Sunday, July 1, 2012

A Visit from Washington and a "Dead City"

This week has been a whirlwind of events in Conakry. I spent most of my time at the Embassy in the USAID section, where the Washington-based malaria team for Guinea held numerous meetings to discuss the Fiscal Year 2013 President's Malaria Initiative (PMI) budget. It was a great opportunity for me to get in on the ground floor and see how initiatives like PMI really function, in particular how they work with the implementing partners that Peace Corps Guinea hopes collaborate with. The Washington team did a great job of helping to promote the role of Peace Corps' Stomping Out Malaria in Africa initiative, which will help key NGOs warm up to the idea of working with our volunteers. The week was also increased my awareness of the immense challenges that Guinea faces in malaria reduction despite the millions of dollars committed by PMI, the Global Fund and a few other donors.

I was impressed by the level of dedication that the Washington team brings to their job and their commitment to finding the most productive ways to use the funds that PMI has allocated to Guinea. They strongly emphasized building the capacity of the National Malaria Control Program (NMCP) so that Guineans themselves can better do this kind of analysis and decision-making. The team was made of up two entomologists from CDC Atlanta and two USAID Washington staff members. They worked closely with the PMI in-country staff, who I will also continue to coordinate with over the next year. During pauses between meetings the team leader and I had enjoyed sharing Peace Corps stories since he was an education volunteer in the then Zaire, now the Democratic Republic of Congo. It's encouraging to see such a high percentage of USAID staff are Returned Peace Corps Volunteers. Another benefit from this week is that all of these former volunteers now have salaries, so I ate a lot of good food before coming down with an intestinal bug late in the week. A special thanks to Tom, Pascal, Ellen and Gail for their support!

The NMCP described to us that one of the reasons they need so much help right now is that they have limited basic capacities and very little money. The agency barely has enough funds to pay for gas to drive to meetings, and a a result have significant outstanding debts with gas sellers in the area. In addition, the only real means of communications the NMCP currently has is four USB internet keys that donors purchased for them. Otherwise they are completely reliant on the notoriously bad phone networks here in Guinea. This is clearly not a sustainable situation for a government agency tasked with tackling the number one cause of mortality and morbidity (malaria, if you've just joined us) in a country of eleven million people. Unfortunately government funding right now is minimal and even that is unpredictable. The NMCP has been promised a large amout of money from the Global Fund, but because of a number of factors the money may get suspended.  Lack of qualified staff and management, especially accountants, is one potential reason for suspension. Other primary recipients of Global Fund money are able to pre-hire staff to meet stringent Global Fund requirements, but the NMCP simply doesn't have the funds on hand to do that. Suspension of the money would be a disaster for the fight against malaria in this country which has constant stock-outs of vital tools in the fight against malaria. Almost yearly, Guinea depends on the Global Fund for thousands of doses of SP, hundreds of thousands of rapid diagnostic tests and millions of bed nets and courses of artemisinin-combination therapies.
At the same time that we've been immersed in macro-scale analyses and calculations about malaria prevention in Guinea, I have continued to work on preparing training for the new group of volunteers arriving next week. I've just confirmed that I will be facilitating malaria training sessions for about five total hours spread across the 11 weeks of Pre-Service Training. I'm thrilled to meet the new volunteers and teach them about the rewarding ways they can help prevent malaria in their future host communities!

For the time being, heavy rains continue here in Conakry and are sure to meet the new volunteers upon their arrival. The rains don't appear to be causing any major problems yet except for making it a challenge to dry clothes after doing laundry. On Thursday we witnessed what is known here as a "ville morte," literally "dead city," but a more accurate translation would be something along the lines of a protest or general strike. The idea of "morte," or "death," is that the city shuts down (shops clothes, people stay in, cars don't drive around), so there is no activity or "life." I know I had you worried there for a minute with those sinister undertones! The ville morte was called by the opposition in response to the eteneral postponing of legislative elections.  If I'm following correctly, these are essentially the same legislative elections originally scheduled for 2007, but which have subsequently been pushed back every few months until today. Many factors have contributed to the delays, ranging from coups to lack of funding for the National Electoral Commission to general political turmoil and lack of support from the president. Naturally, the political opposition in Guinea is quite upset with the delays. We were advised by the embassy to avoid crowds when driving through Conakry, as we were told that sometimes protestors throw rocks at vehicles. Fortunately, the only unusual thing we saw driving from Taouyah to the Embassy and then to the nearby house of a USAID staff member was light traffic. So, aside from obvious political problems, poor sanitation, miserable communications systems, and insufficient electricity, all is well in Conakry for the moment. In all seriousness, as we know from Mali, things could be a lot worse.

Speaking of our neighbors up north, uncertainty pervades in the upper regions of Mali as power struggles have again broken out between the MNLA and Ansar Dine. It appears that Ansar Dine, a significantly more extremist movement, has won out and controls the north. If it were possible to identify the lesser of two evils, I'd say that Mali just took a step backward. On Thursday, UNESCO listed two world heritage sites in Mali, the city of Timbuktu and the Tomb of Askia, as endangered as a result of the unrest and instability in the north. It is with dismay that I now read reports out of Timbuktu saying that irreplacable ancient tombs are now being actively destroyed.