Loaded into the white Landcruiser and bouncing along the sand roads I watch a blur of tiny antelopes, termite mounds shaped as 10 foot tall castles, sky blue birds and innumerable camels sashaying through the brush. A little boy with a stick tends to a hobbled camel that crosses the road with indignation. A nomad family with their well packed camels encouraged along their donkey that had a large white goat strapped to its back, legs splayed. I do not know if the goat was special or obstinate to earn a ride on a donkey.
We were passed by a van full of men and miraa (qat- a leaf and twig with amphetamine like effects) bouncing cartoonlike ahead of us. We had witnessed it running a checkpoint in a not so cartoonlike fashion a few minutes prior. They were friendly enough when we met up with them in Kokar and after a brief unintentional interaction had no further.
Pulling into Damajale, there are no tire tracks, just camel, donkey, goat, chicken and human tracks. Twig, mud and a few corrugated shacks are confined be stick and brush fences. All have a pile of branches for firewood outside.
Arriving at the community clinic we were disappointed to find the health workers absent. Only the watchman with the keys was present. Due to security reasons, we do not pre-announce our arrival. It would have been inappropriate to use someone else's clinic without them, so we observed a WASH training which was really amazing and acutely reinforced my opinions regarding preventitive services. The 'ounce of prevention is worth a pound of cure' idiom is so valid. Our partner organization is performing a KAP (knowledge, attitudes and practice) assessment on these communities and also offering the WASH training. I reviewed the surveys and it is eye opening to see the beliefs and practices regarding germ theory. Most people are not washing hands after going to the bathroom (nowhere to do it anyhow, but more on that later); fortunately this town now has a higher rate of pit latrines so most of the respondents were using these. Nobody knew how to make rehydration salts and many treated childhood diarrhea by reading from their holy book. The WASH training was so great, I was impressed to see how in a few hours germ theory was presented and hygiene not only taught, but understood. The teaching methods were effective, not pedantic, and the participants were fully engaged. Class was held on mats on the ground and followed by creamy tasty (camels milk?) chai. The host community was gracious and beautiful.
Part of the training is building tippy-taps, an ingenious hand washing station built from some strings, an old Jerry can and some sticks. Our host was very proud of his and demonstrated washing hands with more enthusiasm than I've seen in a while.
Sure, I can save an ill baby's life with aggressive medical intervention, but this program is preventing disease measured in the quantity of families and villages. I was very humbled to be reminded that string, leftover containers and a few hours of training can kick Western Medicine's butt when it comes to reducing sickness. Thats not to say medical teams don't make a difference (we do, but differently), just that prevention is the foundation of truly healthy communities.
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