We will build a wall…

It’s humbling to realize that, despite my age, there are still some things I’ve never heard of. Or, is it because of my age…?

I suppose I could be forgiven for being unaware –I almost said uninterested– in things that trend nowadays, the inference being that, lacking in statistical significance, those things which appeal to a segment of the population to which I am not credentialed have been assigned a new category. But what about issues that have been bubbling about for almost a century, albeit far enough away that I am seldom directly affected? And yet, distance excuses nothing. I hear of hurricanes, and distant floods. I am all too aware of the melting of Greenland’s glaciers, not to mention similar changes in Antarctica, so why would Africa be any different? News of terrorism, political coups, and natural disasters there abound in everyday news, so how could anything as filled with potential as a decades long project to arrest the steady creep of desertification into sub-Saharan Africa have crept past me?

The Sahara is the second largest desert in the world, after Antarctica and throughout the history of the region, it has undergone millennial climatic oscillations. From about 11,000 to 5,000 years ago (during the early Holocene epoch), trees, lakes, grasslands once covered the arid Sahara. ‘The Green Sahara was the most recent of a succession of wet phases paced by orbital precession that extends back to the late Miocene. When the precessional cycle approaches perihelion during boreal summer, the increase in insolation drives a strong land-sea temperature gradient over North Africa that strengthens the African monsoon, bringing rainfall deep into the Sahara,’ according to a paper authored by geologist Jessica Tierney of the University of Arizona and published in Science Advances http://advances.sciencemag.org/content/3/1/e1601503.full

The last few millennia, however, have been dominated by aridity and a fear that the desert is slowly creeping southward. And while, apart from the Nile arriving from much further south, little was felt to be able to reclaim the desert itself. So, the idea of preventing further encroachment along its southern borders –the Sahel- was proposed.

As the Smithsonian Magazine reports, ‘The Sahel spans 3,360 miles from the Atlantic Ocean to the Indian Ocean, a belt stretching across the southern edge of the Sahara. Rainfall is low, from four to 24 inches per year, and droughts are frequent. Climate change means greater extremes of rainfall as the population skyrockets in the region, one of the poorest in the world. Food security is an urgent concern. By 2050, the population could leap to 340 million, up from 30 million in 1950 and 135 million today.

‘In 1952 the English forester Richard St. Barbe Baker suggested that a ”green front” in the form of a 50km wide barrier of trees be erected to contain the spreading desert. Droughts in the Horn of Africa and the Sahel from the 1970s onwards gave wings to the idea, and in 2007 the African Union approved the Great Green Wall Initiative.’ https://qz.com/1014396/the-plan-for-a-great-green-wall-to-beat-back-the-sahara-needs-a-rethink/

The idea was that a green ‘wall’ from from Senegal in the west to Djibouti in the east would not only halt further desertification, but the people in this area would benefit with jobs, increased arability of the land, and maybe even tourists.

As it was originally conceived, however, it seems retrospectively naïve. Perhaps the Smithsonian magazine summarizes it best: https://www.smithsonianmag.com/science-nature/great-green-wall-stop-desertification-not-so-much-180960171/ ‘”If all the trees that had been planted in the Sahara since the early 1980s had survived, it would look like Amazonia,” adds Chris Reij, a sustainable land management specialist and senior fellow at the World Resources Institute who has been working in Africa since 1978. “Essentially 80 percent or more of planted trees have died.” Reij, Garrity and other scientists working on the ground knew […] that farmers in Niger and Burkina Faso, in particular, had discovered a cheap, effective way to regreen the Sahel. They did so by using simple water harvesting techniques and protecting trees that emerged naturally on their farms. Slowly, the idea of a Great Green Wall has changed into a program centered around indigenous land use techniques, not planting a forest on the edge of a desert.

‘The African Union and the United Nations Food and Agricultural Organization now refer to it as “Africa’s flagship initiative to combat land degradation, desertification and drought.” Incredibly, the Great Green Wall—or some form of it—appears to be working. “We moved the vision of the Great Green Wall from one that was impractical to one that was practical,” says Mohamed Bakaar, the lead environmental specialist for Global Environmental Facility the organization that examines the environmental benefit of World Bank projects. “It is not necessarily a physical wall, but rather a mosaic of land use practices that ultimately will meet the expectations of a wall. It has been transformed into a metaphorical thing.”’

I like metaphors, especially wall metaphors… Edge metaphors in particular. There is something intriguing about what happens at boundaries when things alien to each other, let alone inimical, meet. There is usually a testing of one another, a probing for similarities, weaknesses, and then often as not, attempts at breach. And if both sides absorb the assaults, the wall then becomes a compromise –not maintaining a separate identity, but melding, as it were, into a new entity. A new creature.

So, although it may be true that what lies far away on either side stays true to itself, the wall is a relationship -a neither-nor that exists as a bridge to each. Walls, are like skin: it separates us from the world beyond, but it also joins us to it. The Green ‘Wall’, in a way, highlights this. Rather than artificially planting trees, the farmers allowed the tree roots still in the ground to regenerate –these, presumably, were already adapted to the local conditions. ‘Tony Rinaudo, an Australian with Serving in Mission, a religious nonprofit, working with local farmers, had helped the farmers identify useful species of trees in the stumps in their fields, protect them, and then prune them to promote growth. Farmers grew other crops around the trees.’
For example, ‘One tree, Faidherbia albida, goes dormant during the wet season when most trees grow. When the rains begin, the trees defoliate, dropping leaves that fertilize the soil. Because they have dropped their leaves, the trees do not shade crops during the growing season. Their value had long been recognized by farmers […] but they were never encouraged to use them.’

So, far from being a wall, the Sahel is more of a chain, with different parts linked together, however tentatively. However unlikely.

You have been told that, even like a chain, you are as weak as your weakest link.
This is but half the truth.
You are also as strong as your strongest link.
To measure you by your smallest deed is to reckon the power of the ocean
by the frailty of its foam. Kahlil Gibran…

Metaphors are powerful things.




















An Even More Modest Proposal

How many of you remember being presented with Jonathan Swift’s ‘A Modest Proposal’ in English 101? It was a not so subtle satire of 18th century British treatment of the Irish, in which he hyperbolically –and anonymously- suggested that the Irish might be able to ease their economic distress by selling their children for food to English gentry. It was clearly so outrageous and inflammatory that it was intended to make the readers see how wrong the then-prevailing treatment of fellow human beings could be. To alter, in other words, the perspective, and facilitate the shift to a different world view. To allow people to see what they had hitherto ignored and perhaps make them want to improve it.

My own modest proposal is less preposterous and certainly not satirical, but it does fly in the face of what we in the richer nations have come to expect and accept: only the use of professionals in our health system; and discount: the adjunctive use of non-professionals to help with some aspects of that care. It was engendered by a segment in an October 2016 PBS program and has intrigued me ever since: http://www.pbs.org/newshour/bb/can-ordinary-citizens-help-fill-gaps-u-s-health-care/ The idea that health care is becoming increasingly expensive and that even with universal coverage, there are still a lot of gaps that are unlikely to improve even with the addition of more doctors and nurses. Training and equipping them is expensive, and still does not usually solve the problem of their accessibility to those most in need –the poor and disadvantaged in our societies.

Professionals are viewed as part of a power structure that is often alien to a population all too frequently ignored, isolated and denigrated by the mainstream. Issues of cultural safety frequently play a role in this –lack of understanding and respect for cultural or economic disparities may make them unwilling to engage with professionals until the problem is untenable or even irremediable. Prejudices don’t need to be stated; they are too often felt. So the idea that there may be bridges into this demographic –keys, however counterintuitive, that could unlock barred doors- is worth exploring.

The idea of using trained volunteers to talk to those in society that are often ignored until in extremis is certainly not new. Think of the ‘barefoot doctors’ working in rural villages in China, for example. Or, ‘In sub-Saharan Africa, community health workers have long formed the backbone of health systems, filling in gaps where doctors and nurses are in short supply.’ The key concept for the acceptance of these para-medical workers, of course, was the relative lack of other facilities and professionals to fill them.

So why should we, in our relative affluence, consider the use of non-professionals? Especially here in Canada where, in 2003 at least, there were 2.14 doctors and 9.95 nurses per 1000 population? Perhaps in Malawi, where there is 1 doctor per 50,000 people (2004) the need is more readily apparent, but Canada…?  Well, it seems to me that the gap is not so much one of professional numbers as engagement. As one of the patients interviewed in the PBS program said of the volunteer that talks to her about her severe diabetes condition: ‘With your doctor, you don’t really want to say what you eat, so I’m able to tell her like, really, if I’m not going well, or, you know, if I sneaked and cheated. I tell her the right things, and she helps me.’

In other words, the volunteer is not attempting to take the place of the doctor or nurse and give medical advice, but is acting almost as a translator of patient concerns that are not verbalized in front of the doctor or nurse. We sometimes forget the power discrepancies on display between doctor and marginalized patient.

The addition of trained community volunteers should not be seen as a threat to the professions, but rather as a helpful, and essential, adjunct to expand the reach of healthcare beyond its present boundaries. Nor should it be seen as creeping multi-tiered medicine with the poor being relegated to substandard care –swept under a carpet where they can be safely ignored until they become seriously ill and show up in Emergency Departments across the land -an expensive way to provide health care, not to mention wellness-promotion. It is simply not cost-effective, no matter the system.

The volunteers can be used to penetrate the layers and develop relationships with people who otherwise might not seek help until they had no other choice. Help them to know when to seek professional advice. Check to see if they are following whatever recommendations were given; make sure they take their medicines as directed. Emergency care is expensive and its facilities limited; timely, early intervention is both preferable and, ultimately, more humane. I know that our Social Service is already doing a sterling job in this regard -especially in our larger cities- but they are stretched pretty thinly nowadays; I would think they might appreciate a little help. Doctors and nurses in the various walk-in community clinics or in smaller towns could suggest clients who might benefit from some additional help, and the word would spread from there… As I have suggested, there are layers within layers to penetrate in a neighbourhood.

And if we agree that the volunteers would be better prepared and more useful if they received an appropriate basic training course to equip them for what they are likely to encounter, why not fund this? For that matter, why not pay them? Or am I being naive?

It’s a modest proposal, though… Isn’t it?