This cannot be the same world and only five hours away. I am sitting in the bright light of a August morning in Paris writing you one last postcard about our last day in Bamako. Only last night we were picking our way through the mud outside the airport in Bamako, shouldering our way through the throngs at the departures hall past boys changing euros and men selling bootleg CDs (hoping for one last sale) and ladies balancing their carryons on their heads and this morning, we are here. A few hours, a few centuries, away.
How to explain this gradual imperceptible shift that occurs in midflight – somwhere above the straits of Gibraltar, that makes what seemed so beautiful and proud in the heat and the dark of Bamako seem so garish and odd on the tarmac in Orly? The dresses that the women purchased for this occasion: damask from the looms of eastern Europe, hand-dyed pink and indigo in big pots in the Medellin market, pounded by hand with wooden paddles in dusty huts in the backstreets until the fabric takes on the sheen and stiffness of silk, beaded and embroidered by hand, embellished by west African beauty, look tawdry and overwrought here. The baggage delivery belt serving our flight speaks volumes: overstuffed duffels wrapped in packing tape and well-worn suitcases are mixed in with simple plastic sacks containing someone’s life belongings and tagged with AirFrance baggage tags, with cardboard boxes hand-sown into cast-off rice sacks, with recycled carryalls and simple boxes (full of mangos we think) tied with twine, with plastic sacks of corn, husks and all.It seems so strange to see this here, and yet so wonderful and so right and perfectly harmonious in Bamako.
It seems so strange too, that the dirt and rock streets of Sikoro should be just five hours away from this City of Light. We were there just yesterday, taking one last tour of the clinic where the Rosalie Fain Mere Enfant clinic will open. Dr. Dao met us and showed us the doctors office, the day hospital (two patients getting IV fluids from bags hanging from a single rusted metal pole), the delivery room (the medical student who was visiting the clinic with me was clearly shocked by the contrast with his own recent experience of delivery rooms in Chicago), and the recovery room. Two women rested with their newborns nestled in their arms. Here were two new beings, less than a day old, that had been brought to light in the village of Sikoro. The implications of having chosen this place to be born, luck of birth, was already quite clear to me, and frightening to think about.
When Dr. Dao first started working here less than five years ago, there was no running water at his clinic. And no electricity. Let us remember that this is the capital city of the country of Mali, and that the year we are talking about was 2000, on the cusp of the 21st century. Babies were delivered by “lampe de tempeste” (gas lantern).
We took pictures of the clinic and then climbed into the doctor’s ancient Toyota sedan to make the requisite visit to the village chief, since, by way of supporting the clinic, we are building a relationship with the entire neighborhood. The short trip to the chief’s house, past a market where dogs lay in the dirt only inches from our tires, across a stream, up a hill that was traversed by deep ruts, over stones and through potholes and past corrugated sheetmetal shacks, was more excitement than any SUV in the States would see in a lifetime. At one point, we decided it would be best if we got out of the car and walked along side it, as if it were an overburdened beast climbing a mountain road. The chief was not home, but we met his wife (beautiful smile, hardly any teeth, and lower lip tatooed blue) and some of his advisors. They were thrilled to have us helping Sikoro. We’ll have a goat barbecue when we return in January, that’s for sure.
Dao gave us some background on his job as we picked our way back down the rocky slope to the main road, past the herd of sheep on the bridge, past the lone cow parked in the intersection, past the vendors hawking freshly cooked chicken (grilled on woodfires over barrels by the side of the road). He earns $200 per month as a clinician at the site and pays the salaries of the rest of the workers from the clinic “copays”. One dollar per consultation. Clearly not enough to live on. So he and the others take private patients and do housecalls on the side – but it is never enough to make ends meet. I am overwhelmed. This man, a fully trained medical doctor, who brought water, light, and medical care to a village of 25,000, makes less than $3,000 per year.
And so we left the rutted, stone-filled, dirt streets of Sikoro behind us last night as we got on the plane less than six hours later, I sit here, and the noises of success float through my window from the streets of Paris. Scooters whir, taxis rush, heels click by. How can our lives be so completely different when the distance between our continents is so small? And what is the best way for those of us who are born into a world under the glare of a modern delivery room, share our “luck of birth” with those who are birthed under “lampes de tempeste” in the heat and dust of Sikoro?
What do I do with my luck of birth? Probably not enough. But I am striving to achieve a greater balance, sharing mangoes and medicine. Sharing knowledge and technology. Sharing music and laughter. Sharing these stories with you. Hoping that you have had the pleasure of seeing, and hearing, and thinking about Bamako on this Friday morning in August. Thanking you for listening. Not knowing what will follow. Perhaps greater balance for us all.
Annie De Groot MD,
GAIA Scientific Director and Founder
The Warren Alpert Medical School of Brown University