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Dioila, Mali

Welcome to Mali. I don’t think the African soil gets redder than this. It’s green, lush, and the rivers are full. I guess you could call this spring? The rains are ending, not stopped! just ending. I think it is so hot and humid now, but I’m told this isn’t the hot season.

( All Blog Post Photos:  © Bartay )

What I’ve noticed driving across the three countries here in West Africa, is a somewhat changing sign of the Islamic faith. Niger, which is about 90% Muslim, had mosques everywhere and very prominent. Burkina Faso, which has about a 50% Muslim population, was a lot less visible. Mali is more like Niger with a 80% to 90% Muslim population. The mosques are a lot more prominent here and can be quite beautiful. The interesting thing to me is that the Islamic design and style is different than that of the Moorish design, I saw in Morocco and Spain. This mosque was in the village of Bancoumana. With the market out in front, it just was very strong and prominent.

Today is going to be a bit more of a ‘technical’ posting. I’ve been out to the city of Dioila (pronounced; Joy lah) about 3 hours east, southeast of Bamako. I was out there to see the MMAM program (Management Moderate Acute Malnutrition) with joint investigators: HKI, the World Food Program, and UNICEF. It’s a study being conducted and overseen by HKI and the University of California Davis.

First though, I must tell you Dioila is not a big city, really quite small. So at the end of Monday evening, it was time to go to our respective rooms. Some were at the HKI office building, the others went to get their ‘hotel’ rooms before dinner, I waited till after dinner. Big mistake, I think I got what was left. Now I’m not saying any one else had it much better than I, however I think I didn’t get a suite. There was no ceiling fan, no window screens, and no mosquito net, just a mattress and 4 walls. I opted to sleep with the window closed, after I heard stories at dinner about the little bugs that just fill the room by flying through the holes in window screens. I survived to write to you now!

I happened to get to Dioila the same time there was a Steering Committee meeting going on. There were people from HKI, UC Davis, WFP, and UNICEF there to see the progress of the study. So while they were in meetings, I was driven out to the village of Wakoro and dropped off. The driver went back to Dioila and waited for the meetings to be over. So I got the village and the HKI field workers and the village all to myself for about 5 hours.

One thing I’ve noticed so far in Mali (along with everywhere else I’ve been) is how happy most of the people are. Whether they’re young or old. When I first got there, early in the morning, I was walking around and ran across this young girl. She was so cute and happy and it reminded me of the Elder of the village I saw and talked to the day before. Both ends of the life spectrum.

When I was walking back to the village clinic, I ran across this little girl getting water out of the well. What caught my eye, besides her being so cute, was that at an early age, the women in Africa already have this sense of colour. Her dress is just fabulous native African vividness.

So onto our technical post. This little baby girl and boy are in for a rather long morning. They are exactly 1 year old and they are enrolled in this study. Which means they are going to get poked and prodded and samples taken from all varieties of that prodding. The data is taken, recorded, transported for lab work (contracted to the local hospital), and meticulously handled by trained HKI field workers. I’m only a photographer, not a nutritionist nor researcher, so I’m not even going to try to explain what exactly they’re researching.

We started around 8:30 and I followed these two babies through their entire regiment, lasted until about 1:30 in the afternoon. On to the study. The first thing is to get baseline saliva samples. Now this is one of the things they disliked the most. Having little cotton wedges in their mouths until they filled with saliva. Not one, not two, not even three, but usually 4 or 5 samples taken and then labeled.

Then they were given a dose of Deuterium. Again I’m just a photographer, but it has something to do with being able to tell what the water retention is of the baby by before and after saliva testing. They didn’t have any trouble with the first drop, but there were two eyedropper full’s to go.

Then of course we have the urine sample. As an adult you just get a cup, but a baby needs a little bag with a glue edge to hold it in place for a while!

No comes the hard part. The blood sample. There are a lot of adults that don’t like needles, but they know what’s coming. These little guys didn’t. But with mom holding them, three very gentle adults doing the work, it does get done. And I might add, the babies didn’t mind it as much as the saliva gathering.

What amazed me was what they did with the samples they were taking all day long. They have this icebox in the truck that runs off of the car battery. They can get it down to 33º F and keep it there all day. Couldn’t believe it.

On to the next test. This I found out is a BIA test (Bio Incidence Assay). It does quite a few things. I know this because after the reading, the field worker kept clicking buttons and getting more readings to record. Body fat, water content, on and on.

Then after waiting 1 ½ hour from the eye droppers of Deuterium, they needed to get another saliva sample. I think by now, the babies are just saying ‘Alright, already!

Finally after the testing is done, there usually is a small cooking lesson for the mothers and sometimes a father. They learn how to make a hot meal concoction that is produced with a fortified bag of meal and nutrients, given to them, to help the nourishment of their child. Then the reward… the kids finally get to eat and did they love it.

So I’m still going out to villages around Bamako, then on Friday I’m going to be driving about 4 hours north to the city of Diema (pronounced: Joy mah). On Saturday I will be going out to see what is being done with NTD’s (Neglected Tropical Diseases) before driving back to Bamako. My time is getting short here in Mali, I hope to get back to you one more time from West Africa before heading back to the states.

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