House on Fire

House on Fire by William H. Foege Page A

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in the yam fields, and finally a trip late in the day for firewood to prepare the evening meal.
    We gradually learned how to bargain. A market was held every fifth day in our village, and markets were held in other villages on a preordained circuit during the other four days. Markets would provide the usual local foods, clothing, flashlights, kerosene, matches, and so on. As part of the market, or on separate days, there would be opportunities to buy fresh beef. Small herds of cattle would be driven from northern Nigeria by young men and boys, usually from the Fulani tribe, and a local entrepreneur would buy a cow and butcher it for sale. The price was 2 shillings (0.28 cents) a pound, regardless of cut, and the entire animal would be sold within hours. Because of the long walks experienced by the cattle, the meat, no matter which cut, was sufficiently tough that it required cooking in a pressure cooker. For most other things, bargaining was required. Initially, after thinking a fair deal had been concluded, we would find that we had endangered the local economy by paying far too much.
    At our house, we hired a young man to bicycle to the closest watersource during the dry season with two ten-gallon tins tied on his bike rack. When full, the two tins weighed about 160 pounds. By the end of the dry season, when the water trips were long, he could make no more than two daily trips, but this provided adequate water for our small household. Boiling the drinking water on the propane stove took hours every day. The boiled water was stored in bottles in a kerosene refrigerator, which also put out heat, increasing the temperature in the house to even more uncomfortable levels. In late November the annual
harmattan,
the breeze from the north, arrived—a welcome event because it cooled off the temperatures even though it brought sand and dust from the Sahara Desert, dimming the sun and leaving everything dark and gritty. A dusted table would be covered with another layer of dust within an hour. Mosquito nets on the beds—necessary to reduce the chance of catching malaria—kept out not only mosquitoes and rodents but also any welcome breeze that might have come through the room at night. During the hottest months we sometimes sat up for hours at night to avoid getting into a stifling bed.
    We had read about the arrival of the first rains, which usually occurs in March, but to experience the relief they brought was something else again. The water poured down in torrents. People left their houses and gathered in the rain, dancing and rejoicing. The rains signaled the end of the dry season and promised new crops, cooler temperatures, and the end of the long trips for water.
    To practice community health in another culture requires an understanding and appreciation of that culture. But it’s also arrogant to assume you can truly understand it. Paula and I had daily lessons in Yala from an American who had settled in the area six months before us and who was the first foreigner to analyze the language. We learned to prepare local foods with pounded yams and cassava, and to bargain in the markets, which were held according to the local five-day calendar. The calendar had existed for as long as anyone could remember, and was still used alongside the seven-day weekly calendar introduced by the British.
    As much as we learned, the differences between the villagers’ experience and ours always remained starkly evident. For one thing, we could leave any time we wanted. For another, we had access to basic healthknowledge and the money to be able to apply it, while the villagers did not. To cite just one example, we arrived in the village at the end of a whooping cough epidemic. The characteristic coughs, or whoops, which often go on for weeks, persisted throughout the village at night during our early weeks in the village, making clear the price paid for not having routine childhood immunizations. We were able to provide our

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