A Visit with the Neighbors

Hein and Barnaby inside the clinic.



The kids of Gare Bogedin
Photo: Mike Wagner



I live in a small two room house in a private courtyard, constructed with mud bricks lined with cement for durability. It had been built for a volunteer who worked with the health personnel, so it is on the grounds of the rural clinic, maybe a five minute walk, or one minute bike ride from the center of town. Thanks to the courtyard walls I’m able to keep a small garden- trees and flowering shrubs, growing throughout the year. Not that a five foot wall can stop a determined goat bent on destruction, but not that many livestock hang out in that part of town, having little need to see the district nurse, so they just don’t know about the cache of succulent greenery I hide inside the walls.

Living by the clinic means I see a lot of the village health problems even though my work is focused on small businesses and I don’t usually collaborate directly with the nurses. I watch the seasonal ebb and flow of diseases, from outbreaks of malaria in the rainy season to bronchitis and asthma when the weather turns cold (70 degrees) and dusty. Fortunately the dreaded meningitis outbreak, epidemic in parts of Burkina, didn’t hit the village during my two years there.

Sometimes people would stop by my house after they had been to see the nurse, frequently to my amusement. Hamidou the shopkeeper came by one day, limping. I asked him if he had fallen off a motorcycle and injured his leg. No, he had gotten a shot for malaria. In the buttocks. “Ca fait mal!” he complained. It hurts!

Fairly regularly, people come banging on my door, waking me up in the middle of the night, mistaking my house for one of the nurses’ residences. It must be quite a surprise to see a groggy, half naked American emerge from the house, white skin shining in the moonlight. I witnessed the first and second births of my life when an ambulance carrying a woman in labor fifty kilometers from Kiembara to the hospital in Ouahigouya made an emergency stop because the babies wouldn’t wait. I was really surprised to hear a car horn and see headlights shining in my window at two in the morning. Unqualified to deliver twins myself, I woke up Barnaby, the nurse next door, to take care of things while I stood around and helpfully gaped.

Barnaby is a bit of a rarity in Burkina- a functionaire, or civil servant, who has fully installed himself in village. Nurses, teachers, forest rangers, gendarmes, and various other administrative and support employees all work for the state. They have little choice where they work, otherwise no one would go to the villages. Frequently from middle class families, growing up in cities, they don’t like living in the bush with no electricity or other amenities. With their modest salaries, workers sent to village usually maintain a second residence in a nearby city. The most common arrangement is for the worker to live alone in village while the spouse and rest of the family stay in the city and find other work. Hein, the head nurse, or “Major,” at our clinic, for example, lives in this fashion. He works in Zogoré but whenever he had a day free he travels into Ouahigouya to see his wife and daughter. The rest of the time, he is alone in his house in village. Think for a minute and understand how this arrangement can facilitate the spread of certain infectious diseases.

Barnaby, however, seems to have taken to village life. He shares his house with his wife, Claire, and his three young boys, Caleb, Foster, and the oldest, Atanas, who attends the village elementary school. While Barnaby works at the clinic Claire cultivates corn, peanuts, and okra, which is also somewhat rare for families drawing a salary. They have been in Zogoré eight years and counting, and show no signs of itching to move anywhere else.

The third nurse, Coolidiaty, is another functionaire archetype. She grew up in the capital, passed the nationwide test administered to select new government employees each year, completed a two year training and was sent out to village. In Zogoré for nearly two years now, still young and single, she is on a career track that will hopefully move her out of village and into a city clinic or hospital before long. There are advantages to village life, in the meantime- her parents sent her younger sister to live with her in Zogoré where she can concentrate on her school work away from the distractions of Ouaga.

That’s it for the clinic staff. There are also two family compounds near me. One holds a small family, perhaps middle class by village standards. Dennis, the head of the household, is the secretary to the Prefet, who is kind of a cross between chief administrator and chief of police for Zogoré. Dennis lives with his wife, two kids, mother, and younger sister and brother, sharing several small houses grouped in a larger courtyard. The brother, Pierre, runs one of the village pharmacies. The mother, wife, and sister run a dolo cabaret. I pass by their courtyard on my way home from Ouahigouya. If it finds that the cabaret is running and friends are there, I am obligated to spot for a calabash, no matter how tired, dirty, and sweaty I am. There have been times I’ve gotten myself lost in the millet fields outside of town trying to find a new, back route home that doesn’t pass the cabaret and force me to drink.

The other compound, called Gare Bogedin for some reason I’ve never fully understood, is illustrative of why the size of Zogoré is so deceptive. If you had asked me how big I thought the village was, I would have said 1000 people, maximum. But according to the 2006 census, it’s more like 5000. Take Gare Bogedin, though. It doesn’t look that impressive from the outside, but enter the walls to find a twisting maze of houses, granaries, animal pens, little old ladies, and kids- kids everywhere. The same kids that like to come hang off my courtyard gate and chant “Bonjour, Madame!” I have no idea how many people live inside Gare Bogedin but it wouldn’t surprise me if it approached eighty.

Now, we seem to live on the outskirts of town. There are a few more scattered neighborhoods, but most of the action happens between the clinic and the high school, an area less than a square mile. However, the actual limits of Zogoré continue for miles in some directions, and among the endless millet fields, you do stumble periodically on other family compounds. Holding thirty, fifty, or eighty people per, the numbers add up, and that’s how an apparently tiny village can hold a surprisingly large population. It’s not dense, per se, in terms of people per square mile, given all the fields and empty space, but inside the homes themselves things are extremely dense, extended families sharing small spaces, and masses, hordes, colonies of kids running around everywhere.

Part of the clinic’s job, of course, is maternal health, with pre and post natal consultations and delivery by a professional, if a woman so chooses. Babies are given a course of standard vaccinations, and severely malnourished infants and their mothers are eligible for free meals. The upside of all this is a reduced infant mortality rate, somewhere between 85 and 105 deaths per 1,000 live births depending on who you ask. Still high, but an improvement from 137 per 1,000 in 1985. Nobody can argue with that the value of saving children’s lives. The downside, however, is rapid population growth in an impoverished land that can barely support the people already living there. More children mean more mouths to feed, more school fees to pay, and less land for everyone when they grow up and start cultivating their own fields. Birth control, in various forms, is available and fairly affordable, but is still viewed as either a luxury or some kind of bizarre joke by many people. Somewhere, there is a solution to this problem, but we haven’t found it yet- else, we’ve been unable, or unwilling to recognize it.