Where We Go From Here

Elias Estabrook - Senegal


December 21, 2011

Tucked away in the north of Dakar surrounded by green lawns and palms trees, the Meridien President Hotel is glaringly different from the swelling, sandy neighborhoods and bustling, littered streets through which our taxi weaves. Within the five-star conference center’s halls, the environment is abuzz with the conversations and presentations by dignitaries, professors, and representatives of NGOs, tackling the complex theme of family planning.  Nevertheless, outside of the hotel gates is reality: a city – and an African continent – still struggling with providing basic health care and addressing fundamental needs for family planning services. The picture outside is not so clear and, hence, can’t be simply boiled down into statistics, however moving some of the presented numbers about the millions of “underserved” women may be.

 Indeed, this is the contrast with which I grappled as I volunteered – accompanied by Lucy and Emily – at the Gates Institute’s International Conference for Family Planning. Having begun to fully integrate myself into every aspect of village life, I initially felt oddly uncomfortable dealing with the predominantly American crowd, and felt most natural speaking to the hotel staff in French and Wolof. Was it a taste of reverse culture shock? Undoubtedly I was feeling guilty for basking in such luxury, however much I was enjoying the buffet lunches. But maybe it was a cost I just had to swallow, given the fact that the conference’s guests were contributing tremendously inspiring work, genuinely concerned with reaching the world’s poor and underprivileged, especially women.  Similarly, the jump from observing development at the village-community scale to analyzing health and reproductive services on a global scale was jarring, and yet all the more eye-opening.

 Of course, my mind is flooded with memories from this remarkably different – within the context of my stay in Senegal – yet formative week. However, my greatest takeaways are, admittedly, moments that I shared with young Senegalese people. Even though I’d previously only seen them drifting among the various events and occasionally greeted them in mixed Wolof and French, the youth attendees blew me away when I stepped into the designated “youth tent” one afternoon and discovered a discussion raging:

In rapid-fire French, several speakers vented their frustrations and ensuing hopes to the circle of intent faces. “We’re spectators, not participants,” they argued, implying that their invitation to the conference had just been symbolic, hardly intending to ask for their contribution. Indeed, one young man argued, “This happens all the time with NGOs, with development projects.”  He cited these groups and initiatives as hypocritical, because they may select a few young interns or trainees but never seriously include them in policy-making or sustained efforts.

Therefore, fed-up and wanting their perspective to be heard, the jeunesse in the tent took matters into their own hands by formulating a “youth platform” on sexual- and reproductive health. In particular, recognizing youth as a key demographic in the future of family planning, the points of their declaration referenced endorsing and integrating the education of young people (about reproductive health, sex, and family planning) into policy. If youth are the “hardest” to reach, why not cooperate with them to create strategies that cater to their needs and capitalize on their strengths, right? Especially in Senegal’s social context, where sex has been a taboo subject for decades, maybe the youth (the new generation) offer the greatest hope of sparking an effective dialogue. Utilizing the right channels of communication and outreach, young men and women could be at the helm of triggering widespread, heightened awareness of options like contraception, birth control, and the strategic spacing of births. Nevertheless, the leaders in the room – soon to be youth no longer – emphasized that such a revolution would depend on maturing youth to carry on the torch and extend communication to a larger audience.

Indeed, there were numerous doubts and challenges that I recognized. To discuss and endorse certain rhetoric and values was one thing; but to effectively apply strategies and install new programs was another thing.  I became most aware of the question, “what now?” as I rode home in a taxi one evening, conversing with the youthful taxi driver about the purpose of the conference. Clearly frustrated with the frequency of such conferences in Dakar yet the lack of visible impacts, he questioned whether any of the swanky-seeming goings-on should concern Africans. “Yes!” I answered emphatically, knowing what pivotal issues had been discussed at the Meridien, though I sympathized with his concern about the lack of real reform in Senegal.  Impressed by his interest and stirred by our conversation, I stepped out of the taxi, asking myself, how will the benefits of the conference trickle down?

As I reflect on all the viewpoints I confronted – of determination, disdain, optimism, and critique – I realize that, in most respects, all are valid reactions to the reality we face, just as perspectives from all “levels” and demographics in society are in some necessary to holistically and innovatively addressing issues of health, in this case.  Everyone’s voices, from the young Senegalese students’ to the seasoned health experts’, are critical. Similarly, everyone I met at the conference, from the Malian academic who befriended and candidly discussed sexual habits with me, to the youthful Gambian AIDS activist who held the opening ceremony’s crowd breathless with his speech, to the wise American woman who insisted, “when women survive, families thrive,” all undoubtedly play a part in generating progress.

And, with an eye on the inclusive, democratic process that must be integral in informing and maintaining efforts in development – though, like the taxi driver, wary of the patience it may take – I retain a sense of hope.  I have after all witnessed the testimony of Zara, the young Nigerian woman who shines as the alumna of a peer educators program whose model is spreading across the globe, and – closer to home, my new home in Senegal – discovered the provision of contraceptives and reproductive health consultation for women, young and old, at the local health post.  Cultural barriers, such as early marriage, and lack of education may still exist, but the enthused consensus of the Family Conference assures me that momentum is building in the global community, and that serde serde – step by step – we can collectively move forward.

Elias Estabrook