Charting a Medical Future: Mali

Reprinted with permission from Dickinson College Campus News Extra

With her Dickinson College Engage the World Fellowship as her ticket to a summer of discovery, junior Katie McClellan walked straight into a war zone.

It’s a silent war. Down dirt streets that lace an ancient, diverse West African culture along the Niger River, more than a million individual battles are fought every day. It is a winnable war for sexual and reproductive health in one of the world’s poorest nations.

As the nearly 10 million people of Mali, a functioning constitutional democracy since 1992, begin to openly confront sexual issues—from AIDS to contraception to female excision, a form of genital mutilation—they are working toward a more enlightened future.

McClellan, a biochemistry major and her class’s scholarship recipient for Bioinformatics, chose to help build that future half a world away from her Asheville, N.C., home.

In the office of the Association de Soutien au Dévelopment des Activités de Population (ASDAP), in the teeming Malian capital of Bamako, McClellan was “la stagière”—the intern or person in training—on the front lines of Third World cultural change that sharpened her view of her own future in medicine.

With ASDAP, a Malian nongovernmental organization, McClellan worked directly with a young and vibrant peer-education outreach group.

ASDAP’s mission, McClellan says, is to “go out into the community and bring in adolescents, which they categorize as people from about 16 to 24. They train them as peer educators for a couple of weeks, then continually throughout the year. The peer educators then go out into their neighborhoods and to their schools.”

The goal is to educate Malians about family planning, female excision, sexually transmitted diseases, contraception, HIV and AIDS. It’s not easy.

“As much as sex can’t be talked about in the U.S., it can be talked about even less in Mali,” says McClellan. “You don’t talk about things like excision. And AIDS has this incredible stigma attached to it. People won’t even say AIDS. Many people don’t even believe that it exists.”

“My work with ASDAP really sparked my interest in public health,” she says. “While I’m not sure where that will take me in the short term ... I imagine that I will end up relating that interest in public health to whichever field of medicine I go into ... I think I might like to do a joint M.D./M.P.H. program after I graduate.”

McClellan’s dreams of Mali were planted in high school, when she met Lynn Lederer, whose parents are McClellan’s neighbors back home. Lederer lived in Bamako for six years as director of the field office for Save the Children. When Lederer found out about McClellan’s interest in medicine, French, and other cultures, she invited her to come to Mali.

“What probably prepared me the most was a women’s studies course called Women’s Health…” says McClellan. “We focused primarily on women’s health issues in the U.S., but it taught me how to look at things from the outside.”

McClellan spent about six weeks in Bamako, then spent another week traveling into rural villages up the Niger (80 percent of Mali's population resides in far-flung rural areas).

“ASDAP is reaching out to women because excision obviously affects the female community more than the male community,” McClellan says, “but you’re not going to have any sort of impact on the cultural ideas unless you reach out to men too. The message is being spread, but there’s so much ground to cover.”

In the fall following her interview, KATIE McCLELLAN studied at the University of East Anglia.