Wednesday, May 8, 2013

Matt & Eric | Benin


Matt Dooper and Eric Schlidt are senior UW students who traveled to Benin West Africa during winter break of 2012-13 as part of a Faculty Led Program. Matt and Eric enjoyed their time in Benin and have several recommendations for others looking to visit the area.

BEST PLACES TO VISIT IN BENIN 
Matt suggests visiting Songhai, a self-sustaining city in Porto-Novo Benin’s capital. According to Matt:

“Songhai’s claim to fame was that nothing goes to waste- and truly, nothing did.  They used special plants native to Benin to purify water coming from the septic system, which was then used to drink, process foods, water other plants, and assist in the production of agricultural machines and ceramics. In addition, all animal waste and compost was used as fertilizer for their gardens and fields. They also build their own agricultural machinery that would be sold to help other developing farmers in order to promote the ideals of further self-sustainability. Beyond selling the equipment, Songhai offered extended courses to educate young farmers how to manage a farm. The over-arching goal of Songhai was to promote independence in agriculture and a “live off of the land” type of lifestyle. We were lucky enough to be able to enjoy a few exquisite meals, both produced and cooked, at Songhai along with the eco-tour.  With the meals, all-natural fruit beverages produced on location were available that were equally incredible!”

Eric suggests visiting Benin’s annual International Voodoo Festival in Quidah. According to Eric:

“Voodoo was born in Benin, and remains the official religion of the country.  Unfortunately, due to misrepresentation in movies and general bad press, the religion has been misconstrued.  In America, it is extremely misunderstood, but this course, in addition to attending this festival, enlightened me to the true principals of Voodoo.  On the contrary to the “Black magic,” that usually represents Voodoo, practitioners are not interested in harming anyone or anything, only self-improvement and the practice of kindness.  The voodoo festival took many questions I had about voodoo and provided a great firsthand experience of a religion and culture that I would never have been a part of otherwise. “

At the festival, the group of UW students had a chance to participate in traditional dances. According to Eric:

“The dancing was incredible. Although we were drenched in sweat and working on sunburns, their routines kept us entertained all throughout the show. They knew a plethora of intricate dances and many of them played instruments and drums at the same time. After trying to master these instruments for two weeks (and failing), I was amazed that in the heat and pressure from crowd didn’t distract them, and that the performers could perform at such a great level.”

GREATEST CHALLENGES IN BENIN 
Although Matt and Eric never felt in danger during their time in Benin, they did encounter several challenges, specifically climate and language. The boys said, “It was very hot and, unfortunately, air conditioning is a rarity.  We sweat constantly.” Additionally, although the group studied French during the trip, they were never fully able to communicate with the locals. According to Eric, “ it would have been extremely rewarding to have been able to chat with the local people.”

Another challenge was the group's minority status. Matt said, “we definitely stood out, but luckily the majority of the population was extremely friendly and courteous to us.” Witnessing poverty also challenged the group’s notion of privilege. As Eric stated, “Beyond those more superficial burdens, it was difficult to observe a nation that essentially lives at or below what is considered the poverty line in America.  It begs the question of why we deserve the luxuries we have, and is conducive to overall appreciation to the lifestyles we are granted. “ Matt continued saying, “With all things considered, the trip was very easy on us, but it was hard to see some of the socioeconomic situations present in Benin.  The lesson we learned was to not abuse or overlook any of our luxuries, be it hot showers, cold drinking water or infinite educational and career opportunities, and to ultimately be thankful.”

What the boys took for granted the most, however, was the U.S. school system. Eric said:
"Education is not a right in Benin, it is a privilege.  The subsequent fallout is a populous of children ecstatic and driven to learn.  We were able to observe the classroom setting of the elementary age group, and although they were loud and energetic, they were absolutely focused, as opposed to a country like America where students begin to resent school attendance at an early age.  That alone definitely makes one, if not forces, to be more appreciative of the opportunities available.” 

The group had an excellent opportunity to study Benin’s education system during the trip. In addition to observing classes, they also spoke with Peace Corps education volunteers and education-base philanthropists in the country.

The group spent the bulk of their time at the Centre International d’Art et de Musique de Ouidah (CIAMO) in the city of Ouidah, Benin, which focuses on the training of arts and music primary teachers. During their time at CIAMO, the group participated in music, dance, art, and French classes taught by locals! Matt found the French lessons particularly rewarding, he said:

 “It was profoundly entertaining to be able to apply the French phrases, words, and bargaining skills we learned in class.  By the end of the trip, each of us could effectively bargain and shop in the local markets with the vendors, which was not only exciting for us, but entertaining for said vendors.   That in itself was the most rewarding activity of the trip to me.  In addition, this basic task gave me further incentive to learn a foreign language in order to travel independently to a country in which I don’t speak the native tongue.”

Eric particularly enjoyed sampling a new cuisine  He said:
 “ I found the food to be a completely refreshing and amazing experience. We were constantly sampling various foods that I would have never had the opportunity to try had I not been there. I especially enjoyed the fried plantains, which I (as well as everyone) ate whenever possible. While plantains are available here, nothing compares to the freshness of them while in Benin. Experiencing the local dish of pate was likewise a new experience. It can be eaten with your hands  and can be paired with anything. The fresh fruit was abundant there and that was something I appreciated greatly because it is so difficult to get in Laramie.”


RESEARCH ON BENINESE HEALTHCARE SYSTEM
In addition to learning about Benin’s education system, each student in the course chose a topic for independent research. As aspiring physicians, Matt and Eric chose to study Benin’s health care system. Because common Beninese diseases, like malaria and tuberculosis, are well studied, Eric and Matt chose to study the infrastructure of the health care system. As Eric stated, “The presence of disease in a tropical environment is to be expected.  However, what we didn’t expect was the exodus of physicians, and the ripple effect that this had throughout the country.  Thus, we chose to delve into this topic as our scope of research.”

To gain a firsthand experience about the health care system in Benin, Eric and Matt interviewed Dr. Rufin Kpadonou. Rufin Kpadonou, M.D., occupational health/tropical Medicine & Parasitology,  a doctor for the Peace Corp at the head office in Cotonou, Benin.  Eric and Matt’s research findings are summarized below.

As a physician born, raised, and educated in Benin and still practicing in Benin, Dr. Rufin Kapadonou is adept at seeing the issues surrounding health care in his native country. He listed the main diseases affecting Benin as malaria- an infectious disease characterized by severe fever and headache and its spread through mosquitoes, and tuberculosis- which presents symptoms of intense coughing and fever. Beyond these two diseases, he stated that the migration of doctors from Benin is paramount to the issues surrounding Benin.  Health care is not great in Benin, or Sub-Saharan West Africa in general, but before it can improve, physicians and facilities need to be present.  This is the reasoning behind our topic of study.

To begin, doctors are leaving their native African countries for several reasons. One, they wish to improve their education and learn more about their field. The better educational opportunities are not found in developing countries like Benin; they are found in North America and Europe.  This phenomenon has been occurring since the advent of the first medical professional. Historically, however, once the physician has learned the new methods and perfected them, they return to their home (Eastwood, 2006). But, this is not the case today, as increasing amounts of doctors are leaving and working in other countries that offer greater compensation and perhaps better living conditions. For instance, this is heavily documented where 515 physicians working in the United States and Canada are from Ghana alone. This might not seem so shocking a number in terms of the massive number of physicians working in the US, but when there are only 1600 total physicians practicing in Ghana, it becomes quite statistically significant (Hagopian, 2005).

The effects of these doctors leaving are not readily noticed in the countries in which the emigrated physician work, but are heavily noticed in the countries from which they depart (Hagopian, 2004). This is an issue that must be addressed in the countries where those doctors are working. The effect of those doctors leaving in their native countries is harshly negative. The overall health care system is put into jeopardy with fewer doctors practicing. With lower numbers practicing, it becomes increasingly difficult for people to access care and see doctors when necessary (Hagopian, 2005). Because of this lack of care, people must travel further to see a doctor, or recruit foreign doctors, deepening the strain on these health care systems.

The emigration of physicians not only affects the health care in Benin and Sub-Saharan West Africa, but the economies of those countries as well.  Losing physicians results in fewer clinics and health care facilities, which require nurses, technicians, secretaries custodial faculties, etcetera.  The UN Conference on Trade and Development estimates that the loss of one health care professional is equivalent to approximately $184,000/year in potential revenues.  With as many migrating physicians and health care professionals as there are, the total number of lost profits can become astronomical.  Consequently, with physicians leaving, Africa must bring in a health force externally.  As an example, Ghana brings in a large population of Cuban health care professionals, which require travel expenses as well as translators; an extremely inefficient and not self-sustaining system (Eastwood 2005).

A problem definitely exists which is what to do about the problem.  As one of the primary destinations of migrating African health care workers, the United Kingdom has proposed a solution in preventing practices in UK from recruiting African physicians.  In addition, they have proposed to limit visas to foreign medical students to the time that they are in training, which would force said physicians to return to their native countries after they are finished with their training. Similar proposals have been made in France as well, which is another leading recruiter of French-African physicians (Eastwood, 2005).

Another scheme, introduced in Ghana, is for the government to subsidize the financial burdens of a physician studying in a developed country.  The deal is that those physicians will then return to Ghana after their training is completed to begin practicing (Eastwood 2005).  As a side note, Wyoming has enacted similar programs,  WWAMI and WICHE, to try to entice doctors to return to Wyoming.  These programs offer increased acceptance rates and decreased tuition, as long as health care professionals who completed their undergraduate work at the University of Wyoming return to practice in Wyoming for three years. 

Along a similar school of thought, we believe a possible solution might lie in allowing medical students from the US (or other countries) to work off some/all of their student debt as volunteers in Africa, assisting in clinics and hospitals.  The United States recently enacted a similar program known as the Public Service Loan Forgiveness Program, which is a part of the College Cost Reduction and Access Act of 2007, allowing college graduates to work in full-time public service positions (usually low income) and receive assistance in loan repayment.  However, stipulations do exist and this is not available to medical school graduates in the United States, it may be something that could work where medical school tuition rates are not as high.  We realize underlying economic issues would be present, as those debts still need to be paid, but this could be a potential benefit to African health care.  Although Doctors Without Borders does exist, the incentive to alleviate student debt does not.

In conclusion, any solution will be extremely complicated and will require each country to make its own personal decision to retain its physicians. While countries such as the United Kingdom and France can write proposals to regulate the issue, in the end the physicians must want to stay in their home countries or their governments must entice them to do so.  If this can’t happen, health care in Africa will continue to struggle. We believe that initiating programs to incentivize physicians to stay would be highly beneficial and work well to retain physicians.

 Eastwood, JB., Conroy, RE., Naicker, S., PA West, Tutt, RC., Plange-Rhule, J. 2005 Loss of health professionals from sub-Saharan Africa: the pivotal role of the UK. The Lancet, 365(9474). 1893-1900. Retrieved from

Hagopian, A., Ofosu, A., Fatusi, A., Biritwum, R., Essel, A., Hart, L., & Watts, C. (2005). The flight of physicians from west africa: Views of african physicians and implications for policy. Social Science & Medicine, 61(8), 1750-1760. Retrieved from http://dx.doi.org/10.1016/j.socscimed.2005.03.027

Hagopian, A., Thompson, M., Fordyce, M., Johnson, K., & Hart, L. (2004). The migration of physicians from sub-saharan africa to the united states of america: measures of the african brain drain. Human Resources for Health, 2(17), doi: 10.1186/1478-4491-2-17



CONTACT ERIC AND MATT
Overall, Eric said that, “Benin is a great place to visit,” and Matt said that he will, “remember the experience in Benin for the rest of his life.” If you are interested in traveling to Benin, please feel free to contact Eric at eschlid1@uwyo.edu!


Rhiannon | Israel


Rhiannon Jakopak is a UW junior who traveled to Israel during the summer after her sophomore year.

During her trip, Rhiannon lived mostly in hostels, which she would recommend to others.

Rhiannon’s favorite activity of her trip was visiting Jerusalem’s Western Wall each Friday. The Western Wall is considered one of city’s holiest sites and visitors come from all over the world to pray at the wall and to manifest their wishes. About the wall, Rhiannon said, “Jerusalem was my favorite city, but the Western Wall was my favorite part of the city. It is definitely a must-see.”

In addition to the Western Wall, the Tel Aviv beaches were one of Rhiannon’s favorite places to spend time. Looking back on the trip, Rhiannon said, “I couldn't possibly pick a favorite memory; there were so many incredible parts of the trip.”

If you’re interested in finding out more, or visiting Israel yourself, please feel free to e-mail Rhiannon at rjakopak@uwyo.edu

Heidi | New Zealand


Heidi Meador is a UW Master’s student who travelled to New Zealand over winter break as part of a Faculty-Led Program. Heidi was one of several UW students to earn academic credit by participating in the trip. During their time in New Zealand, the Heidi and the other students got a chance to study New Zealand’s biodiversity. In addition, the students had plenty of downtime to explore New Zealand’s many sights.

Reflecting on the course, Heidi said, “It offered an amazing opportunity to explore the vast biodiversity of New Zealand, as well as an unforgettable experience." One of Heidi’s favorite experiences of the trip was climbing Mount Taranaki, one of New Zealand’s volcanos! To reach the top, the group climbed 131 stories to a view that was, “absolutely amazing.”

The group also visited several beaches and had a special New Year’s Eve beach celebration, which was very memorable for Heidi, in her words: “we went swimming in the ocean on New Year's Eve, and watched fireworks from the water.  It was an amazing New Years !”

If you’re interested in traveling to New Zealand, or participating in a Faculty Led Program, please feel free to contact Heidi at hmeador@uwyo.edu