Serious Beauty

You might well expect to find a somber mood at Delta Survie’s obstetric fistula center. But you would be wrong.

In a blizzard of tropical color, about 60 Malian women rose to their feet to greet us. I wondered whether we might be in the wrong place: after all, my traveling companions and I had come to work in a treatment center for obstetric fistula, a serious medical condition requiring months of multiple surgeries and recovery. But these radiant, stylish women were, indeed, the group we were looking for: patients at the Delta Survie Fistula Center.

I have only been to West Africa twice, but both times I have felt oddly and completely at home. Mali and United States are certainly different economically, with Mali being the 4th poorest country in the world. There are also important differences in religious habits, gender roles, the definition of marriage, etc. But Malian street life, with its constant and ready exchanges of words and glances between people – mostly dressed in a peacock-like proclamation of individuality and amour propre – makes me think of downtown Manhattan on a hot summer day. In the middle of a parade. With loud music playing.

Add to the mix the quick bloom of charm, irony and humor at the first hint of any of these from a visitor or customer: this makes almost every interaction a happy adventure. Throw in children flocking around to have their pictures taken, and a wandering vendor or two selling turban cloths or Tuareg jewelry or just fresh vegetables, and a few handfuls of fine red-orange dust, and you have at least a few of the key ingredients of Malian street life.

In January 2009, my travel companions to Mali were Jean Johnson (director of merchandising for SERRV International, an artisan-focused fair trade group), and Julie Danis (SERRV International board member). We had the privilege of stepping out of the happy confusion of street life and into the more intimate space established by Delta Survie’s center for women afflicted by fistula. 

The center was founded in Mopti (Mali’s second largest city) in1986 by Doctors of the World to provide surgical and medical services to rural women suffering from obstetric fistula. Their condition, essentially perforations between the birth canal and the bladder and/or rectum, results from prolonged and difficult labor, childbirth at an early age, large families, poor nutrition, anemia, poor pre-natal care and scarce midwifery. Virtually unknown in the developed world, it is estimated that in developing countries 50,000 to 100,000 women annually suffer from the condition. Compromised internal organs result in infections and odors and infertility. As a result, many African sufferers are abandoned by their husbands and isolated from village life.

In 2000, Delta Survie, an NGO based in the Mopti region, saw that social services were needed in addition to Doctors of the World’s medical attention. The multiple surgeries usually needed to address fistula require a long convalescence. And the marginalized social situation of many of the women calls for a fresh set of skills in order to build new lives after the medical situation has been addressed. Though Delta’s main activity focuses on mobile schools designed to meet the needs of Mali’s nomadic fishing and herding population of Bozo, Tuareg and Fulani peoples, they decided to join with Doctors of the World to shore up the social side of the center. With the guidance of Delta’s inspiring leader Ibrahima Sangare, over 200 women a year receive surgical and social assistance now, and Delta’s national communications program is seeking to strip the veil away from fistula and define it as a treatable disease like any other.

It was clear from the start that the women see themselves as a community – that they bond together to help each other recover, to mind each other’s children, to make food. Indeed, to meet all the challenges of the surprising turn their lives have taken. Yes, they often cluster together in groups that share one of the several African languages spoken in the Mopti region. But language is not a barrier here. What they share is so much more important than what might keep them apart.

Jean, Julie, and I were there to lend a hand to Delta’s efforts to support the center with the sale of handmade jewelry. Beadwork is a light, stationary kind of work perfect for women in surgical recovery. And, as you quickly learn from the pretty necklaces and earrings and bracelets worn by many of the women, such jewelry is part of the vibrant style zeitgeist of Mali. The center divides the profits in a fair and careful manner between the women, the staff whose work contributes to the jewelry making activity, and the businessman-market-liaison-problem-solver who keeps supplies flowing and ships the product. Even with only two export customers, SERRV being one of them, and a small base of local sales to tourists, they are within reach of funding a large percentage of the center’s services through their jewelry business.

Our four days with Delta passed quickly. Jean took charge of reviewing pricing and costing practices, as well as general export conditions. Julie focused on gathering the life stories of many of the women. I worked steadily with the staff assistants on developing new jewelry designs.

Staff assistants Fanta, Tata and Keitou were joined by Safiatou, once a patient at the center and now a constant participant in the center’s life, and Solo, Fanta’s big-hearted brother. He keeps supplies flowing when there are orders. He also, with Safiatou, repairs any flawed necklaces, washes and inspects all stock before it is declared ready to ship, and does the packing. Fanta, Tata and Keitou train the center’s patients, and work closely with them to produce samples, counter-samples, and stock. Peace Corps Volunteer Rabiah, who just recently began an 18-month stint with Delta Survie, also worked with us.

During our visit, we worked (in between conversations and jokes in English, French, and Bambara) to produce over 15 different necklace prototypes, with a handful of earrings thrown in. As is so often the case when working face to face with artisans, language is not a barrier. We often spoke through doing. And when doing and language was not enough, we often found ourselves looking at each other’s faces, listening to words and gestures that in and of themselves were incomprehensible… and arriving at a solid understanding of the next step that surprised all of us. 

We tried some designs based mostly on techniques already used in the local and tourist market – only changing color or composition or proportion. And we tried some new ideas that pushed available materials and skills forward a step or two. We developed only ideas that the ladies thought would sell in the local market; these were the products they were most enthused about, and enthusiasm always smoothes the way to solving any problems of making or of supply. A sense of enjoyment speeds the work along.

Not everything turned out exactly as I might have expected: but such is the beautiful happenstance of many hands working at the same thing. The product development effort got a huge endorsement from all the Moptians at hand. When asked whether other makers and sellers in Mopti would copy what we had done, they replied, “If they have eyes, they will copy us!” Do they know, I wonder, that Picasso is reported to have said something similar: “All art is theft?"

We left behind a SERRV sample order for almost all the necklaces we developed. Jean restated the price goals and the need for strong quality control. Julie took with her the unusually candid stories related by her new friends.

We are already making plans to return next January, with additional volunteer designers in tow to contribute to the product development effort. What I saw there is too good and too helpful to stay away for too long. 
See for examples of Delta Survie’s jewelry. New designs premier in Spring 2010.



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