04-30-2007 04:10 PM
I so enjoy questions and discussion; it's truly one of the most enjoyable aspects of being an author. No question too small - no question too big!
04-30-2007 08:16 PM
How have things for women changed in the approx 15 years since you left Mali?
for example: are more well-trained midwives in the field?
Are they continuing to use tapes (or movies) to reach low literacy groups in the countryside with messages about birth control, female genital cutting etc.
05-01-2007 07:21 AM
As you may have heard, Mali just had elections. It is one of the shining examples of democracy in West Africa (since the coup in 1991). There are women legislators now; there are more community radio stations; there are more women's organizations dedicated to education and health. I learned recenty that the President's wife is a midwife! She is pushing the maternal and child health agenda. However, maternal mortality rates are still very high and though the studies that I've read indicate that slightly more births are being attended by trained midwives, much remains to be done in this area. A recent study showed that the midwives in Mali want more training, and more resources to do their work.
As for female genital cutting, it is still as common in Mali (studies show between 96%-98% of girls are cut). The community radio stations continue to be used for health education messages, even more so than in the past. There is no law in Mali that makes FGC illegal. I know that there is movement by female lawyers in Mali to apply existing laws on personal injury to FGC.
On a micro-level, I spoke with Monique's cousin last week about the clinic that we are building in SE Mali, and he told me that electricity is coming to his village. It will be on 8-12 hours per day, and thus the solar generators that we're buying will be used when the electricity is off. Picture: light, power for sterilizing instruments, power for grinding beans to flour for baby foods.
I haven't been to Mali since 1999, and look forward to returning this year and seeing for myself how things have changed.
05-02-2007 03:29 PM
In writing the book, was it a difficult decision to reveal to the reader from the outset what ultimately happened to Monique?
As a reader, I liked learning her outcome at the beginning of the book; it made her story (and her community's reliance on her) more significant.
Melissa in Sacramento
05-02-2007 09:17 PM
It was a difficult decision indeed. Perhaps b/c the story of Monique's life and my friendship with her could be told in many different ways. In the end I went with my first instinct - to reveal that Monique had died right up front and then go back into the past and talk about the years I lived with her. Otherwise, I would be withholding this important information from the reader. It was her death that spurred me to write the book in the first place.
Anyone wish that they hadn't known ahead of time? How do you think it would have changed how you read the book?
05-03-2007 08:57 AM
05-03-2007 10:05 AM
05-03-2007 10:35 AM
I was wondering 3 things after reading the book:
1. What was your most challenging moment of your experience in Mali?
2. What was your favorite moment?
3. What was your least favorite?
Thanks for writing,
05-03-2007 10:49 AM
I imagine through writing this book and through working in your field you've completed a good deal of research on the topics you explore in Monique. What have you learned about midwifery, birthing practices, and women's health in other areas of the world, outside of Mali?
05-04-2007 10:12 AM
Good questions. I'm glad that Africa is in the news and that we hear about what's happening around the world, whether it be in Darfur, Addis Ababa, Capetown, or Nampossela. When we feel connected to the lives of others in distant lands - through reading books, traveling, or hearing/watching others' stories - our community, the place and people for whom we are responsible, expands. And because our community has our compassion, our compassion expands as well. We do not tolerate the pain and suffering of those we care for. In this way, my book is connected to the stories of those in Darfur.
My views on Sudan? Europe drew Sudan's borders and created a country with an Arab north hostile to its Black African south. The two sides have been ceaselessly fighting since independence in 1956, a situation only made worse by the oil in the South. Sanctions are key, as is a strong peace-keeping effort. Oil profits fund the government and its military, and China buys 2/3 of Sudan's oil. What do we do about that? Any ideas?
As for contributions to the people in the book: donors here are generously supporting the education of Monique's children as well as a maternal and child health clinic in Mali (founded by Monique's cousin). We've already bought the land for the clinic, have enough money to begin construction, and purchase 2 of 3 needed solar generators. We need to raise $10,000 more to complete the first phase of building. Folks can donate tax-deductible gifts to Clinique Monique through Women's Trust, Inc., P.O. Box 15, Wilmot, NH 03287. Or, people can donate online thru PayPal at
05-04-2007 10:37 AM
In answer to your questions:
1. What was your most challenging moment of your experience in Mali?
I'd say the first few months in my village, when I didn't know anyone, didn't speak Bambara well, or Minianka at all, and wasn't sure what the heck I was suppposed to be doing. Some days I just didn't want to get out of bed (which, for anyone who knows me, is saying something). I was lonely. It was hot. I hated being served goat head for breakfast. And I didn't want to be "on" as the new person in town. And then, I started working with Monique, and suddenly had a purpose, and a friend.
2. What was your favorite moment?
There are too many! Taking tea with John and Monique on a cool night, under the stars. Dancing with the village women. Watching Monique dance for the first and only time. Walking into the newly refurbished birthing house for the first time. Listening in on the conversation that guaranteed Monique her salary. Walking to Monique's compound in late afternoon, with no rushing in my feet, taking in all the sounds and smells, greeting all the villagers that I passed in fluid Bambara, and feeling a great sense of belonging.
3. What was your least favorite?
Did I mention the goat head? Seriously, I think it was moments when someone died. Whether it was one of Monique's friends, a mother in childbirth, or a sick child. Death is simply more common in Mali (sounds funny, since we all get there at some point, but people die young there due to infectious diseases, malnutrition, and pregnancy-related illness). Even today, John and I have lost more friends in Mali than we have elders in our own families. Another least favorite moment for me was saying good-bye when it came time to leave. Maybe b/c life is more precarious there, and I didn't know if I would see people again. This experience certainly taught me to cherish the moment.
05-04-2007 01:48 PM
Yes, I certainly have learned a lot about birth and women's health in writing this book! Also, my grad degree is in public health, and my thesis had to do with midwifery and birth in an urban setting. I do dig the topic. I hesitate to make generalizations about women's health around the world, but I can safely say this: countries who have the best maternal and child outcomes use midwives for majority of births.
Our health as women is also inextricably connected with our human rights, like the right to attend school, to control how many children we have, and to participate politically and economically in our countries.
Did you have more specific questions about birth in various countries?
05-06-2007 05:25 PM
05-06-2007 05:28 PM
Also, have formula companies made their way to Mali with their marketing?
05-09-2007 08:24 AM
Great questions - and I say 'yes' to all of them. I think we as North Americans can be involved in many ways.
1) Give money and volunteer with organizations that do good work. Charitynavigator.org is a great resource to use in evaluating organizations and deciding where you want to give your money and talents.
2) For women's health and reproductive rights in particular, The Women's Funding Network, the Global Fund for Women, and the African Women's Development Fund are funding networks that funnel money directly to grassroots organizations. Use them.
3) Go, study, volunteer abroad. Host exchange students. Expanding the definition of community and home is key to caring about the world.
4) Become political. Our nation's policies affect the rest of the world. We must hold our elected officials accountable for the decisions they make on our behalf. For example, 90% of all national security money is spent on war and weaponry, while less than 4% is spent on foreign aid, including humanitarian aid. What would the world look like if we demanded that those numbers be reversed?
5) Go green. Our world is actually quite a small place, and little actions have huge ripples.
6) Practice reciprocity in any development work. Come in with an open mind and an open heart. The Peace Corps model makes this possible. It is one of the few organizations where we can live side by side with our hosts and work with them to achieve the goals they have for their communities. It may not be the quickest way to create change, but working hand in hand with others (not top-down, and not with just a one-way flow of information and advice) is the only way to achieve sustainable change.
I could go on forever, but I'll stop here. Other thoughts?
05-11-2007 08:33 PM
i have a birthing question for you. my daughter (20 months) was
> born at the holyoke hospital in massachusetts with the midwives (who are wonderful) but our birth was traumatic for me as the pain level was just out of sight.....did you find that to be true in your own birth experiences? (i think you have two sons, right?)
i have friends who didnt find it that bad (both who had home births and hospital births), and friends who agree with me!
> there is such a range of experience, it is amazing to me. i wonder what your perspective is on this as a mother and as someone who has worked with a midwife. i would also love to know your thoughts and opinions about home birth.
> i love your book, thank you so much,
05-12-2007 06:32 AM
I never saw a bottle or a can of formula in Mali. All women breastfed. That said, I was pretty far outside the capitol, where there is a stronger Western influence. The latest WHO statistics show that 3-4% of women in Mali use formula, with most women breastfeeding well into the child's second year.
Many child deaths in Mali occurred during the weaning process from breastmilk to adult food, usually when the mother became pregnant again. Many times the transition was abrupt, involved drinking dirty water (i.e. water with bacteria and/or parasites in it), and not enough protein-rich food. We forget here in the U.S. that one of the biggest benefits of breastmilk is that it is sterile! Not so well water in Mali.
05-12-2007 06:50 AM
As your questions suggests, pain is subjective. We all feel it, true, but we feel it differently. And birth is unpredictable - perhaps your child's birth was painful because he was sitting on a nerve for awhile, or some ligament was stretched due to his size or position. I have a pretty high pain tolerance, but found that the recovery after birth was very long for me. Both of my births were pretty much lightening fast (my second son took four pushes!), but I was sore for a month afterwards.
I remember reading some books about birth being blissful, about people playing cards during labor, and describing it like one big orgasm. I remember thinking "what have you been smoking???" It was so NOT my experience. So that speaks to the diversity of how we experience birth. If birth was painful the first time, seek some pain relief for the next time (obviously, researching what types of pain relief, natural or otherwise, are available and what kind of effects they have on the fetus). There is no badge of courage here.
Studies have shown that fear only increases a woman's sense of pain in chidbirth, thus it's critical that a woman feel safe about where and with whom she is giving birth. This is why I am such an advocate of women having choice. I recently did a reading with Tina Cassidy, author of "Birth: The Surprising History of How We Are Born" and she and I both agree: choice in birth setting and provider is what matters. I think this is especially important for low-income or otherwise marginalized women. Their birth experiences, if empowering, can put in motion a lifetime of advocating for their children's needs.
05-24-2007 08:29 PM
I so much enjoyed meeting you and Tina at the BPL reading and event. I wanted to tell you how much your book has meant to me, especially this month. I have read it twice now. I am a childbirth educator, and last weekend one of my students lost a baby at 32 weeks. The hardest thing I have ever done as a teacher was to tell their classmates what happened. Your book has provided a context as I have explored this experience with my students. Time and again I have found myself talking to people about birth, life, and death, as you present them in your book. A woman's risk of dying in childbirth in Mali is one in ten. And an elderly woman dies and the entire village convenes in celebration, because it is truly a remarkable thing that a person could live to that age. We are so shielded from death here; birth in America is so rarely about death, and yet, over the ages, the two have been intricately linked. We are blessed with low odds that we or our children will die in childbirth--and yet, that makes it so much harder to know how to cope when this happens. And it even feeds what's wrong with birth in our culture; there is an expectation of perfection, since we have few children and they don't die, so obstetricians are scared of litigation.
I guess this is not a question, but I just wanted to thank you for giving me a context in which to think about and explore these issues. I love your book and will be giving it to and recommending it to many people!