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.
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!
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!
