IGNORANCE IS THE BIGGEST BORDER:
HEALTH, HUMANITY, AND HISTORY IN
SENEGAL

photo Jamilla H. Webb

WE ARE ALL CONNECTED

As I sat in Charles de Gaulle Airport in Paris, awaiting one of several connecting flights and an opportunity to recover from jet lag, all I could think about was the comfort of my home back in New Orleans. Going from airport to airport, I grew weary of seeing images and news reports on Trump’s proposed wall, global military attacks, and violent protests replaying across TV screens. For some reason, there was something eerily familiar, yet unknown about the name de Gaulle. Then it dawned on me: until this moment I never cared to learn who General de Gaulle was nor why his name decorated a major thoroughfare on the ground (Westbank New Orleans) and in the air in cities that are thousands of miles apart.

I served as a nurse volunteer with International Medical Relief. What began as a medical mission trip overseas this spring morphed into a life-changing experience that altered how I view our world. My understanding of imperialism, healthcare, and privilege were transformed. Although we live in a world where we proudly separate ourselves by nationality, ethnicity, and language, we are actually more connected than we realize.

ON HEALTH AND HUMANITY

Commanding, indistinct chants pierced the starless sky and ended my sleep on my first night in Dakar. I was agitated and stiff after enduring nearly 24 hours of flights, layovers, and time zone changes. Initially I wasn’t sure if there was an argument in our hotel or if someone was yelling outside. After several more minutes of chanting, I realized something more meaningful and purposeful was occurring. It was “Fajr,” the first of five daily prayers Muslims recite to honor and give thanks to Allah.

The art of nursing is a very intimate one; hearing someone’s story, holding their hand, looking into the depths of their eyes and seeing the imperfections of their wounds and scars. This sacred honor knows no language, culture, religion, or region.

I humbled myself and thought that I should be thankful for arriving safely. I wasn’t forced to be here. I paid to fly thousands of miles to cross the Atlantic Ocean—not to vacation or boast on social media, but to provide free healthcare to those in need. My destination of choice was Senegal. This beautiful West African country is majority Black, over 90% Muslim, and was a major port for the exportation of African slaves. Senegal, like New Orleans, is a unique place with a rich history and culture, amazing cuisine, and beautiful, hospitable people. New Orleans is majority Black and Catholic and was a major southern port for the importation of African slaves. Senegal and New Orleans are steeped in indelible marks of French language and culture. They are both former French territories.

Despite my fatigue, I was unable to return to sleep after the prayers. I figured it was best to rise and start the day. Our first clinic day, the team of American volunteers congregated in the lobby of our hotel where fresh baked bread, coffee, and our Senegalese partners greeted us. We all exchanged names and received formal introductions. Our team leader Amy, along with the lead Senegalese physician Dr. Mourtalla, gave us our plan for the day. We would set up an outdoor clinic in a village about two hours away, with the hope of serving at least 300 to 400 people.

As soon as we arrived in the village, children ran toward our buses. Bright smiles, colorful t-shirts, and Ankara print garb glowed against their beautiful, dark brown skin. Villagers gathered around us. We set up various stations: one area for the pharmacy, sections for triage, and wound care. The heat was intense and unforgiving. We saw dozens of villagers with old wounds and skin infections. Some of the children suffered from dehydration and respiratory distress. On the dental bus, the dentist and his assistant were swamped treating decaying tooth and gum infections.

Some of the villagers I served had such heartbreaking stories. Many had wounds and illnesses that went untreated for months (and sometimes years) due to lack of transportation and money. After several team members triaged a patient that needed to be taken to the city hospital ASAP, my assigned translator said, “Jamilla, you are fortunate to be American. I bet things like this don’t happen in the U.S.” Yet I begged to differ. In my 15+ years in this field, inequity in access to quality affordable services remains an undeniable reality, especially in the South. For overall health statistics, the U.S. ranks horribly when compared to other developed nations, and Louisiana consistently has some of the worst stats in the country. According to the CDC, in 2014 Louisiana ranked second in the U.S. for cesarean sections, low birthweight, and preterm babies. For infant mortality, Louisiana has 7.5 deaths per 1,000 live births, significantly higher than the national average. We rank in the top five nationally for heart disease, kidney disease, HIV, syphilis, and cancer.

In January of this year, I lost my mother to cancer. She died owing thousands of dollars in medical expenses, despite having health insurance. Even though she suffered from severe pain and weakness for quite some time, she kept working in an attempt to pay off the accumulating debt. Eventually, she succumbed to the pain and spent her last four months of life confined to a bed and wheelchair. I was not able to share all of this with my translator. However, it was a stark reminder that illness and lack of resources do not discriminate.

Day one for Team Senegal was long but rewarding. Beneath the sweat, insect bites, and fatigue, the most primal of human instincts connected us all—the act of giving and receiving. The art of nursing is a very intimate one; hearing someone’s story, holding their hand, looking into the depths of their eyes and seeing the imperfections of their wounds and scars. This sacred honor knows no language, culture, religion, or region. For me, aiding in the healing of another is humanity expressed in its highest form.

TO BE YOUNG, PRIVILEGED, AND BLACK?

Several days of working in 105+ degree weather and seeing hundreds of people per day is enough to make the most seasoned volunteer have second thoughts and become homesick. To be honest, the huge sores and scabs the mosquitos left all over my body—despite having soaked myself in DEET—gave me second and third thoughts. I missed air conditioning and consistently flushing toilets. Could I imagine life without Amazon Prime, my washer and dryer, and Uber? It’s easy to put oneself on a pedestal and wonder how anyone today could thrive without such amenities.

Yet as the days went on, I started to ask myself who among us was really privileged. The majority of villagers we served were poor. Despite being the wealthiest country in the world, we also have poverty in the United States. However, for those of us who have been fortunate enough to exist beyond grim statistics, how well have our privilege and resources served us? I felt ashamed and limited because our translators (all of whom worked as teachers in Dakar) and the majority of the Senegalese physicians spoke at least three to four languages a piece: French (Senegal’s national language), Wolof, English, Arabic, and other local dialects. The U.S. was created from “manifest destiny” and upholds ethnocentricity in many of our dealings with other countries and cultures. From the Atlantic to the Pacific Ocean, unless we are intentionally educated or born into homes where more than one language is the norm, most of us only speak English. Looking at Africa, Europe, and Asia on a world map, with so many countries and cultures sharing borders, trade avenues, and bodies of water, it’s easy to understand why a multilingual tongue is more of a norm.

As I exchanged more of my culture and experience with the Senegalese volunteers, a few of them began to ask me heavy-hitting questions: “Is it true that Black Americans still deal with racism?” “Why are so many Blacks in America protesting?” The most difficult question (which I was unable to answer) was: “How do you as a Black American define yourself outside of the struggle of slavery?” Unlike the reality of most of the Senegalese, I couldn’t imagine living in a place where Blackness was the norm in every aspect of my life. I would trade in Amazon Prime and Uber to be microaggression-free any day. Maybe privilege is in the eye of the beholder.

One night at dinner—a flavorful meal of ceebu jen (Senegal’s national dish of simmered fish and vegetables with rice), fataya (a stuffed fried pastry), and fresh baobab juice—I continued my conversation with a doctor and translator whom I had befriended. I asked them that if there was one thing I could do to repay their kindness for going out of their way to show us around and keep us protected, what would it be? Both of them answered simultaneously: to help them visit the United States. The physician said he wanted to further exercise his fluency in English and see all of the monuments and museums in D.C. I then ignorantly responded, “Then why don’t you just apply for a visa and buy your plane tickets?” The translator laughed so hard he almost choked on his food and responded, “It is easier to enter God’s paradise than it is to visit America! I’m African; I’m Black: I have an Arabic name; and I’m a Muslim! Forget it!” All the other men started laughing. Then they all told me that unless there were special circumstances, Black Africans face extreme difficulty traveling, even to other African countries such as South Africa and Egypt. With travel clubs being a major trend among Black American professionals these days, there is one major advantage I have that I never knew existed. As a Black woman living in the midst of discrimination, police brutality, and racial profiling (all remnants of chattel slavery), one piece of freedom and privilege that I possess is my American passport.

photo Jamilla WebbAT THE EDGE OF NO RETURN AND A NEW UNDERSTANDING

Of all the amazing monuments and historic sites we visited while in Senegal, the “Door of No Return” on Gorée Island impacted me the most. Gorée Island was a major port and holding place for Africans who were captured and sold at the infamous “House of Slaves.” As our tour guide lead us to the site, the streets felt so familiar. Brightly colored homes filled narrow paths. Bright stone tiles with street names in French decorated homes and buildings. Shutters decorated the windows while eager vendors bargained for my attention and money. Music and children’s laughter echoed in the distance.

A tall brown and yellow statue of a woman holding on to a man with broken chains around his raised hands set a somber tone. “How do I redefine who I am without the struggle that has been such a part of my history?” As we walked into the House of Slaves, we saw various rooms that had been used as dungeons, holding cells, and torture chambers on the bottom level. The upper level, which is now a museum, was once used as resting quarters, a mansion and event space for French and Portuguese aristocrats. It is said that when captured Africans were being loaded upon the various ships headed for the journey to the Americas, they would walk through the threshold of the door of no return, a one-way exit, down a long plank leading to the ships. So many of them committed suicide by jumping off of the plank, and so many diseased bodies were thrown over for the sake of deterring the spread of illness on the island that sharks used to swarm around the perimeter.

Today, many Africans in the diaspora use achievements in academics, entertainment, politics, and such to prove that we have overcome the struggles of slavery and racism. Yet despite my own accomplishments, I sometimes feel that something is missing. Who am I outside of the history of struggle? I am still answering this question. As I gazed through the door of no return, remembering the stories of my grandparents fleeing the Deep South and never looking back, hoping to have a better way of life, I knew that I would never be the same.

photo Jamilla WebbI don’t know my family history beyond slavery. I don’t know what village my ancestors came from. What I do know is that part of my heart and life purpose is in Africa. Maybe in the future I will recover the pieces of myself used as sacrificial losses which contributed to the expansion of the New World and the creation of a global economy. This history is something that affects all of us. The more I learn, the more I have yet to learn.

I hope my trip to Senegal will be the first of many more to come. I’ve decided to enroll in French classes this fall once I finish closing out my mother’s estate. Through Nurses for Africa, The Association of Women in Development (AWID), and now International Medical Relief, I’ve experienced three incredible international trips. I intend to continue my travels and learn more about our world through my own eyes. This is only the beginning of my journey.

For more information on International Medical Relief and their global volunteer opportunities, please visit internationalmedicalrelief.org.


photos Jamilla Webb, BSN, RN, Birth Doula

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