About two months ago I was able to
participate in the Pecadom Plus project started by Ian Hennesy and currently
being run by Anne Linn. Pecadom Plus is
a malaria initiative that piggbacks on the Senegalese ministry of Health’s
Pecadom initiative. Pecadom stands for
“something something a domicile” (I don’t actually remember what it stands for,
but it’s in French, so it sounds cool).
Anyway, it’s a project where they train a member of a village that is
over 5 kilometers from a health structure to act as the community malaria
worker called a dsdom. They’re trained
to diagnose cases of malaria and are given ACTs (artemesinin based combination
therapy) to treat simple cases of malaria.
If the cases have progressed to a severe state, they are told to refer
the person to the closest health structure where they can be given a quinine
therapy. Anyway, the PLUS in the Pecadom
plus model turns the passive Pecadom model into an active model. In this model the dsdom, instead of waiting
for individuals of the village who feel sick to come to his house, once every
week goes on a sweep of every house of the village to actively search out the
cases of malaria. This is an improved
model because one can imagine a scenario in which a person is too sick to go to
the dsdom’s house to get treated. Thus
with active sweeps this person would be identified and treated. Anyway, that’s the boring details. This is actually a pretty cool project, now
let’s see how it worked out in practice.
Are you
buckled up? Is the safety harness
on? Is the tray put up and your seat in
an upright and locked position? Well
then, come take a trip with me, down memory lane, to the five days of my life
spent helping out on the Pecadom project.
Let me paint a word picture for you.
You’ll laugh, you’ll cry, you’ll be mildly interested!
So this
project took place in the Saraya district of Kedougou, which is mande
territory. It was actually a part of the
Mali Empire of the 14th century.
Apparently one of the leaders of the Mali Empire, Mansa Musa, was one of
the richest men in history. The story
goes that during his Hajj to Mecca he gave out gold so freely that it
destabilized the global gold market.
Whatever the veracity of that story is, there were a lot of gold mines
in the old Mali empire (and there’s still gold there, as the recent gold boom
in Kedougou evinces). The Saraya
district was also a part of the more militarily powerful Songhai empire. Askia the Great’s burial mound in Gao is a
world heritage site (Too bad I can’t go to Mali).
Anyway,
tangents aside, they all speak mande languages over there: Malinke, Jaxanke,
Jolonke (but nobody really know what they do out there in Jolonke land). I, however, speak Pular. This posed various problems, the largest of
which being that I wouldn’t really be able to communicate with the people
there. However, since I really only
needed to shadow the dsdom and only really needed to talk to him, French would
suffice (assuming that the dsdom also spoke French). See, my role in the project would be to
shadow the dsdom and make sure that he was going to every house and only giving treatment to those who tested
positive on the TDRs (teste diagnostique rapide). The first day was for the 15 villages that
would be a part of the treatment group, and the next 3 days would be for the 15
control villages (it took longer for the control villages because people had to
leave so there were less of us).
So I
packed my bags, caught a sept-place (a seven seater old French peugot) and I
was off! What would the next few days
entail? What would it feel like to be an
actual volunteer and actually be productive?
Only time would tell.
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