Saturday, May 5, 2012

Crowded buses and honey selling in the bus stations

We left our beekeepers in Mamfe and headed off to Barmenda the regional capital of the central southern area, and then north to Belo about 40 miles away in a shared minibus.  We had the usual sort of journey, crowded with people, loaded up on top.  We are getting used to all this now.  It is funny though, that we are jammed in four to a row and don't mind unlike home.  We always seem to meet some character.  I suppose it is because it takes a bit of an extrovert to come and chat away to the white people even if they dont speak our language.


This time we saw a chap in a full cowboy outfit and I just knew he was coming our way...and sure enough he sat next to Gill.  

Brian thought he had a good seat with only 3 on a bench until the largest lady in the whole bus station started walking towards our bus...and sure enough she asked him to move over and sat herself down.  She was so large he had to sit sideways. Brian seemed to manage.  Our cowboy turned out to speak only french and decided he would practice his English on us for the whole journey!  It kept the other passengers amused at least.

We had an eventful journey firstly travelling on the newly made chinese road.  This is really impressive and falls in with mechanisms of development.  Last year the road was mud and so slow as we climbed to the mountain plateau of Barmenda taking most of the day.  This year the journey was about 3 years with most of the road finished.  We did have a flat tyre and had to get down, but it was mended in a few minutes.

On the way we spent a long time in the bus stations waiting for the bus to fill up with passengers and found people selling honey.  The first chap keeps his bees in his village and was filtering the honey at the roadside in the dust of the bus station.  Brian got talking to him and was taken on a tour of his little shop.  We just went and looked at the honey he was selling which was packed in water bottles as buying plastic bottles is too expensive for most.   While we were there he sold 4 litres in less than an hour, so this is obviously good business.  It gives us hope for increasing the sales of honey and maybe hive products in the future.

This bee keeper was very happy to talk to us.

Tuesday, April 17, 2012

running a beekeeping training course in Cameroon

Having been out to the rainforest for a week without running water, power or any creature comforts should have made us feel a bit deprived.  But quite the contrary, we had been well looked after, had warm water to wash with every day in our rainforest shower and slept well at night in our tents.  If anything it was food that we appreciated on our return.  We all laid into cold beers, chicken and chips, fried fish and plantains instead of porcupine stew and yams washed down with palm wine which had been our norm.  We must remember that to eat meat at all was a luxury, and the villagers had fed us as if it was Christmas day every day a much richer and better diet than they would have normally.  We did enjoy the comfort of the hotel and slept well in beds with sheets.

Gill and I went for a walk to look at Cassava growing and to cross the German Bridge.  Originally built in 1904 during the period of German colonialism it has been restored but is made of planks of wood spread out over metal struts.  It sways badly and has gaps, and the sides are not at all reassuring.  We managed it both ways and even had the locals stopping to watch so we could not appear anything but cool about it.

The training was for advanced beekeepers.  Due to limited funds we were unable to reimburse travel or offer food to our trainees.  While this might be common in the UK, the Africans often attend just for the free trip to town and the food.  We therefore attracted a small group, but of very committed beekeepers.  Some came from near Barmenda about 4 hours away to the east.  We used the Forudef training room and had to compete with National Women's day for chairs, but managed to find some.

The training covered a variety of topics chosen in a brainstorming session by the delegates.  We looked at

  • siting of hives both for the bees and to benefit crops, 
  • how bees help in farming through pollination
  • dealing with pests which include lizards who can eat as many as a bee a second if they sit on the landing board by the entrance, rats, wax moths and ants
  • dividing colonies, 
  • extracting wax and building a solar wax extractor, 
  • marketing and selling honey and beeswax/hive by products.
All the earlier topics involved much discussion and became a workshop sharing problems and thinking up solutions.  The trainees did not have any knowledge of plants pollinated by bees so we had quite an interesting discussion about designing planting patterns to maximize bee keeping opportunities.  Perhaps the most useful topic that was new to them was on marketing and selling honey.  Since these beekeepers have only been operating a few years they have just been trying to produce some honey to sell, but now they are producing sufficient quantities to be needing to consider how to maximize their returns. Most are packaging in 500ml and 1lt water bottles, though we suggested trying smaller sizes such as 250 ml or even sachets because this could increase income further when selling in the markets.

It was good to see a couple of people from last year in the group and to share news and ideas with the group.  They so appreciated us coming back and the opportunity to talk and share beekeeping experiences together.  We also talked to them about the problems of keeping bees in the rainforest, but none of them had much experience of this habitat..

Monday, April 16, 2012

visitng a primary school en route out of the rainforest

We have finished our work in the rainforest village of Ote, and it is time to go.  We packed up our tents and were ready to leave at about 10 am becuase the drivers with the adapted Toyota pick-ups try to get as many journeys in as possible and so could arrive at any time.

Half of the village came to wish us farewell and we waited.  Whole family groups gathered and chatted and we ended up taking photos of everyone and eventually one by one family groups came and asked to be photographed. and eventually our vehicle came and we loaded up for the journey. We had fond farewells with many hugs and kisses. Some women wailed and cried.  We set off only to be stopped for another farewell in the upper quarter and more photos and crossed the river fairly quickly and disappeared into the nothingness of the forest.  The road was as bad as ever.  We got stuck many times and again the boys dug us out.

En route we stopped at Akwa about 11 miles along the track where we are organising a twinning with a primary school,  Stanley Primary in Teddington, West London. The deputy head Sue Leney, is keen to set up a link with the year 5 and 6 children which will also tie in with their curriculum in which she has done a lot of work with her pupils on beekeeping, and also with their charity days in the school.  Here we dropped off a package of notebooks and pencils for the year 5 and 6 children as a gift from  the London School.  The teachers and the children are very interested in our visit.

The school have no resources including pens and paper, and instead the teacher writes everything on the black board.  Children have their own blackboard slate which they take home with them and sit at wooden benches and rote learn from the main blackboard.

They obviously adore their teacher who was especially pleased to link with us.  They have trouble with leaking classroom roofs in the rainy season and so classes and teaching is interrupted. We will be looking to bring out some resources and possibly raise some money to support this school during the next year. Despite what we perceive to be difficulties and disadvantages,everyone is very proud of their school and the children looked very smart in their uniforms.

We also took a gift from Stanley Primary School of a cloth bag which had been given to them by their local beekeepers association.  It had been donated by Rowse Honey, a company in the UK which sells honey thoughout the UK and is virtually a household name.  The bag had been distributed to the English school by the local Beekeeping Association, part of the BBKA who maintain the school's bee hive, to support them as part of an awareness raising programme about beekeeping and learning about the environment.  It contained a jar of honey, a wooden spoon for stirring collected honey, some lavender seeds, as lavender flowers are attractive to bees, some recipes using honey, and the bag itself.  I don't think the lavender will survive in the wetness of the rainy season, and the gift was intended for the UK climate,  but the idea tied in with our other gifts.  We gave them a variety of bean seeds and some hoes to tend their vegetable garden as well as tomato seeds.  This is all in an attempt to encourage a greater diversity of food plants to be grown and also to encourage horticulture.  Growing and planting crops is on the national curriculum in Cameroon, but the school cannot afford the equipment and seeds to do this.  Eventually Bees Abroad are hoping to introduce bee keeping into the Akwa school as part of the move to spread the culture of beekeeping wider afield to help provide another income source in these remote rainforest villages.

The honey jar was a plastic squeezy bottle shaped like an old fashioned beehive and the honey producers who saw it just loved it and want to put an order in for some immediately.  The problem is that they cannot afford to buy plastic bottles for their existing production and collect old plastic water bottles, which are free.

The gifts were very well received and it is nice to know each child has a pencil and notebook and it is funny to think of English honey in a very modern packaging being tasted in a rainforest village.

Sunday, April 15, 2012

finding clean water supplies, siting latrines and thinking of power

climbing around on the hillside trying to find the
head of  a stream
Streams flow from the hill behind Ote village into the main river.  Arising out of the hillside and cliff there are no pollution sources except for soil and vegetation debris when flow is high in the rainy season.  Therefore we decided that these would provide the cleanest supply of water to the villagers.  The problems of debris and soil particles as well as the high flow in the wet season will have to be overcome as will the relatively low flow by the end of the dry season, but the streams do flow continuously all year round.  Because the river is quite dispersed with a group of houses at the river crossing and another about a mile downstream, more than one stream will have to be used.

in the dry season there is not much water in the streams that
arise out of the hillside cliffs

We do not know much about tapping into water sources, how to go about installing filters, a reservoir tank, piping and taps but intend to find out what the best available system would be that is affordable, safe and can deal with the variation in water flow.

houses are very simple and children do most of the work when the
dults are out farming for food
We also looked to site latrines in the main areas of the village.  The upper village is sited on a low river terrace and to place latrines there needs to be some height above the river water level in order for the pit to remain dry and aerated.  If waterlogged decomposition will not occur and the latrines will become unhealthy.  It appeared to us that the water could over-top the banks in the rainy season and when pressed on this the chief confirmed that it does happen, though not every year. However as more agricultural activity is occuring as the population is growing slowly, and commercial activities starting, the river will become more extreme and frequency of flooding is likely to increase.  The chief also confirmed there is already evidence of this.  A solution is to site latrines above the village on a higher terrace, but these would be too far from the dwellings to be used.  The chief therefore proposed that new building should only be allowed higher up the slope and the latrines go ahead in a higher location.  Since many of the houses are made of mud daub they have a limited lifespan and when renewal is needed, the opportunity can be taken to relocate upslope.  This was a considerable move in the thinking of the village to create a more healthy and sanitary living environment, but the villagers recognise their own health problmes and are seeking to improve the situation.  The ideas were confirmed at a village meeting later that day.

no sanitation exists in this village of about 300 people
Our task remains to link up with specialists in water provision and sanitation to find a solution that can be applied in this situation.

We decided that we could probably install some solar panels to power some lighting in the village we wish to sponsor in the village.  We have decided to investigate these when we get back to the towns or even in the uk.  We should be able to provide enough power for some lighting and even to charge some equipment.

Friday, April 13, 2012

Finding a site for our building, latrines and water supplies

We have decided that we cannot proceed with our work of providing local people with a central place to bring their honey for trading without a building that is permanently staffed.  We also have the problem that the extension worker James Assam has his family at a distant village in the rainforest and rarely sees them because he is constantly travelling round visiting the bee keepers.  We would like to think that James could have a base where his family live, from which to go out and do his job.

If we build a honey collection room with filtration and storage that is bee proof we can test the honey for quality when it arrives, clean it and seal it ready for transport.  This means it will remain in good condition even in the rainy season and not take up water.  With a base we can ensure that there is someone available at all times to receive bee farmers honey, assess it and pay them immediately.  This will encourage the farmers to bring their honey to us rather than going to the markets in Nigeria where they are kept waiting all day and finally paid a much reduced sum at the end of the day by traders who know they have to trek through the forest to get home and are impatient to leave. A guaranteed purchasing system for quality honey will improve the trading within Cameroon, ensure the farmers receive a fair price and increase trading of honey in the area by encouraging others to take up bee keeping.

The village elders of Ote would also like to see the building put up as they will benefit from associated trade opportunities and visitors.  Currently there is no real commercial activity and travelers are given a meal and a bed for the night as they pass through, by villagers whose culture it is not to charge any money.  Those who are trading their crops to the town realise that this system will inevitably have to change and welcome the opportunity for the villagers to benefit from people travelling through.

the view downstream
They elected to provide a piece of land at a village meeting.  They chose a flat area above the river on a terrace which they selected for its beautiful view of the river and the fact that it does not flood.  They specifically said that they want visitors to be able to enjoy the view of the river when they visit.  They also want the training facility we are suggesting and since this will be partially covered by a veranda and partially in the open, they also wish to have a good view and nice location.  Currently it is quite densely wooded, but they will clear this.

They would like an 'L' shaped building so that on one side they can have the honey plant and staff quarters and on the other some guest bedrooms and a health room so that a medical team can be persuaded to come to the village for vaccinations and other clinics which will improve the status of health in the village.
looking upstream

We spent most of the day with a GPS and a tape so measured up with the help of the chief and elders who had to decide which trees they will cut down.  Large timber trees they need to keep but there is also a lot of bamboo which they have trouble controlling and the clumps get very large, so they are happy to remove or cut these back.

a large clump of bamboo

all the men carried machetes to hack away at
any vegetation in the way. We took time to
understand what was required

they all joined in with the measuring

Ncho Tabe Moses, the director of Forudef gave instructions

this is a beautiful place and the building will make an impact.
 It is important to try to preserve the feeling of the forest and its
tranquility in whatever we do

Everything had to be carefully agreed and discussed

The village people have a clear idea of what they want in the village, but we also have to ensure that what we help them to build will also meet our own ethical standpoint.  For example, there is currently no sanitation so we cannot sponsor a building project that offers less than a minimum we would find acceptable.  We therefore need to find a way of providing clean water and sanitation.  We will also explore providing electricity even if it is some minimal lighting.  We do not know anything about these issues as yet so are off to explore the possibilities.

the chief seated on the hill of his compound

After measuring we climbed to the chief's compound to draw up an interpretation of what the villagers wanted.

the chief and director of Forudef clarify what the village needs

Then we had to discuss in detail all their requirements and ideas to ensure we had recorded what they wanted before we took the plans away.  Marsh and Grochowski Architects in Nottingham have kindly agreed to help realise the ideas.

Tuesday, April 10, 2012

Trying to attract bees to the rainforest hives in Cameroon

The chief of Ote, in Akwaya district, Cameroon came on a training course  held by Bees Abroad last year (2011) in Mamfe in the South West,  for beginner beekeepers.  He had already formed a group of 5 other men and invested in 5 KTB hives.  This constituted quite a large investment at around £15/hive plus smoker and suits, especially for a rural agricultural community, and even more so since they have to pay a further £20 to register as a beekeeping group.

After the training we went to look at the hives, travelling to Ote for the first time - the 53 mile journey took 7 hours of very difficult driving in a specially adapted 4x4 (see previous blog 'the road).  I thought at the time that the site was very shady and the hives quite close together tucked in under the trees but I was not an experienced  beekeeper and certainly not in the rainforest so I just took some photos and accepted the decision and agreement to the site by more experienced people with us.  At the time I merely spoke to the extension worker James, who we support, about the importance of getting bees in the chief's group's hives.

Our visit this year revealed no bees and a very despondent group.  The Forudef hives are less than a mile away in an open semi shaded forest area and of the 7 hives 4 have been colonised this year at different times while none of the 7 of the chief's group have even had any bees.  The group have therefore moved the hives a few yards away to a less shady place, near a stream with open forest and a variety of different trees.

the new apiary in a more open varied area of cultivated forest
under oil palm with cocoa nearby
There is an abundance of flying insects including bees and pollinators in the open forest though there seem to be more high up in the trees near the top of the canopy rather than lower down.  This seems to be where the flowers are at the moment.  However where the hives are, is near the oil palm and the flowers of these trees provide abundant forage when in flower and apparently are buzzing with diferent bees, though only for a short period of time.  Without these flowers the bees are off nearer to what flowers are present now.

We decided that the hives were in a similar site to the forudef hives and that they should be left once we had cleaned and baited them.  We went through the same proceedure as with the other hives of sterilising and cleaning them and baiting them with either lemon lure, propylis or simple bees wax.

At first only two members of the group came along.  This is because they are losing interest in beekeeping as they seem unable to attract bees and have seen only expenditure and no return so far.  We worked to light the fire and sterilise the hives and set to work rewaxing the top bars to make them attractive to the bees.

Ants were all over the hive

the ants had laid eggs in the hive and the men threw burning leaves in to
clear the antsbefore turning the hive upside down over the fire

One hive had a nest of ants which we killed and one had been gnawed by a mouse, referred to by the locals as a rat.

chatting and rubbing wax on the hive parts
After a while all but one of the group arrived and joined in the cleaning and preparing of the hives.  We talked about the problems as we worked. I suggested that trying to attract bees is much like trying to hunt.  A hunter will place his traps in the rainforest in one way and will change them around if not successful, visiting them every day until he catches his prey. He will constantly make sure the trap is in first class condition so that it is most likely to catch his prey. I made the analogy that the same approach should be taken with bees to try to give the men some encouragement that they need to persevere to attract bees, moving the hives if they do not get bees to try new sites until something suitable is found.  We emphasised the need to keep the hives 'bee ready' and baitted and clean if they are to hope to attract bees.

I also suggested forming a social bee keeping group.  If the men meet once a week or even once a fortnight, they can tidy up the hives together and move them if necessary and discuss the situation and options for improvement.  This would get them into the habit of tending the hives regurlarly.  I explained how my own bee keeping group meets monthly Derbyshire Beekepers association and after the business is over we have some food and there is a bar.  The men are very partial to palm wine (more about this later) so the idea seemed to appeal and the whole concept of a social meeting for a purpose such as this was completely new to them.  Maybe this will be the beginning of the Ote Village beeKeeping group.Finally they reassembled the hives but fitting the bars in again took some doing, revealing how variable the size of the top bars is - very different from our own machine made and standardised hives - in my own case thanks to Maisemore Apiaries, in Gloucestershire UK

We did wonder if placing traditional log hives higher in the trees might be a solution to the inability to attract bees, but we are trying to discourage this method as it is destructive to the colony when harvesting takes place.  However it may be something we suggest in the future if the current baiting etc does not work.  Also in some areas bees colonise when there are flowers but move off when they die off, quite different to our own ideas of bees taking up permanent residence.  This may happen down in the area of the oil palm where there is an abundance of flowers for just a short period when they will be buzzing with bees, but then the flowers appear high in the canopy and there are no bees near the ground.

Friday, April 6, 2012

How should we approach our beekeeping project in Akwaya, Cameroon

Bees Abroad were approached by Forudef to establish beekeeping in the rainforest area of south-west Cameroon to help alleviate poverty and improve standards of living. We have been training beekeepers and helping them to establish honey trading routes for over 2 years now, but our work is being hampered by difficulties in the rain forest area itself. The inaccessibility with such a poor road that it takes over 7 hours to drive 50 miles (see blog entry 'the road' 16/3/2012) coupled with the fact that the rainy season closes the road between June and November, and because the single road leads only to the village of Ote, beyond that people have to trek through the forest and honey has to be head carried for as much as 30 miles to reach the road for transport out, but in addition to the problems of accessibility, the people themselves are faced with problems that impair their lives and impact on their health and even their life expectancy, so these cannot be ignored in considering beekeeping programmes.

The local people presented their issues to a district meeting led by Forudef in 2011 and  our visit aims to  identify the impact of these issues on the development of beekeeping to establish our own plan of the way forward to meeting our goals in line with what the people need and want.

Within the forest there is little access to health care as described in the previous post. Villagers from Ote have to walk 23 miles to the nearest hospital for routine health checks including ante natal.  There is a small clinic about 11 miles in the other direction but this is not staffed by a qualified medical professional and does not stock a wide range of drugs and treatments.  Vaccination of children is not carried out because health workers do not visit the outlying villages.Villagers presented many cases of health problems including high infant mortality last year, but there are large numbers of children present in Ote indicating that life expectancy is improving particularly in the under 5's. The general lack of transport has an effect on most aspects of the lives of the people.
There are many children in the village.  Others are still at school

Dr Gill Johnson, the English GP who accompanied us, found stunting of growth in 50% of the children she saw, and pot or extended bellies in most cases.  Stunting is indicative of a diet lacking in either calories or nutrients or both.  Stunting, along with underweight and wasting are all signs of malnutrition in children.  With only limited equipment, Gill was only able to take height for age measurements, but this gave some indication of nutrition status in the community. Malnutrition is common in subsistence communities who rely solely on what they can grow or hunt, and the variety of foods is limited. The pot bellies seen in children could also be indicative of malnutrition but could also be attributed to intestinal worms which are common in rain forest areas in West Africa. If intestinal parasites are present they will deprive their human host of much needed nutrients.  Malnutrition also has further efffects on mental development and ability, including  motor skills and deduction, and has a lasting effect on educational achievement and economic achievement later in life.  Also, mothers who are stunted in growth and who are suffering from malnutrition themselves produce smaller children who develop less well than normal weight children during their whole life.  All these factors combine to indicate that people from such environments are more likely to suffer physical and mental impairment in development which will have a lasting effect on them and their own future children.

Intestinal parasites
The village has no sanitation, or pit latrines or designated toilet areas.  This means that cross infection or the likelihood of picking up intestinal parasites from water sources such as the river or the soil is high.
Parasites can also be present on foods especially if human waste is able to contaminate crops. Without sanitation, it is impractical to treat these parasites and it is easy for transfer and for hosts to be reinfected.

Water Borne Diseases
children washing dishes in the river
The lack of sanitation and clean water means that water borne diseases can be a problem.  At the time of our visit only a few children presented with diarrhea but several had stomach pains, but people reported that this does happen and several women spoken to confirmed that families commonly lose children to illness indicating that child mortality is probably high.

Access by road
As already described the village is 53 miles along an unmade road that is in such poor condition that the journey takes 7 hours in the dry season and is impassable in the wet season.

What can we do?
We are trying to support beekeepers who we are training in the rain forest. Many of our beekeepers live in the outlying villages and have to head-carry their honey to Ote after the harvest.  This means that we need to have someone based in the village to receive any honey after they have checked it for quality and to ensure it is well sealed in the rainy season to prevent water absorption since the sugars in honey make it hygroscopic.  This will help produce a standard of honey that is acceptable for shipment out of the area to gain a higher price.

We currently support an extension worker and beekeeping mentor and trainer who works for Forudef.  He bases himself in Ote but his family are some distance away in one of the remote rain forest villages so he rarely sees them.  If we can provide accommodation for him in Ote with a honey processing unit, he will be able to manage the honey harvest coming in from the beekeepers and its safe storage through the rainy season preventing moisture getting into the honey, and transportation out when the road is passable again.  As Ote is at the end of the road, all further villages will come here to trade their honey and we can help facilitate this by providing an office that can be manned even when the extension worker is out of the village doing his support work.  By setting quality standards we can also help them to get the best price for their stocks.

We also feel that we cannot ignore health and sanitation issues in the village and that whatever we do must be of a standard that would be acceptable to Europeans who are our funders and our workers.

We will construct a building 
We have therefore decided that our work can only go ahead if we construct a building to house the extension worker and his family, provide a permanently manned honey trading office, a store and filtration room.  If we add an extra room for an office which can double as a medical room, government officials would be willing to travel to the village but more importantly they can ask the regional government authority for a medical worker to visit for immunizations, and medical checks.  This will immediately improve the health status of the people.

Forudef have already been working with Matt and Misha to improve nutrition through education and training and also introducing a greater variety of foodcrops.  They are doing a collection for this on Global Giving. Having a building would enable Forudef to base their training near the office and honey plant, so creating a small centre in the area.

buildings are mud brick or wood sticks with daub.
They have a thatch or aluminium roof
The structure will use locally made mud bricks, but will have an aluminium roof.  This is the cheapest way to construct and the building will be in keeping with the others in the village. Julian Marsh from Nottingham, UK, architects  Marsh and Grochowski has kindly agreed to put some designs together for us.

However the building cannot be done in isolation as we need to consider both the water supply and sanitation both for this building and the entire village.  If we can pipe water from a cliff up behind the village it will be clean and safer for the village than the river.  Latrines can be sited in strategic areas around the village and our own building can have toilets.

The chief of Ote wearing his woollen hat which is the marque of his status
This is quite a big project for us, but it feels a pragmatic approach and will provide a workable solution to introducing beekeeping in the area. We put our ideas to the village people through Ncho Tabe Moses who is the director of Foudef and the chief relayed that he and his people are very pleased with the idea as it will offer a real chance of improvement to his people.  We will get the building designed and costed and will have to think of fund raising.

Tuesday, April 3, 2012

An English Doctor looks at Health issues in Akwaya, Cameroon

Bees Abroad work to alleviate poverty through beekeeping in developing countries.  Therefore our work in Cameroon centres around teaching people how to keep bees and working to support them to become successful beekeepers.  We were invited to assist in the area of Akwaya, South West Cameroon by Forudef a local NGO set up to assist in rural development.  

Dr Gill Johnson
Having done a one day visit last year into the rainforest area to the village of Ote 53 miles from the nearest town and outside the area of mobile phone signal, electiricty or services, we had established that there were other needs within the area before beekeeping could make an impact. The major issues were around health, sanitation and nutrition.Therefore Brian Durk, the project leader for Cameroon, persuaded a Gloucester GP (General Medical Practitioner) from the UK, Gill Johnson, who is also a bee keeper, to come along and advise us.

On our first visit we noted the scattered nature of the settlement of the village of Ote.  The upper village was the largest quarter near the crossing point where vehicles could cross the river, the second quarter near and around the chief's house is about a mile from the upper quarter, and a third, but very small quarter lay across the river and it is impossible to cross to the main village quarters when the river is in flood. The village quarters do not have any running water, and all water is drawn from streams feeding the main river or from the river itself.  People also bathe and wash their clothes in the river.  There is no sanitation including latrines and there is no designated toilet area.  Therefore people just go to the toilet in 'the bush' and most of the children choose to use the river banks.  This is clearly not a good practice and we feared for water borne  pathogens and the likelihood of disease.

We observed that the children did not appear to be particularly underweight but many had enlarged pot bellies which we took to be a sign of malnutrition of some sort.  Therefore we were interested in Gill's assessment of the health situation on this year's visit.

She held a clinic and worked non-stop on the first day to get through the huge queues that had formed by 7 am.  People were dressed in their best clothes and came and waited patiently to be seen.  Benches made of bamboo were brought from other parts of the village to accommodate the numbers.  Mostly the first day was women and children.

The older man on the right is the village medicine man.  He an Gill met as colleagues
The next day older men started to come along with a few older women.  Only on the final day, in a rush at the last minute a number of younger men joined the crowd who attended.  They all patiently resigned themselves to waiting their turn, and each was seen by the doctor. After 3 days this is Dr Gill Johnson's report:

'A group of local people gathered early the first morning in Ote. Word had spread that an English doctor was coming. I had a makeshift consulting room in Moses' relatives' house, where I used some basic equipment and dispensed from a bagful drugs brought from home. Dickson, Moses' relative, acted as interpreter and I saw 68 patients the first day, working up to 8pm when consultations were by kerosene lamp and torchlight. I saw many adults with back pain related to their heavy work, pregnant women, three children with deformities, and recorded a significant proportion of children with stunted growth. Access to health care is very limited; the nearest health centre is a 24 miles walk away.

Gill seeing a patient in her consulting room.  Diskson our translater  is in the foreground