La Guingette

I actually did something that was just for fun this past weekend! It was lovely. I - we - need to do more that's just for fun.

Dana, Siddiqui (Suzanne's Malian friend) , Suzanne, Allison and I all went out the La Guingette, which is a small protected forest around a river area about 15km from Bobo. The trees are so big... most of the trees around here are small as there is really extensive deforestation. So it was great to see enormous ceibas, and lots of other ones. In the dry season here, most of the grass is brown, and the trees are generally looking spares. La Guingette though is green and lush looking... though without the lush tropical smell that I usually associate with this sort of forest... I guess that comes with moisture.

It doesn't rain - at all - between the end of October and the beginning of June; so the only things that are green are either very hardy, or watered either by a spring like at the guingette or a hose, like my garden. (My garden is currently flush with green beans and zucchini).


A few people have expressed disbelief that i actually ride a motor bike... so for those disbelievers, and now that i have a helmet carried all the way from Calgary, here is the photo of 3/4 of us on our motos at La Guingette (I'm the one in the middle bearing an unfortunate resemblance to Marvin the Martian).

We have a workshop in Ouagadougou scheduled sometime in the future to help develop norms & protocols for the treatment of HIV in children... I was all set to head out on Tuesday morning, when at 6pm Monday I got a call from my Ouaga colleagues saying that it was postponed by 6 days. First thing Tuesday morning, I changed my plane ticket, rescheduled drivers in Bobo & Ouaga and Dana changed our hotel reservations. Not even an hour later, it was pushed back another week... I am embarrased to contact everyone again! We are anxious to get going with this, though, because we won't be designing the HIV training curriculum until the norms & protocols are set... and training health center physicians may get way more kids on therapy than we can achieve here in the 'big city'.

At the workshop I was at 2 weeks ago, several of the people working in various parts of pediatric HIV care said that one of their biggest needs was "motivation"... at first I didn't quite understand what they were refering to... then, I didn't want to understand it. One of the problems with trainings, meetings and even getting referrals is the lack of "motivation"... if health care workers aren't paid a "sitting fee" / "per diem" to go to a meeting, they won't go (or, if they do go, they won't remember it). Even if they've had the training on who to refer for HIV care (as one example), they won't refer patients unless they have "motivation"... in other words, a fee provided for each referral. A prevention of mother to child transmission study here found that initially they were getting no referals of HIV positive pregnant women. Once they introduced "motivation", the referrals started pouring in.

So then the ethical dilemma... without "motivation" we may not get referrals... but how sustainable is that? And how appropriate is it to use funds that way?

On another note... we are trying to come up with a way to improve severe malnutrition care but one of the big problems is finding a sustainable source of the refeeding supplies. One has to buy them from UNICEF. On paper, the government officially supplies them... but in reality, they're not available. (So, if anyone knows of funding groups that are willing to contribute a certain amount per year for severe malnutrition refeeding supplies, let me know!)

Anyhow, all the best - enjoy your week.
Laura