The Deception Endured by Domestic Workers and the Impact of Trafficking

A 22 year old woman and her mother greeted us at our next stop in the village. There house was made of the same material as the Mrs. Heang’s but it was much larger and had a distinctly separate kitchen area at the base and a narrow staircase that lead us to a large living areas. Beautiful straw mats lined the floors, which I later learned the mom made herself.

Upstairs—they had walls and two windows, overlooking the kitchen area. The windows were cut outs—so they were permanently open.

I remember thinking, wow, this is really nice. And, for them it was. At the same time, it was sad to think that a few walls, and windows made for a significantly better living experience. In NY we complain about our tiny apartments—but we rarely think that the bare basics that we take for granted are pure luxury for counterparts around the world.

We sat together on the mats upstairs. The 22 year old sat silently next to her mom. If I hadn’t known her age I would have guessed 14. Ms. Noeun and Sophanara assured me that they both wanted to meet with us.

After about 5 minutes of taping, I asked the videographer to stop. I hadn’t even heard any of the dialogue translated, but I saw from the lost look on the 22 year olds face as her mom spoke, that a difficult story was being re-hashed and I just didn’t feel that is was fair to make her re-live the experience in any way, especially it is wasn’t even her talking about it.

The mom clearly was still traumatized by the experience and felt a great deal of responsibility. She blamed herself, a widow in poverty, for encouraging her daughter to seek work as a domestic worker (helping with house work, cleaning, cooking, etc) for a foreigner. Her daughter, along with 4 other girls lived full time with the man from New Zealand and his Cambodian wife. While living there all 5 girls were sexually assaulted. The first time it happened to the 22 year old, she didn’t say anything—she didn’t know what to do. The second time, she dropped a hint to one of the others and soon learned that many had already been abused. She’d been threatened by the man, and her fellow workers also threatened her not to tell. They would lose their income, they would become disgraced by their families, and on top of that, there didn’t really seem like a way to escape.

The 22 year old managed to escape and her family supported her and pressed charges. The man is now in prison. But the long term implications linger. Her mother explained that in Cambodia, being a virgin before marriage is a must. “I have three daughters- 28, 22, 19. Because this happened to one of my daughters none of them have been able to get married….most girls here are married before age 19.” CWCC is working on community empowerment, but changing deep rooted stereotypes are not easy.

The daughter herself seemed to have more courage, more optimism. She said she hopes to learn to be a hair stylist and hopes to have the money one day to start her own company. She has the motivation to succeed. She smiled, I think almost with surprise, when I commended her courage and explained that often victims don’t have the courage to come forward. I said she is an example of hope for so many other victims. And her legal victory, with CWCC’s support, and her willingness to speak up, has prevented other women from becoming victims. I shared a poster of the Brooklyn Bridge with her and suggested that when she looks at it in the future to remember that many Americans believe in her and support her. I explained that in many ways she is a role model to other survivors for her courage and strength to come forward.

Skinny Cows and Economic Empowerment in the Village

We went to a local village today. It was unlike anything I could have imagined. The drive there was an escape away from hotel-tourist central. As I looked to the side of the road, I was shocked by how skinny and hungry the cows looked. Talk about an oxy moron. I kept picturing the black and white wrappers of the low fat, “skinny cow ice cream bars…and thinking if only they KNEW there was such a thing, I think the ice cream company would change the name. I could see their bones through their skin.

En route we stopped for lunch. Mind you at this point I’d already spent a day and a half with our video crew. Half way through lunch, I realized that one of the video guys is actually American! California driver’s license and all. The day prior, when we were having trouble translating a phrase or two, I noticed he chimed in, but he certainly didn’t say more than 20 words the whole day. I guess it’s easier to casually forget to mention that you speak English than to get stuck translating when you signed onto videotape. But, it was nice to be able to communicate now and again without a language barrier. Lunch by the way was amazing. Soups are an essential part of Cambodian eating. Today’s we had what’s called “Sour Soup.” Not so sour and pretty good. We also had some fried fish. Parts of Siem Reap are quite touristy, and like we associate the sea side with seafood; I think Siem Reap has the same feeling.

As we walked through dirt paths by what felt like a mini forest, I was in some way expecting to see a simple, small house. A house as we know it that is--with walls, roofs, and a door that can keep the outside world out. Mind you that the only buildings I’d seen so far in Cambodia, were hotels, the CWCC office space, the CWCC Shelter for Women and Children, the outside of the Royal Place/Residence (its right in the city center), the police station, a restaurant or two and rows of hotels catering to largely international tourists.

We walked through the trees, down the dirt path, and next thing I knew Ms. Noeun was grinning ear to ear as she stumbled upon a woman and a small child that used to live at her shelter. It wasn’t the family we had scheduled to meet up with, and since we seemed to be in such a desolate village, I was surprised that she ran into someone she knew.

Ms. Nouen embraced the child in her arms and carried her as she spoke to the woman. According to Sophanara- the UNFPA Cambodia Communications Associate and my ad-hoc translator, the woman referred to Ms. Noeun “as mom” –“hello mom, so nice to see you, yes I am keeping well mom…” As the day went on these phrases became common place. I had the opportunity to meet three families that had been reintegrated into their communities following their stay at CWCC and the end of their legal battles related to their rape, trafficking and domestic violence cases.

Ms. Noeun would smile when the women referred to her as mom, and she’d laugh about it. To one of the women she said, how can YOU call me mom? You are older than me and have three kids of you own. As we walked to the end of the path, I saw a woman in blue standing at her wooden table cutting coconuts in half. She stood under what looked like a tree house with a thatched, straw rood. As I look around (there were no wall) I didn’t seen anything that resembled a bed.

Mrs. Heang was the woman is blue’s name. She has a beautiful, welcoming face. Her 3 year old daughter lingered by her side and her 8 year old peaked around a tree, checking out the video crew as they set up the cameras. She also has an 18 year old, but he was away at school, thanks to a scholarship he’d received from CWCC.

She makes cake for a living and earns between 6000-9000 riel a day (less than $2usd on average) She sells the cake to her neighbors in the village and she also receives small sums of money or assistance through social services. Though she learned to sew while at CWCC when she left the center there were no machines available for donation. So instead, she developed a business plan with CWCC’s support to start her cake making business and she was granted start up capital of $100,000 Riel…($25). It was incredible to see what a difference that money (the equivalent of two cab rides home from midtown Manhattan to my apartment) had on her life.

As she spoke to us, she reflected a bit on how her life had changed. She was happy with her life changes and she cherished her children with all her heart. She said, “I know, that still, my economic situation is not very good, but at least I am not being threatened every day.” What makes a happy home, really? I learned that it is far more than a roof over your head and first and foremost it is a safe space.

After a quick segment of filming, we spent a few minutes together. They let me test out what seemed like a see-saw and learned how to “grind spices.” I stood on one end and the other end, like a hammer, pounded into the ground, chopping, breaking, etc. anything that needed to be chopped. I LOVE my pampered chef chopper, and value a good mortar and pestle but this wooden contraption took the cake in terms of efficiency, design, and easy of use!
Mrs. Heang invited us to sit down with her on the mat, and her mother, who also lives with her joined us. She continued to cut coconuts without any difficulty (whereas I have to use all my might to even cut through a watermelon) and poured the fresh juice for us. We drank some coconut juice and the kids ate the chocolate chip granola bar that I had in my purse. It was so fun to watch the little girl smear the chocolate over her face and then pick up the coconut juice, snap her head back and pour the fresh juice in. It could have been a commercial it was so cute. For those few minutes, I completely forgot about the sweat pouring down my face. In fact I don’t think I even felt the heat. I just felt such optimism, as I sat with this genuinely happy, healthy, strong family, who despite their difficult living situation seemed to live life to its fullest. I didn’t want to leave.

First Day in Cambodia

Breakfast at the hotel was a mix of soup, fried rice, kimchi, eggs, fruit, pancakes and toast. Sophanara (UNFPA Cambodia Communications Associate) and Sultan (Driver) met me at about 8am and the film crew followed in a pick up truck behind them.

We went straight to the Cambodian Women’s Crisis Center Shelter. Like most shelters there was no identifying information outside to be sure that abusers, etc, are unable to find it. Ms. Noeun was there to greet me and I could see she had plenty of energy. Her motorcycle was parked out front, since she too had just arrived. I explained that it would be wonderful if she could just go about her morning like she normally would—and allow the video crew to follow behind her. I’m sure she did some of her meetings in fast forward but she really was great at ignoring the camera and giving her un-dived attention to each person she encountered.

Women and children who have been victims of domestic violence or sexual abuse are able to live at the shelter during their legal process. Ms. Noeun started her morning by stopping into the kids classroom. Kids of all ages were in one room—and when we walked through they were busy tracing shapes at the table. A couple babies were asleep in small hammocks and a few kids were sitting in a group and drawing. They all looked forward to seeing Ms. Noeun and responded early as she asked them about how they were and what they were working on. She stopped and helped them on their project and makes time to somehow make each child feel acknowledged.

The Sewing room was pretty cool for me to see. Twelve extra sewing machines were against the wall—that said donated by UNFPA. When the woman are ready to leave the Center they are given one each allowing with 100,000 Riel ( $25) to help them start their own business.

Women also learned how to cook. Each day four women are responsible for cooking. They are given $25 to go to the market and prepare 4 meals for 50 people (breakfast, lunch, snack, dinner). They had porridge and water for breakfast and for lunch they were making fries, sour soup, fried tofu, and rice. They usually calculate costs at 50 cents per person per day but they also reserve some money for the kids to have transportation to school and also for travel to the market.

The girls are age 17 and younger; boys age 8 and younger. Women vary in age—but the average age in 55. Most stay for about 8 months to one year. Other women come to receive CWCC legal services and support, but they chose to live with family instead of at the shelter.

CWCC has an in-house attorney and medical staff that come to the center. There is one other center is Siem Reap that provides similar services. Though the capacity of the shelter is 50 people, they’ve never turned anyone away.

Sometimes the women go back and live with their abuser, who is most cases is their husband. The husbands must testify and sign a document with CWCC promising that they won’t abuse again. CWCC explains that this does not always work, but they system is currently set up so that women can come back three times if they need to.

I spent the afternoon learning more about Ms. Noeun and her work. We went to the Center and met her team there. She actually lives at her office and two of her grandkids live really close by. At the end of the day she took them on a motorcycle ride to the park and it was fun to watch as they held tight to their grandmother.

My Journey To Siem Reap

I've arrived safely in Siem Reap. The flight was delayed though for the first hour of the delay the airline claims that my ticket, itinerary, and all related documentation actually listed my flight time wrong. Though my ticket said 7:30pm departure from Seoul, Korea the airline staff were adamant that the flight was actually scheduled for 8:30pm. Ok, whatever, Í'll go with the flow. Since I had several hours to pass, I sat down for some traditional Korean food-- double boiled beef short ribs in broth. A couple years ago I learned how to make Korean style bbq short ribs...so it was fun to experience the authentic cuisine. I think I was the only non-Korean person in the whole restaurant.
The flight took off until about 9:30pm and I arrived in Siem Reap about 5.5 hours later. Of course, just my luck, there is a 2 hour time difference between Korea and Cambodia (3 between Mongolia and Cambodia) so it might have only been 1am in Cambodia but as far as my internal time clock new it was 3 am!!
Though my hotel was supposed to pick me up from the airport, when Sophanara, the UNFPA Cambodia representative who was meeting me in Siem Reap, stopped by the hotel to make sure everything was set for my arrival., the hotel manager said that her staff had gone home for the night and sorry, there is no one to pick me up. Sultan, also from UNPFA Cambodia, saved the day, and though he too was exhausted from driving Sophanara from Phnom Phen that afternoon. He graciously offered to pick me up and stood waiting, smiling at the airport to greet me.
What a difference a friendly face makes upon arrival in a new place. I felt at home immediately.
Even though it is so late at night, it is incredible humid out. The road from the airport to the hotel felt very dismal. Unlike Ulan Bator, which felt somewhat industrialized with pockets of great disparity, tonight my eyes only saw what felt very much like a low income country in need. It was strange to have the immediate feeling that UNFPA's help was needed. I was also reminded of Sri Lanka. In Sri Lanka the road from the airport is pretty dark and dismal, but as you approach the city the strips of hotels feel like Las Vegas. I know Siem Reap is known to be a huge tourist destination, so maybe it's the just the late night arrival and the humidity. We shall see.
My days in Cambodia are very, very packed. I'm not sure when I'll be able to post next. In the mean time, I encourage you all to read my friend Rebecca's blog. She traveled to Cambodia with Americans for UNFPA in January with a delegation of about 12 Americans. Because staff and guests of Americans for UNFPA were here so recently, my trip is focused closely on meeting Ms. Ket Noeun, 2007 Americans for UNFPA International Honoree for the Health and Dignity of Women. Ms. Noeun is the provinical coordinator for the Cambodian Women's Crisis Center and runs a shelter for women. Her Center is heavily involved in the legal aspects of the work and has unique community partnerships to ensure health, dignity and justice for vicitms and the community at large.

A visit to the unregistered migrants mining for gold and coal

We hit the road at 8am friday to beat traffic for our 2 hour drive to Darkhar (I know I'm spelling that wrong, but I don't know where to look it up!) where there are mining sites for both coal and gold.
Funny thing. We arrived there at 1:30pm. Five and a half hours later.
There were very bumpy roads but not really that much traffic, so I'm not quite sure what happened. Lucky for me, the company in the car was compelling and, I was able to take a cat nap or two. Dr. Munkhuu had this great cashmere back brace that she offered up for me to use, but I said that at more than half her age, I thought she deserved it more than me! Apparently the brace costs about $6USD which to me sounds cost effective, practical and trendy! Sign me up for one! Cashmere is plentiful here…but cashmere is still cashmere and even at the discounted price, you are still paying a lot.
It was my first day free of a camera crew, and though they were fantastic, it was nice to not have to think about interview questions, or video footage.
The governor of the Soem where the mining takes place, two of his staff and a few others, met us in a Jeep about a hour away from the mining district to direct us the rest of the day. Everything seemed to be 30 more kilometers or 10 more kilometers but everything seems to take at least another hour. At the time, the distance didn't really phase us—the countryside was very peaceful.
We were shocked though, after driving for hours through empty fields to see a massive city crop up in the distance. The mining district that we visited was at the tip of the city, but still in a very rural location.
As we approached the mining fields we saw 2-3 people in various quadrants in the distance. Each hovered near a bed of water, seeking their treasure. The mining industry is filled with unregistered migrants—which to UNFPA equates to people who are in dire need of help because they government can not officially offer them care and support.
We drove "10 kilometers more"—30 minutes and we met several miners and their families. Unlike the rich herdsman we met yesterday, these families literally had merger fabric tents pitched on the sand and very minimal resources. Two little boys helped their dad—we asked where his daughter were and he said they left them with family in the city because he didn't want to expose them to this lifestyle. (The boys were all about the photo ops as you'll see!) My pictures show them working hard, sieving through the rocks and gravel and achieving success in finding 4 small (tiny) pieced of gold. I was pretty impressed that they found some on the first try.
The adults have been encouraged to get jobs in the Soem Center, but they say "the money there is worse and they have to report to a supervisor." "Here, I am my own boss."
Unlike most of the UNFPA projects that I talk about, in this case, the men are the particularly vulnerable group. They have hard, laborious working conditions, low income, poor shelter, few resources, and they have little to no access to social services or health care of anytime. There wives suffer too, of course, but you can see the worry and hardship in each man's face.
We gave them a carton of apple juice as we left and the few families living in the neighboring tents gathered together with joy. If only apple juice was a long term sustainable solution to ensure then happiness, health and dignity.
We made our way back to the city and I met with the video crew to pick up the tapes. Anika left for the airport at 4am the next day and I left at 10:30am.
It was time to say goodbye to Mongolia.

Our Ger Experience

Though we didn't get to sleep in a Ger, a herdsman knew that we were coming to visit the Mobile Clinic and had heard that Dr. Munkhuu would be receiving an award with us, and as such, invited us in for a home cooked 5 star lunch. We dined in his guest ger—which was absolutely gorgeous. He's a rather wealthy herdsman, with 500 cattle of his own—though I don't know where he kept them because I only saw 2 or 3). Anika, by day President of Americans for UNFPA by night as aspiring interior decorator—was taking detailed notes on the ornate decorations. I will not be surprised if her daughter Amani's bedroom is soon decked out in Ger style. To be honest, the workmanship was incredible. It felt like a lifesize dollhouse. Even the entrance to the ger is done with beautiful workmanship.
There were four beds inside that lined with walls on the ger—all were carved and painted with an orange base and blue design work. The design seemed to have Moroccan influence and they basically felt like "Day Beds." We sat on them…apparently the men are supposed to sit on the left and the women to the right. They had an amazing coffee table in the same design and all of the spokes holding up the ger were also ornately designed in the same colors. The herdsman (in his spare time) built, carved, painted EVERYTHING. He said the coffee table alone took him four months.
Twenty of us gathered in their Ger—which I'm guessing was about 30 ft diameter. They fed the doctors, trainees, drivers, video crew and all of us from UNFPA and Americans for UNFPA. They served lamb, cabbage, potatoes, carrots, cubed cheese, crème( which was a cross between butter and clotted crème) and bread and Dr. Sumbertzel's wife and daughter packed us a picnic lunch with we shared with all of them. The food is cooked over hot stones and just before we ate, we each were given a hot stone to toss in our hands and improve circulation. It was HOT but I'd definitely do it again.
We also had fresh Mongolian yogurt (both Anika and I are big fans) and Horsemilk—which is fermeted milk which smells very potent of alcohol. The Mongolian tradition calls for either a drink of horsemilk or vodka 3 times during every visit—at the beginning, to line your stomach, at the middle (for fun??? I'm not sure, actually), and at the end to send you off. Right. In an effort to respect tradition, we had a sip each at the beginning and end….but lets just say, we'll stick to the yogurt!
As is obvious, we won't forget the experience. The herdsman and his family lived in the ger next door which was decorated in a minimalist style. While their home still had lofted beds, it is rather common for mattresses to be at ground level, or to just sleep in a sleeping bag on the ground.
I'm still worried about how things are going back in NYC…maybe I can convince one of my colleagues there to guest post and fill us in. A natural disaster, caused by rain that lead to a steam pipe explosion…?! I hope all is well.

Seeing a Mobile Clinic Made the Bumpy Roads Well Worth It!

When I signed onto the internet Thursday morning, I was pretty shocked to see "steam pipe explosion near Chrysler Building" as the top story on yahoo news in Mongolia! There is a 12 hour time difference between NYC and UB. For those of you that don't know, Americans for UNFPA's office in NYC is located just across the street from there. Thankfully, no one from our office as hurt- Deni and Marcela were the only employees in the office and they were quickly evacuated from the building (So quickly that Deni's cell phone, wallet, and the video footage from her visit to 2007 Honoree Mdme Traore in Niger are still sitting on her desk..oy!) I've since heard that the external damage to the building is quite bad and they are waiting for reports about the inside. Our office and the entire building are closed until mid next week at the earliest.

About 20 minutes later, that same day, I learned that there was an Anthrax scare in Kar Khorem—the ancient city—where we were planning on spending the night in the Ger. Who knew that there was more to Anthrax than being a chemical weapon? Apparently it is actually first transmitted through cattle. According to Dr. Munkhuu's son, (the dean of public health), there is no evidence of cattle to human transmission, yet. None the less, there is NO WAY we are going to Kar Khorem today. Anthrax in Mongolia and a natural disaster explosion in NYC—definitely not a lucky morning for Americans for UNFPA.

As planned, we carried on with the first half of our day—a visit to a UNFPA funded mobile clinic. Once my photos are posted you won't have to rely on my descriptive visuals—but in the mean time—picture two tents pitched in the middle of countryside fields with an emergency mini-van beside them. The only things in any proximity were two gers about 300 meters away, A couple of cows and horses close to the gers and our two cars pulled up in front of the tents.

Right there, in the tents, they had two pretty impressive things going on. In the first tent, they were conducting an ultrasound on a pregnancy woman and in the second tent, about 8 doctors were seated on the floor for a "train the trainer section." I kid you not when I say a laptop was loaded up, and a powerpoint presentation was reflected on a screen at the front on the tent. Technology.. it is everywhere.

The mobile clinic serves about 500 patients a year and spends a week or so at a time at each of its regular locations. I've seen many pictures of mobile clinics, but I never realized conceptualized how remote they actually are. We traveled bumpy, unpaved roads for several hours to get to the clinic. Even when the roads were paved, we often drove next to them because some how the grass/dirt was smoother. We saw zero street signs and a couple dirt forks in the road. A doctor from the clinic greeted us about 20 minutes away from the mobile clinic and directed us the rest of the way. If our car took off, I'd still be standing there and would probably become best friends with a stray cow. Moo.

But, the clients that need the services seem to know exactly how to find them. A great deal of public awareness and advocacy exists locally to ensure that remote rural communities receive quality care. They receive a lot of support from the governor, which I guess helps a lot.

Mobile Clinics operate in 7 provinces in Mongolia . (They call provinces/states—Amags..pronounced Imags.) In the province of Tuv , where this particular mobile clinic was located, the clinic visits 4 distinct locations (they call theses soems…which I guess are the US equivalent of a county).

Through the train the trainer program, annually UNFPA helps train 3000 doctors, nurses, counselors and other social services providers. The project operates in 9 sites, seven of which are rural and 2 that are urban.

It's pretty incredible work.

We arrived back in Ulan Bator at about 6:30pm and spent a bit more time at the UNFPA office. (I received my third lesson on Amags versus Soums, etc…and finally grasped the concept)

In retrospect, timing wise, it probably worked out for the best that we were unable to go to the ancient city. The bumpy roads without four-wheel drive made the trip pretty long and tiring.

Anika and I went to a Lonely Planet recommended restaurant for dinner that night called Silk Road. The hostess told us the wait would be two hours, but I spotted a daughter/dad pair that were clearly about to finish their dessert. About 20 minutes later we were seated. The ambiance was great—although there was a tour guide seating across from us that felt the need to speak at the top of his lungs non stop for the entire meal. We are convinced he didn't stop for questions or even air. I can still hear his voice in my head. All I can say is I'm glad I didn't pay to have him as my tour guide.

Six Degrees of Separation

Today we met with U.S. Ambassador Mark Minton and Mr. Dan Nadel, a Presidential Management Fellow working at the Embassy. Turns out Ambassador Minton used to work with our former Board Chair, Phyllis Oakley and Dan is originally from Queens, NY. Oh the small world we live in!

From there we had additional media interviews….apparently when Jagga, the media advisor at UNFPA Mongolia, arrived at work this morning, her phone was ringing off the hook from a variety of media asking why they had not been able to interview Anika or Dr. Munkhuu. I know a segment ran again on tonight's 8pm news because a friend of Dr. Munkhuu's called her during dinner to say congratulations..she just heard the good news on the news.

Our evening tonight with Dr. Munkhuu's family was unforgettable. Dr. Munkhuu hosted a lovely dinner at the Mongol Hotel—which is a must see location that takes you back to Genghis times in its historic scenic step back in time. We met almost all of Dr. Munkhuu's children, grandchildren, and even a great grand child, and had a wonderful celebration in her honor. We also celebrated Susie Smith's birthday—Susie if you remember is the Peace Corp Volunteer who met me at the airport and also played a significant role in organizing our trip logistics. BTW Susie's heading back to the U.S. this fall and will be entering a job search…did I mention she's personable, professional, a great organizer, culturally sensitive, speaks a bit of French, Spanish, English and Mongolian, and has her Masters in…something. She'll be heading home to Denver, Colorado but will go where the wind takes her when she begins her job search. (Ahh, the glory of networking)

After dinner we made a quick stop at Strings, a "club/lounge" where a band from the Philippines, "Midnight Shift" was playing. Delia is originally from the Phillipines and it was our last chance to chat with her before we leave. She'll be on mission when we return from Kharkhorin. We caught part of the first set, classic American favorites like "Africa" and they sang happy birthday to Susie. We promised to stay for one or two songs as they transitioned into a more dancing set.

In the spirit of the small world we live in, I'll share the following: I accepted an invitation to dance with a friend of the Band, also from the Philippines. We started out Swing dancing (I don't swing, but thankfully my red polka dot dress at least twirled a bit) and quickly I was safe as the song shifted to salsa. Anyway, I explained that we were in town from the U.S., he said he thought India..I explained that my parents are from Sri Lanka…and in "classic Angie style" he used to live in Colombo, Sri Lanka. I didn't get a chance to hear much more, because I was pretty tired and we needed to head back to the hotel and I needed to blog! : ) Delia by the way can tear up a dance floor!

Hopefully, you all are enjoying the blog and living the experience vicariously. Though sleep is hands down one of my favorite hobbies I'm cool with sacrificing it now and again for the greater good. And what greater good than taking the opportunity to share with the world my experience with Mongolia (my first UNFPA field visit), my deep respect for Dr. Munkhuu and my thanks to UNFPA and Americans for UNFPA for allowing me to witness this important work.

Tomorrow morning we head to Tuv aimag to see a mobile clinic and then will visit Kharkhorin soun, the ancient capital of Mongolia. We'll be staying in a Ger in the middle of a remote area so there will be no entry until Friday at earliest.

Ok so I went a little over half an hour…but not too far…I'm a fast typer. Really.

“The Godmother of Mongolia” and her entourage

It's great to have Anika here in Mongolia. Anika Rahman, President, Americans for UNFPA arrived in Ulan Bator just before midnight on Monday night, after an unexpected 7 hour or so wait in the Beijing airport due to flight delays. Nonetheless, we debriefed quickly and arranged to meet at 8:15 for a jam packed day. So jam packed that I didn't get to post this until today.

Tuesday was empowering and enriching. We learned in the morning that our camera crew's TV station was planning on announcing Dr. Munkhuu as honoree of the 2007 International Award for the Health and Dignity of Women on the 6pm news. TV 5 is the leading news medium in Mongolia.

You know the way news clips looks when, for example, a president or presidential candidate makes a day trip to a target state? You see the candidate and his/her entourage walking into rooms packed with people, standing at the podium, shaking hands with dignitaries and locals, being interviewed, ect. Well, apparently the segment that ran on the news yesterday (and again today, I guess, because it was such a top story) was just that—except Dr. Munkhuu, Anika and I were the featured women! I guess the President of Americans for UNFPA plus a leading advocate/politician in Mongolia = Breaking News! Sure, we've all been on the news plenty of times before, but I personally have never been to vividly in the limelight with a news crew follow me for an entire day. I haven't seen the segment yet, but I'm hoping to get a link to the online feed within the next day or two.

We started our day at UNFPA, where we briefed the staff on the background of the award, talked about Ms. Noeun from Cambodia and Mdme. Traore from Niger who will also receive the award, and we gave them the lo-down on the fabulous 3 American Honorees, and the lifetime achievement award winner (Mr. Ted Turner).

From there we went to Gal Golomt National Movement, an NGO that Dr. Munkhuu founded. I thought we were going to meet with 2-3 staff members—so when we walked into the room to see a) the camera crew already set up and filming our walk into the office and b) a room full of forty + women, applauding and standing as Dr. Munkhuu walked through the door. At that moment, before even a word was spoken, it was evident from the emotion in the faces of the women (and one man, actually) that immense admiration and love was felt towards Dr. Munkhuu from women of all walks of life. We heard testimonial after testimonial about Dr. Munkhuu's contribution to the country of Mongolia, her implementation of policies to support women and families, and personal testimonials about the way Dr Munkhu touched there lives both personally and professionally. Have I already mentioned that Dr. Munkhuu's was actually one of the signers of the new Constitution of Mongolia in the 1990s? She showed me a fantastic photo from the signing that really reminded me of the famous photo of our forefather's signing the US Constitution in 1776. The people in the room ranged from age 19 to 85 I'd say. I learned today at the 19 year old, a law student and the youngest member of Gal Golomt , who was clearly one of the organizers of the morning event, is actually Dr. Munkhuu's granddaughter! Also Dr. Munkhuu's son, Dr. Sumberzul, who met me at the airport, is the Dean of the School of Public Health at the Health Science's University of Mongolia! Success and commitment to the health and dignity of women clearly runs in the family!

There is so much to tell you about Tuesday- and it's already midnight and I just got a call from Anika, who informed me that she was making an executive decision for me to go to bed! I promised within the half hour and reminded her that if I urge everyone else to blog consistently on trip, how can I not hold myself to the same standard!!

[Michaela—if you are reading this—I'm reminding you that you should be sleeping at midnight in Malawi—Not blogging. Michaela Maynard is the winner of the 2007 Americans for UNFPA Essay Contest for the Health and Dignity of Women. She was selected from a pool of U.S. college students and will be heading to Malawi the 28th. Her blog will be featured on Marie Claire Magazine's website..and will be cross posted on our site as well. ]

I'll keep my fingers crossed that I can get a copy of the news segment to share with you to get a better sense of our day. In the short term, I'll give you the highlights of the rest of our day:

Next stop. Parliament. We met with Ms. Dolgor, Assistant to the Prime Minister of Mongolia and Deputy Chairman of the National Committee on Gender Equity
à She provided a solid background of Dr. Munkhuu's accomplishments and also spoke about her own work and the Prime Minister's work on behalf of women. She summed up Dr. Munkhuu's achievements as follows. "Dr. Munkhuu fought for women's well being, helped develop a civil society (ie. NGO community) and at the policy level made concrete changes by make sure women's rights issues were a priority."

From there we met with Her Excellency, Minister Tuya.--Minister of Health. She had an incredible presence and I was very taken with her willingness to take time to meet with us, her openness to questions and her support of UNPFA. She also gets my personal award for the best quote(s) of the day. I asked her what set's Dr. Munkhuu apart. She responded: She has very high intellectual capacity, high organizational capabilities, she's indeed a godmother to all of us." She said, you know "like the Godfather movies—she's the godmother.!

LOVED IT!

I wanted to say, oh my goodness you are the coolest, but instead I said thank you very much for your time! J

Delia Barcelona, UNFPA Mongolia Country Rep, and our host for the week, joined us for this meeting. Though I know that UNFPA does great work around the world, I thought it was very gracious of Minister Tuya to take a moment to publicly acknowledge and praise Ms. Barcelona's commitment and contribution to the country. Having had the opportunity to witness Delia's compassion, commitment and efficiency, I can't help up share with you Minister Tuya's comments. Minister Tuya was explaining how important it is to grasp the different and unique characteristics of countries and regions so you can operate effectively. She continued…"Dr. Barcelona, from the moment she came, has been very sensitive to the unique differences. We love working with her because everything goes very smoothly and effectively." She extended her thanks to UNPFA for bringing these kind of very capable people to come and work with them.

As I hope I've made obvious, Her Excellency Tuya herself was very impressive and I loved that she could mix humor, bestow appreciation to Dr. Munkhuu (and UNFPA), represent the government to us in an incredible fashion, and still hold a powerful presence over the room. (She also had great fashion sense) Together, she, Ms. Dolgor, and the women of Gal Golomt showed me that Dr. Munkhuu's success is not the exception in Mongolia but rather it's increasingly becoming a standard.

Just as we were finishing the meeting with the Minister of Health, one of her colleagues interrupted the meeting and handed her a phone. Next thing we new she said good bye, apologized for having to leave, and was whisked away. Apparently she'd just received a call that the Opposition party was calling for the abolishment of the Cabinet…so yeah, she had some things to attend to! Quite the "West Wing" moment. For the record, the Cabinet has not been abolished…

From there I was able to visit UNFPA project sites—including a hospital, a maternity rest center and a youth health center. The Youth Center was actually modeled after Mount Sinai in NYC. I have TONS to say about the UNFPA sites…But, my half –an-hour before I turn into a pumpkin has passed so I must go to bed.

Happy Birthday Jeanine!

1.5 people live per square kilo in Mongolia-- imagine life without neighbors!

Mongolia is one of the least densly population countries. The population is about 2.6 million. There are 1.5 people per square kilometer in the country. At the same time, Ulan Bator, the capitol, is very crowded. 45% of the population lives in UB and there are actually 205 people per square kilo in UB. From one point five people to two hundred and five from urban to rural. In the rural areas, who do they borrow egg or milk from if they need some in a pinch?!
I asked why we are taking two cars to the rural area on Thursday and it's because the areas are so remote that its too dangerous to go alone, in case you have car trouble, etc.
The Western region, where Dr. Munkhuu grew up, is the area of the country with the largest nomadic community and the least resources. She grew up in a herder family. She witnessed the daily list of responsibilities-and saw how even a day after giving birth, women (including her own mom) were back in the fields, tending the livestock and caring for the family. UNFPA has programs in 5 of these western provinces focusing on reproductive health and Dr. Munkhuu is amongst the many people now making sure that women in these communities have access to better health care. Still there is way more work to be done. The maternal mortality rate in urban areas are 93 per 100,000 (is 45 per 100,000 in the U.S) versus 380 per 100,000 in the rural areas.
I learned more today than I have in a long time, and what i've mentioned above barely scratches the surface. My brain is still digesting. One thing is clear. Dr. Munkhuu has influenced the lives of so many. Her impact is long standing- both for the success of the country and the growth of individuals.
Enkhjargal, a UNFPA colleague who first worked with Dr. Munkhuu almost 25 years ago in parliament, says that any time she has a big issue that she needs to discuss, personal or professional, Munkhuu is the first person she turns to. Undarya, National Coordinator for MonFemNet, the Mongolian Women's National NGO Network told me that Dr. Munkhuu's leadership in organizing the first national conference on family planning in 1990 is what lead to the liberalization of family planning. Her creation of a Women's Federdation (rather than the former Communist Women's Committee) opened the door for collaboration with women's movements of the opposition's political parties. Bulgan, a young associate at UNFPA, talked about how impressed she was with the way Dr. Munkhuu cares for her family, alongside her numerous political, NGO, and UNFPA commitments. She showed me a picture of her 11 month old baby and said she hopes that her daughter will grow up to have the compassion and accomplishments of Dr. Munkhuu. My camera crew and I stopped by a monestary and the gate keeper let us in with open arms when he heard that we were filming landscape shots of Mongolia for a video featuring Dr. Munkhuu. Her influence is more far reaching than I could have imagined.
The socialist - democratic transformation of Mongolia is enlightening. When I asked Dr. Munkhuu what made her decide to be a doctor, she explained that it wasn't really her choice; it was the socialist government's government moved her to policy work and then made her leader of a youth movement, and eventually to Parliament. She explained even though the choice was not her own, it was a great honor to be selected by the government to play such roles. She in turn gave 100% to every project assigned. She draws very much on her personal experiences and prioritizes sharing the lessons and fortune of her own life with the wider community.
Days are long in Mongolia. Both in terms of sunlight and the hours people work. It's 8:15pm now and its still bright as ever and the sun isn't expected to go down for a while.
I need to go practice all the new names I've learned. Interestingly, business cards say the only the intial of your last nam and your first name. So Dr. Munkhuu's would read D. Munkhuu-- D stand's for Dorj, her dad's name but it's not carried on. Even when you get married you always keep your own name, your first name.
Oh and get this, the reference I made to Lincoln Memorial yesterday; the Genghis Khan memorial is actuallly modeled after it! Who Knew!

Gengis Khan and Dr. Munkhuu- Two of Mongolia's Biggest Names

I can't believe I'm in Mongolia. I don't really know what I expected it to be like, but I do know it's quite different to what I imagined. Ulan Bator, the capitol, reminds me of a cross between Valencia- a sea side city in Spain and the Jersey Shore off season. Everywhere I look I see mountains where I'm guessing the majority of Mongolia's famous nomadic communities live. On Wednesday or Thursday I'm going to actually spend the night in a Ger!

I just had dinner with Dr. Munkhuu, who is essentially the reason I'm here. She's one of three women to be honored this fall with the 2007 Americans for UNFPA International Award for the Health and Dignity of Women. She's every bit as warm and amazing as I imagined her to be. She holds a million positions in Mongolia—she run's a non-profit Gal Golomt and she's also a Culture, Gender and Human Rights senior advisor to UNFPA. Culture, Gender and Human Rights—all in one title—I wish! On top of that, she was one of the first female parliament members, she's a doctor, she has eight kids plus grandkids and great grandkids and she seems to have an amazing sense of work-life balance. And, she seems extremely humble. I however have no problem telling the world about her—and I'm going to spend the next few days filming footage for a short video on her and I'm sure to talk more about her in this blog.

Suzie, a Peace Corps volunteer from Denver who is working at UNFPA met me at the airport along with Dr. Munkhuu's eldest son. I've only been here 8 hours and in the first two of those Suzie walked me through me most of what there is to see in UB. I learned that the most prominent structure is a massive memorial to Genghis Khan—which looks a lot like Lincoln Memorial…and I've seen about 10 other structures, statues, posters, street signs featuring him. Needless to say Genghis is the Biggest Name in Mongolia. (with Dr. Munkhuu a close second or third, I'd like to think…)

Dr. Munkhuu met me at 4pm and brought with her a medley of photos to help chronicle her life. I saw her riding horses in the country side, receiving awards from the president, standing at an event commemorating her first collaboration with UNFPA in 1999 and beautiful pictures of her family.

We just had dinner at a restaurant connected to the hotel called Casablanca—there was a huge picture of the cover of Casablana the movie on the stage of what seemed to be a dance floor; OutKast "Hey Ya" was amongst the songs played as dinner music, and the menu was about 30 pages—because every item had a photo describing it. The menu had everything from Malaysian Beef Rendang to Spaghetti and Meatballs. There was only one Mongolian dish and I wanted to get it, but Dr. Munkhuu said I'd be eating plenty of traditional food this week, especially when we go to the countryside. I opted for a sweet and sour fish; Dr. Munkhuu had fried chicken with cole slaw and rice and our translator had lemon ginger chicken.and an iced tea. [Dr. Munkhuu is shy to speak English (hence the translator) but word on the street is that she's far more proficient than she lets on. I'm aiming to have at least 2 full conversations in English with her before I leave.]

I accidentally left my sweater in the restaurant, and in classic Angie style, when I ran back in to get it—I ran into two friends. YES. It's true, I've only been in the country 8 hours but two of the 7 people I currently know in Mongolia were sitting at my exact table and handed me my sweater. We stood in the wrong line together this morning at 6:45am the airport (apparently you have to go thru customs before you check your bags when leaving Beijing), we shared a pen to fill out our customs form, bonded over chocolate, and they asked me about my watch. At 6:45pm, there they were at Casablanca! They live right around the corner from the hotel. Classic.

The driver is meeting me at 8:45am tomorrow to go to UNFPA so I better sign off. It's only 12 hours away!

I forgot to mention my quick jaunt thru Beijing-

Beijing, by the way was great. Very crowed, very bustling. I'd say it offers some serious competition to NYC. I arrived in mid afternoon and transited overnight there after my 13.5 flight from Newark. Determined to see more than my hotel lobby, I ventured out into the city for the few precious hours I had. I stayed pretty close to the city center and felt extremely safe. I stopped by a small art exhibition and learned about calligraphy art and rice paper, saw three versions of "the four seasons," and tons of drawings of horses! Since I was born the "year of the horse" I'm well versed in how lucky the horse is meant to be. Adjacent to the exhibit, at about 6pm, the steps of the Catholic Church were filled with skate boarders and crowds watching, and at midnight the streets were still full. They have a snack market that lines the streets from about 8pm onwards and instead of pretzels, cotton candy and hotdogs- they have dumplings, fruit kabobs, noodles, every other kebab you can imagine and stall after stall of vendors selling Chinese trinkets. (People could not understand why I couldn't be persuaded to by a fan or a jade budda!). Like Canal Street in NewYork there were tons of fake Gucci, "prados," coach bag. The vendors thought I was crazy when I said I would only consider buying a non-designer purse WITHOUT any labels. I think it was the first time they heard such a request!

Ironically MANY people have complimented me on my "Men in Black" watch. I don't even know if they wore watches in that movie, but basically the day before I left the city I realized I didn't have a watch or my travel alarm clock. I picked up a massive rubber strapped digital watch with a huge face and an alarm clock that was sitting at a store near my office, about 70 percent off—calling my name. It looks like it does a lot more than I'll ever know -perhaps transmitting messages to the aliens. Thanks to Jesse, our outreach coordinator, in about 2 minutes he figured out how to use it and 30 seconds later I learned how to work the alarm clock. Lucky for me the time difference between NYC and Mongolia is exactly 12 hours so the time is still correct! Anyway- the watch is a BIG hit here, and apparently I'm on the cutting edge of fashion. Ha!

I made it to Tiananmen Sqaure just as they were taking the flag down at sunset. As you walk down the road, the classic black and white street suddenly transforms to walls of deep red. It very powerful to see the crowds of people and I felt an air of freedom. The Forbidden City closed at 3pm, so I only was able to see the outside. The gardens surrounding the city and square were beautiful as you'll see in the pictures. I never used to bother walking through Boston Common and I rarely spend time in Central Park, but I longed to have a couple more hours to spend in the Emperors garden. It funny how easy it is to take for granted the parks and historic landmarks we have access to daily. BTW, a historical moment: I passed "Mango" at the Oriental Plaza en route to Tiananmen and I kept walking. I missed the Mozart Museum once; I wasn't going to risk missing the Square!

The end of my trip - You can't bring mangos back to the U.S.

I never had access to a computer my last day in Niamey and I felt that the blog was hanging a little. So, in retrospect, here's the end of my experience in Niger.
As a tourist, I was a failure in Niger. I went to the Grand Mosque (with headscarf ready) but it was locked up and the guy with the key was nowhere to be found. Soumana and I went to the Niger Museum on Friday (supposed to be one of the best in West Africa) but, of course, it was closed on the holy day. (Soumana was, apparently, not paying that much attention to prayers last week.)
Instead we had cokes and talked about being 40 and never married, how it's unusual in both our societies and what kind of people give us grief over it. (Soumana suggests that I'm not married because I can't cook and I suggest he's not married because he's rude.)
On Thursday night I was invited to Madam Traore's for dinner which was a really nice dinner with enough food for about 25 people (there were five of us). I now know about 10 French words and Madam Traore knows about 20 English words so the conversation was light. I told her mangos from really hot climates are much better than the ones from hot houses and so on Friday she brought me a bag to take home. They made it to JFK where the customs agents took them from me (and ate them, no doubt).
The business aspect of my trip was considerably more successful. On Friday I went to the other big hospital in Niamey that is part of the University. Two urologists perform fistula repairs and train gynecologists to do the surgery. I met with the senior surgeon, Dr. Sanda who, like Dr. Abdulai at the National Hospital, seems very dedicated and is very good with the patients.
I found the work being done to address fistula in Niger to be really impressive. This is one of those cases where the reality seems to match the claims. Definately, UNFPA is dedicated to addressing fistula in Niger and definately Madam Traore makes a difference.
At dinner before I left for the airport I asked Ghaichatou why she personally thought Madam Traore was worthy of internatinal recognition and she said because she really views the prevention and treatment of fistula as part of the human rights that women deserve generally. She said Madam Traore doesn't wait for money, she just does the work and if she gets more money, she does more work. Finally, she said, Madam Traore is the only woman in the country that can go to the National Assembly lecture the politicians about the treatment of women.

Everybody who speaks English asks if I'm married

I've been on this computer a few times today without managing to get a connection so if you're reading this it means the power didn't go out and I didn't give up for the night.
The staff here have been really patient with my lack of French but they're very young and we have conversations like this:
Me: I need to send an email and the computer isn't working and I don't know what the error message says.Nice Hotel Staffer: Why not?Me: Because it's in French. NHS: Oh, right.Me: That's ok, I can call. Does the paper in my room say that the room phones don't work?NHS: No, you can call.Me: From my room?NHS: No, not from the room. The room hones don't work.
Ghaichatou: Is Deni Robey in the hotel?NHS: Yes, she's here. Ghai: Can you call her room?NHS: She is not answering, she's probably coming. Ghai: Are you sure she didn't leave for the Grand Hotel?NHS: Ah, yes, she took a taxi.
Eight years ago Friday (July 6th) I watched my nephew, Charlie, come into the world. He's been on my mind because this is the first year that I won't be with him on his birthday but he's also my only experience with childbirth. And I'm sure I don't have to go through the litany of differences between my step-sister's delivery and that of most of the women I've met here. I'll just say this one thing because it's pretty interesting. West African women are expected to give birth without crying or screaming. Literally, they are supposed to "suffer in silence." That's a cultural thing, not a poverty thing. (Imagine a whole country of Tom Cruises.)
I'm here to see women's health programs but education comes up again and again. School is free here (through university) though students have to buy their uniforms and pay small fees that are not exactly tuition. But very few children are in school. The Nigeriens I meet keep telling me that the country won't get any better until the kids go to school.
On Monday as we were leaving the Dimol offices a very young girl was waiting outside with her husband. She gave birth two weeks ago and has been leeking urine ever since. Madame Traore was telling her that she could go to the Dimol Center and that they would help arrange the repair surgery. Then, a little like there was an audience, she loudly praised her husband for coming with her and ranted a little about how most husbands don't care. Then the husband told Madam Traore that he had gone to university with her son and, even louder, she went into a small tirade about how the educated men are the good ones and that if more men went to school we wouldn't have so many problems.
(By the way, I asked Madam Traore if she went to the university in Niamey and she laughed and said she only finished secondary school but she just kept working her way up. Three of Madam Traore's children went into medicine - one son is a gynecologist and the Assistant Director of Dimol.)
Niger is a hard place. It's hard for me to explain but the landscape is so bleak, it makes you feel that bleak is all it's ever going to be here. BUT, the Nigerien health workers and teachers and businessmen aren't flocking out of the country. This is definately one of those cases where the work is already happening - just on less than a shoestring.
Back to fistula. And by the way, after four days I realize that I'm not necessarily getting the facts straight - either because these are casual conversations I'm having or because of the language issues or whatever. For example, there are five doctors who do fistula repair in Niamey - but not all at the National Hospital. So, if you're really interested in this stuff, check out the rest of the website or email me if you can't find what you're looking for.
UNFPA donates the equivalent of $100 to the hospitals for each fistula patient who undergos surgery (the government is supposed to provide additional money but I'm not clear whether it does or not). And UNFPA funds Dimol's reintegration strategy - which includes the cost of each patient's recovery at the Dimol Center, the gas to drive her home and the $100 she gets to start an "income-generating activity."
Another UNFPA-funded intiative is the the contraceptive program at the Reproductive Health Center - which is a large, very nice but underfunded clinic in Niamey. The clinic is a project of the Ministry of Health and offers prenatal care, basic gynecology and contraception. The staff seems large, there are supplies and even a sonogram machine but the equipment is old and the written materials haven't been reprinted since the clinic opened in 1984.
(The midwives I've met are all like Madam Traore. They're smart and dedicated and they mean business. I guess years of helping women push babies out and they tell it like it is and don't care who you are. Madam Traore told me tonight that she doesn't want to retire until the Dimol Center has surgical capabilities but she said that she's tired from the stress of 40 years of delivery and the constant stress about the woman and the baby.)
Apparently, USAID funded a lot of family planning in Niger until they closed that particular program in 1998. There was a break in service while the Ministry and other NGOs tried to fill the void but, according to the midwife who showed me around, the use of contraception never returned to rate it had been. But UNFPA funds the women who do come.
The fistula trifectorate: prevention, treatment, reintegration.
I got to sit-in on a weekly group counselling session with the fistula patients at the National Hospital. Women with fistula who make their way to a hospital generally camp out in one of the courtyards until they get surgery (and there are always the stories of women who live in the courtyard for years). At one point, the fistula program at the National Hospital stopped but the women didn't leave. So they had to find a way to start it again.
Dr. Abdulai runs it now and it addition to being really dedicated, he's hilarious. In addition to talking to them about their own worth, he makes them laugh frequently. (I started to explain a couple of times when he had the whole room laughing but it sounded maudlin in the telling. Women who constantly leak urine have a different outlook on life.)
Every 15 minutes or so the computer screen is taken over by scantily clad women and I just don't want to know what the ad is for. The owner of the hotel introduced himself to me in the dining room and asked if everything was ok and I felt like saying, if you could just change the ads so they're for Dimol or the Reproductive Clinic or the Youth Center that would be great. But tonight I'm taking it as my que to turn off the computer.

Everybody in Niger asks for directions

First - Happy 4th. As there will be no fireworks here (and I am somehow not invited to the party at the U.S. embassy, I've invited some of my new friends to the deck at the Grand Hotel to watch the sunset).
It's occurred to me that it's because I'm often in places where there are large numbers of tourists, there are usually enough people who speak English for me to get by. Not so, here. Soumana is my translator from 9:00-5:00 and I really struggle with the simplest things when he's not around.
And even with Soumana, the cultural differences here make communication a little challenging. Just one example, I told Nourou, the "boss" of the video crew, that I couldn't afford the gas for him to take the the whole crew to the village but that we could fit his cameraman in the vehicle with us. On Tuesday morning, the whole crew showed up and they had even aquired a fifth guy.
Anyway, Tuesday morning, after getting tires and stopping at many roadside stalls for snacks, water (in plastic bags), etc. Madam Traore, Boure the (very serious) cameraman, Nourou (because for some reason he couldn't be left behind), Soumana and I set out to take a young woman, Biba, and her little boy back home.
Biba has been at the Dimol Center for three months. The son she had with her is her 4th child (the majority of fistulas happed with the first delivery) but she had too many deliveries too close together. It's unusual that the boy survived. (I put him at 3 months. He is not unusually thin and while he seemed a little lethargic, I thought it was the heat. It turns out that he is actually 7 months old.)
Biba has had two surgeries to repair her fistula and she actually needs a third but her prognosis is very good. (There are 26 Nigerien doctors trained to do fistula surgeries - largely thanks to UNFPA's Fistula Fortnight in Nigeria three years ago - and four of them practice at the National Hospital here in Niamey.) Normally, Biba would stay at Dimol until she had fully recovered but she wanted to go home and I wanted to see Dimol's "reintegration strategy" so Madam Traore agreed with Biba's promise to return in three months.
There are no road signs in the bush and there are VERY few signs that announce the name of a village (Welcome to Kabe Popluation 230). So, the way you find the place you're looking for out of the thousands of villages is a) find one of the drivers of the bush vehicles that bring villagers to Niamey in the morning and take them home at night and ask him how to get there and b) ask everybody you pass. You meet some very interesting people that way. Occassionally, if you missed an important fork in the "road" but not far back, a kid or young man will jump on the back of the vehicle or cram in beside the driver and get you back on track.
The drive was supposed to take about two hours (I think I said earlier that there was no A/C.) It took four. Apparently, we took a very circuitous route. We drove for long stretches across landscape that, to say it looked like moonscape, would be to exaggerate how much was going on. I mean nothing. There were were times when the only markers to indicate the road were the giant ant hills and times when the only marker was the tire tracks of the vehicle that came before us.
This is the rainy season but there is very little green. The Nigeriens are worried. (Mostly they grow millet and other grains.) One interesting fact that I learned from Madam Traore - most fistulas happen at the end of the rainy season because (she says) a woman's family won't stop working to take her to a health facility if her delivery is going badly. ("Fistula is an illness of poverty.")
On the way we stopped by a village with a health center to ask the nurse, Fatiya, if she would come with us. There isn't a health worker in every village so Fatiya has to travel around and people have to come to her. For her work she makes about $75 a month - which is good by Nigerien standards but apparently not enough to make her independent. The health centers are a project of the President of Niger (Despite many, many heated political debates in the car - in the local dialect Djerma - I really can't tell what people think of the government except that it's not very effective.)
Fatiya looks like she is in her mid-20s and seems very serious about her job. She's been a health worker for three years but she says it's frustrating. Apparently, a company or an NGO or the government donated pharaceuticals at a very low cost but Fatiya was not able to get the houses of her village to donate to a pot of money. She tried to explain that it would be for the good of everybody but they said she would use the money for her own purposes. But she keeps trying.
By the way, apparently the only white people who come to the villages in Niger are doctors because just about everyone who talks to me asks me if I can fix their eyes/hand/wound (even with Fatiya just a few feet away). Soumana has to constantly tell people that I'm not a doctor. (In town, there are few white people but I'm no oddity. Nobody seems to notice my glaring white face in the crowd.)
In the village, the kids are petrified of me. (Possibly because I forgot to take something to hold my hair back in the car and I suspect I looked like a witch.) They crowd around at a distance and the really brave ones will shake my hand if I'm persistent.
When Dimol takes a woman home after her fistula surgery, they send someone ahead to tell the chief and the Imam that they are coming and want to do a presentation for the village. When we arrived the more important men of the village greeted us and little boys gathered around but no women or girls.
(Before I make the following observations I should say that Soumana, the guys on the film crew, the men who work in my hotel and the mostly male staff of UNFPA have been really great to me.) Soumana said you can tell when a village has never been "sensitized" by an NGO (meaning there had never been programs for women or for health, etc. sponsored by an organization like Dimol, CARE, Oxfam, etc.) because they women don't great guests. But if an NGO has been active, the women are much more empowered to come meet visitors.
Madam Traore told the men that the woman should attend the meeting and, duly chastised, the men used the exuse to order the women around - barking at them to come out of the huts and sit down. Then Madam Traore spent about 20 minutes lecturing the men to treat their wives better and about 20 minutes telling everyone about sanitation and their health. Only larger villages have a paid health worker like Fatiya so the women of Dimol are trained in basic health precautions and to identify potential problems. When a woman like Biba returns, it's announced to the village that she is now their health worker and that she may tell them to get medicine or to see Fatiya or that a very young woman should go to Niamey to have her first baby. This is an subtle order to the men not to yell at her because she "inappropriately" tells them what to do.
In front of the village, Dimol also gives the woman the equivalent of about $100 to start an income-generating project (like making soap) because most of them have been abandoned by their husbands so they have no support.
Somehow, the route back to Niamey was "obvious" to everyone else in the car as we went "directly" and in only two hours.

Just because it's not 125 degrees does NOT mean it's not hot

I started this morning by missing breakfast which turned out to be a very, very bad idea. I also skipped the security briefing and am counting on the fact that nobody who cares about that is reading this. They just tell you that there are problems in the north on the borders of Libya, Chad and Algeria and I'm not going there. I asked the UNFPA Representative here if she was suggesting that I don't look Nigerien enough (take a look at my bio photo to get that joke).
Instead I went to the bank where the nice man behind glass waved my hundreds of US dollars and the millions of CFAs they bought for all to see. So blending, I'm not.
Today we started shooting a short documentary that takes us to Dimol, a non-profit organization that deals largely with fistula. The camera crew is four guys (I expected two) and one of them actually has to hold a large boom mic. I feel like there should be some added special effects to this video shoot. Because I was at the bank longer than I expected, the crew went to Madam Traore's clinic to shoot and, as luck would have it, there was a woman delivering this morning.
In the afternoon, we (me, my translator, the film crew, Madam Traore, her ob/gyn son and several of her staff members) went to visit the Dimol Center where women wait for their fistula repair surgery or recover from it. (Our very own air-conditioned caravan plodding across Niamey.) It's a beautiful Center in a sparse area of town that's just being developed. Madam Traore told me she tried for two years to get the land to build the Center but it's lucky for everyone who will live nearby because they brought power lines and plumbing to the neighborhood. That's a nice twist.
The heat, my empty stomach and the five different languages made it tough for me to follow the conversation (even with a translator) so I helped with soap-making. (All I really did was stir the pot.) I've heard others say it but it's true that women whose fistulas have been recently repaired smile and laugh a lot.
This evening my UNFPA chaperone and I went to the Grand Hotel, the best spot in town to watch the sunset over the Niger river. This is one of the places where the elite of Niamey, the grungy American kids (because it's in Lonely Planet) and an odd assortment of expats socialize. We solved our big question to each other - that my FIRST name is Deni and her first name is Ghaichatou - and she told me a lot about her work on fistula in medical school. She started by translating for Americans who came to Niger to train local doctors in repair surgery.
Then we ate Italian food. Seriously.
Tomorrow we leave at 7:00 to take one of the women from the Dimol Center back to her village, which is 140 kilometers from Niamey and the car is not air conditioned.

Arrival in Niamey, Niger

The best part about my job is meeting some of the most amazing women in the world (seriously) who measure their success in terms of change within their societies. To get to meet some of these women on their home turf and see how things actually get accomplished well, that's not something I'll ever take for granted. It's not just the fact that these women stand up against cultural norms and take them on that impresses me (although, of course, it does). It's also their patience to make these changes - little by little, year after year - that inspires me. In the U.S., we want to see change RIGHT NOW.
I arrived in Niger this afternoon to visit Madam Salamatou Traore, President of the non-profit organization, Dimol, (more on that later) and to visit UNFPA programs. Niger, a landlocked country in West Africa is bordered by Libya, Chad, Algeria, Nigeria, Mali, Benin and Berkina Faso. The official language is French (which I don't speak, unfortunately) and the country is more than 80% Muslim. There are just under 13 million people here. The life expectancy at birth is 44 years and the fertility rate is just over 7 children per woman. The rate of HIV, however, is low at 1.2%. Niger is a constitutional republic with a President and a Prime Minister. It ranks last on the United Nations Development Fund index.
The Air France gate agent at JFK airport told me he has friends in Niamey (the capital) and that it was 54 degrees celcius on Friday. I've never gotten the hang of celcius so, against my better judgement, I asked him what that is Ferenheit. 125 degrees. "But it's a dry heat." It's the last thing I heard before I passed out. (Not really.)
On the way here, I kept reminding myself that women in Niger live with that kind of heat all the time (this is just a little south of the Sahara, after all). Since most Nigeriens live on less than $1 a day, they probably don't have the air conditioning (such as it is) that I have in my hotel room and many of them don't have nice, cool water coming out of the shower head, either.
We're so spoiled. It is not 125 degrees, by the way.
I arrived at the Niamey airport and was only expecting a driver but instead, Dr. Kinni Amoul Ghaichatou was there, too. She has been helping me with the arrangements for this trip. Actually, I booked the ticket and she has graciously done everything else. She is much younger than I expected and has only been working for UNFPA for about a year. When I asked her how she liked it, she said, "I love it." I told her I love my job, too and aren't we lucky that we can say that.
Even more amazing, Dr. Ghaichatou works on fistula for UNFPA. (That and her excellent English are how she got assigned to show me around this week.) Fistula is a hard topic and she must see real change as possible for her to love her work.
Dr. Ghaichatou is Nigerien, attended university here in Niamey and studied public health. She did her thesus on fistula. I'm looking forward to hearing more about her work but today was all about planing for the next five days.
(Please forgive spelling and grammatical mistakes - it's been a long trip.)