneurial child marketing her wares to the hungry, breast-feeding mothers waiting (and the snacky toubabu :) On the way home Annie and I munched on our bread and talked about her visit.  She was happy with her weight and how she's been feeling during this pregnancy and began talking about what we were making for lunch - saga saga - and how we needed to get back to get started and also beat the ominous rain clouds ahead.  

Annie and the vaccinator, Diabité, before she received her tetanus booster

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The waiting area of the health clinic with women waiting for their baby's vaccinations who walked anywhere from 0-10 km to get here

As I write this from my new place in Bamako I realize this is what I'll miss most about living in village.  The one-on-one moments where I feel such a part of someone's life.  Going to Annie's pre-natal consultation, planting trees with Bakari, moringa with Dramane and visiting gardens of people I know and with whom I have a real connection.  These interactions will be difficult to replicate in big, impersonal Bamako but I'll strive to achieve them nonetheless.  

*While with Annie I took notes & pictures on the process but asked for her permission to write and publish this on my blog.  She agreed wholeheartedly.