Oct/Nov 2011 Travel

What Won't Kill You

by Ann Starr

Photo by Ann Starr

Photo by Ann Starr

The little road that connects the village of Ngor Ndiongorane to the rest of Dakar's life and transportation is an unmarked, take-it-or-leave-it asphalt byway that sits atop the surrounding scrub and sand. An occasional automobile drives along it, playing chicken with horse carts as it goes. The horses loosen their bowels in response. When sandaled pedestrians jump aside not to get run over, they hop between fresh piles of dung and puddles of sun-melted asphalt.

My daughter, Lucy, assured me that this connecting road, crude as it seemed, was in fact highly improved. During the previous fall's rainy season, it had been almost swept away by the force of downpours gouging out craters deep enough to swallow children. The taxi drivers had refused to risk their cars to drive into the village, so she had to walk when she left her school after teaching every day. When she got close to home, she walked through water and floating trash up to her thighs.

Senegal is a nation of sandal-wearers who don't want to walk where it's wet. All sorts of parasites and worms enter the body through the skin. Feet are the primary portal for worms, as Lucy learned though unpleasant personal experience.

During my two weeks in Dakar, Lucy and I headed down the sandy hill from her building every morning, dodging puddles along the way. We circumvented all obvious sheep relievings, but other pools were more mysterious—soap suds or the emptied pisspot? It wasn't always easy to tell.

Sometimes we departed the sandy road to the village center halfway down the hill, then made for a dirt path across an empty, trash-strewn zone where a modern housing development was rising. Its incomplete structures, broadcast across the sandy plain, almost looked like pyramids along the Nile plains. Wobbly rocks continued the path across a stream so shallow that we'd have been at no risk of drowning. But we zealously kept our footing because the stream was not water, but barely flowing, gray-green sewage, sickening to smell.

One day on a taxi ride in a park-like part of Dakar, we skirted a canal artfully flanked by walls and sidewalks, and shaded by mature sycamore trees. Lucy told me that the canal, invisible to us beyond the concrete arabesque wall, was a deep, green trench of waste water. Children frequently played along those banks and sometimes drowned in the sewage.


The visitor to Senegal is required to have immunization against yellow fever. Shots are also recommended for typhus, hepatitis A, and meningitis. I went to a travel nurse before my trip to get the $700 worth of recommended shots. I also got a prescription for Malarone, an anti-malarial, because Lucy had urged me to. She knew people with malaria; it was real. I didn't want to be a sitting duck for malarial mosquitoes, since I appear to be a favorite dish of the non-malaria variety.

I worried a great deal about the possibility of contracting African ailments. My concern wasn't about doubtful medical practices of Senegalese hospitals, for Lucy had reassured me about the excellent quality of Dakar's central hospital. But my anxiety was not founded in hysterical fantasy. As an American with marginal health insurance and many preexisting conditions, I didn't worry about the quality of medicine but about being able to afford any treatment at all. If I were to get sick in Africa, the consequences of disease would be devastating when I got home.

The travel nurse dispensed little reassurance to go with the battery of shots. She scared me half to death with warnings about food safety. As a student, Lucy had lived in an African household where nothing but native foods were served, and now that she was on her own, she still enjoyed a mostly local diet. Of course, there was always the matter of the ubiquitous palm oil. A bottle of the stuff looks like the contents of a Lava Lamp, its discrete blobs of yellow fats oozing through a glutinous red suspension. Other than that though, Lucy loved local food and recommended it. Freshly slaughtered Senegalese meat had supplanted her taste for American meat. She'd even learned how to help other women disembowel a freshly killed sheep, on the beach where she'd been invited along for a family cookout.

I am an eager and eclectic eater myself, always looking forward to new foods. Before this trip, though, I had traveled nowhere with gastronomy more exotic than the gravy-besotted Czech Republic. Now the nurse was counseling me, "Never eat fruit purchased on the street: Insects can puncture the skins and transmit diseases through the flesh of the fruit." Obviously, she continued, I should decline foods prepared by street vendors: There were no guarantees of sanitary preparation, and the meat could be anything—dog or cat or rat. She urged me to carry my own canned food; it wouldn't hurt, either, to take Pepto-Bismol daily, "just in case," and to have Imodium tablets at the ready for the inevitability of diarrhea.

My first reaction was alarm. But on second thought, I found her warnings hilarious and absurd! I conjured Mad Magazine images of myself falling victim to gross-out intestinal outrages, then stumbling to a risible death as I licked my chops over a seared rat kebab.

I made merry with my friends about her advice—but no one laughed. "Come on, we're talking Africa," was the common thread. It also turned out that nearly everyone had a sensational story about relatives felled by diarrheal horrors in foreign places. These lurid accounts finally prompted me to recollect the incident that should have been at the front of my own mind all along, one that I had sternly repressed. It was Lucy! In Dakar! How could I have forgotten?

During her college days, when she boarded with the sheep-roasting host family, Lucy discovered that her parents, who were contractually obliged to provide her with filtered water, were merely filling empty water bottles at their tap.

This discouraging fact came to light when my daughter, gravely ill with an unspecified digestive disease, was too weak to rise from her bed. With the help of a classmate, alarmed that Lucy hadn't been seen for a week, she visited a German doctor who determined that the force of the diarrhea had caused her stomach lining to disengage and be shed. She couldn't retain food or water because her body could absorb nothing. The tap water probably hadn't caused the problem, the doctor said, but it didn't help because Lucy still hadn't been in Senegal long enough to stomach it.

This episode rattled me so at the time that I must have mentally fainted and suppressed it. And this horrific event happened, anyway, not long after Lucy had been abducted by the police and held until she paid them a bribe. These memories of fearing for my child's life now provoked appropriate, visceral fear of Senegal's potential for gut-wrenching horrors.

Food, glorious food! It satisfies our bodies, senses, and souls. Eating should bring happiness and comfort. Having an appetite is one of the definitions of wellbeing. When I travel, I don't eat in restaurants that protect me from where I am and add the stamp of Cosmopolis to my passport. I want to enjoy particularities of place. Moreover, enjoyment of food is my entrée to manners, mores, and economies. At the table, I see how society, families, and friendships are formed; I watch the roles women and men play. I learn how strangers and the humble are treated.

But did the travel nurse have a point? I'll say this for her cautionary speech: She had the force of our most profound acculturation on her side. Even as newborns unable to control any body functions, adamant parents teach us what we may not touch and what we must never eat. Sanitary laws are primary, and basic to everything about customs of eating, and acceptance of food flavors, appearance, and smells. One of our first lessons is that clean hands and clean foods are life-and-death matters. To survive, we must be able to distinguish clean from dirty and safe from unsafe.


The day after I arrived, Lucy made us sandwiches for lunch while I poured myself a cup of the filtered water that had been purchased especially for me. I hated to do it, but I had to share my misgivings about how we could eat together for two weeks without my being done in. I regretted that I, who had always been so hale at home, had come to Dakar to become vulnerable as a firefly.

"Mom! What's wrong?" Lucy exclaimed with a look of alarm, laying aside the knife with which she had been spreading mayonnaise, and laying both hands on the table to steady her weight. "What haven't you told me?" She was suddenly alive to any possible debility on my part—I could be a goner at any moment! She was steeling herself to hear that I had a fatal disease and had really come to say good-bye.

I confessed the nurse's discouraging dietary warnings, which had grown much less comical to me over the weeks they'd had to fester.

Lucy hit the roof. "Why the hell do people always think the worst of Africans when they don't have a clue about anything here?" she spat, rolling her eyes in disgust. "I eat fruit from the street vendors every day, and I always have. Would you rather have a mosquito on your orange, or pesticides? Did that woman have any idea what people eat in Senegal? Or did she mean South Africa? Or Sudan? She can't even tell you where Senegal is or anything about its climate or what kind of diet people have here."

Suddenly ashamed that I represented all "educated" middle-class Americans, I hung my head and I said that this was very likely so. Lucy had raved about maffé and ceebu jënn (CHAY boo-JEN) ever since her student days. These ubiquitous, popular dishes composed of rice, fresh fish or meat, spices, tomatoes, and vegetables sounded delicious—surely much better than creamed corn in a can. "I eat at a ceep (CHAPE) shack all the time," she sneered. "The lady serves exactly the food she cooks for her own family, out of the same pot. And guess what? The Ngor food market I'll take you to is full of flies and would completely freak out your nurse! But it's the market every restaurant cook in Dakar goes to for all his meat and ingredients!"

When Lucy ceased fulminating, it did occur to me that the nurse had said nothing about the hazard of puddles full of worms. I decided then that I must rearrange my attitude, drop my burden of worries, and let Lucy lead the way with her good sense, observations, and experience. This was her home. She had survived, she valued her health, and she planned to continue living. I guessed that she wanted me to endure too.

As we cleaned up the kitchen together after our sandwiches, and I was resolving to let Lucy be my public health exemplar in Senegal, I nevertheless felt it important to point out that mayonnaise shouldn't sit all day on the counter as hers had—especially in a country so close to the Equator. "Safe practice calls for constant refrigeration, even back home," I explained.

"Oh!" she responded with slightly offended surprise. "No one ever told me that."


In the mornings we lined up to buy Yacine's bean sandwiches for our breakfast. Yacine is a quiet woman with a round, warm face. She's the image of the universal mother, whose smile speaks all languages. Even my punctilious nurse would have eaten what Yacine offered, despite the flies buzzing around the products she carefully wrapped for take-away in Turkish newspapers or completed pages from French students' geometry workbooks. Her sandwich stand was an upright wooden box painted turquoise—a telephone booth in shape—with barely enough room inside for Yacine, a tiny counter, and a small swarm of flies.

A bean sandwich à la Yacine was a third or a half of a fresh-from-the-baker's-just-beyond-the-butcher's baguette. I could turn around and see the white-tiled façade of the bakery. Yacine split open the bread and slathered it with mayonnaise. Refrigerated? Who knows? Onto this portion she ladled, from a large pot, a generous smear of small red beans in a thick red sauce darkened with mild spices. There was just a little heat to it. This was an admirable, satisfying food; a simple food eaten by everyone in the village.

While Lucy purchased sandwiches, I'd take my 100-CFA coin—about 20¢—to the door of the music shop. The shop displayed speaker cabinets with speakers missing, doubtful electronics with dangling wires, and a close-mouthed, grumpy young woman who sold café Touba, brew of the gods. Lucy had introduced me to this delight on the street, where vendors sit under umbrellas and serve it foaming in tiny cups from big kettles warmed on charcoal furneaux. Like every drink I tried there, it seemed to be composed half of sugar, but the coffee was also laced with cinnamon and spices—with cardamom perhaps, and others I couldn't distinguish. It's suave, sweet, and spicy—a glorious coffee. I always bought twice the normal serving, enough to fill a mug. The young woman ladled it into a plastic bag, tied it off and handed over the fragile vessel for me to carry out. The memory of Café Touba and a bean sandwich in the morning made me feel turquoise in an ocean breeze of good will.

We ate West African food every time we ate out, wonderful dishes like Yassa fish or chicken, bissap juice made from hibiscus petals, ceebu jënn, grilled crevettes, bean baguettes, and the fabled hamburgers. When we ate in restaurants, we were always given flatware, but when we ate with families, we were not. Even at the elaborate Muslim wedding we attended, we feasted with our hands.

When Lucy's friend Karfa married, his mother and sisters served the wedding dinner on large platters that they carried to the guests wherever they happened to be all around their four-story house, including up on the roof, where Lucy and I were among those enjoying the sunset and evening air.

We were among a group of five women—elegantly dressed in traditional finery, adorned with lavish jewelry, and exquisitely made up—who circled our chairs around one of these platters, which was placed on an inverted bucket on the concrete floor. As we assembled, Lucy whispered urgently that I must use only my right hand to eat. No cutlery or plates were offered.

Each of us leaned in to eat from the nearest section of the platter. The practice was to form balls of couscous and sauce with the right hand. Chopped chunks of lamb on the bone were arrayed atop the couscous mountain. My dexterous companions stripped the meat off the bones one-handed, but I was shy to attempt it. I ate little, for I felt awkward and I feared dribbling food all over my beautiful garment, sewn by a local tailor for the occasion. Lucy and our companions formed neat little balls of grain, sauce, and meat. They ate as delicately as if they were tasting canapés and balancing cocktails in stemmed crystal.

After we feasted, all the other ladies unapologetically licked their right hands. There was no attempt to disguise the practice, but I felt a little embarrassed to be so free with my tongue. We lined up at the tap placed above sunken tiles and rinsed away the grease and any specks of herb that our tongues had missed, dangling our gaudy purses and, finally, checking our lipstick.

I had winced to engage in this dodgy-sounding dining practice. But it wasn't so bad. Everyone ate as if we sat in the dining hall of an Evelyn Waugh novel. We lacked only chandeliers and silver service. Had we used cutlery, would there have been fewer germs on our forks than on our mincingly deployed fingers? I doubt it.

Talking this over on the taxi ride home, Lucy reminded me about the used papers in which Yacine swaddled the bean sandwiches, explaining that those were all about the right hand. Islam is fastidious. For Muslims, the right hand is the clean hand, with which one eats, shakes hands, and makes contact with others. The left is dirty, never used to touch food. That's why we received food paper wrapping, in case we had to lift or carry it with the left hand.

And this, she further explained, is for a very solid sanitary reason. In most places uninfluenced by Western practice, a jug of water sits beside the toilet to splash and wipe one's bottom with before washing hands. The left hand performs this operation, without toilet paper. To indulge my customs, Lucy had bought toilet paper at the corner boutique. It was so rarely asked for that she had had to choose between the four-pack with three rolls or the four-pack chewed by rats.

Senegal seemed to lack any reasonable public health infrastructure, yet looking from Lucy's roof out across the neighborhood, or walking past mosques, we always saw men performing ablutions, washing their limbs and feet, their heads, and the interiors of their mouths before prayer. The religion mandates personal cleanliness.

Every day Ngor Ndiongorane's rooftops loudly flapped with hundreds of households' line-drying linens. Laundry was hard work there. Clothing was washed on the scrub-board, then rinsed in a succession of tubs and wrung out by hand before it was hung in the sunshine. The water may have been drawn from a tap in the house, or from one elsewhere in the neighborhood and carried home. Despite this arduous daily work, I never saw a person at any social level in a garment smudged or soiled.

In fact, white clothing was ubiquitous. Sandy, littered, sheep-filled streets were strolled by people wearing pure white robes with matching headdresses, long white tunics and wide pants, or white western shirts. Men's mules were the most common type of footwear with their pointed toes and uppers covering the foot back to the ankle, with the heel free. They were usually white or pale lemon yellow. I never saw a mark, stain, or graying of any white shoe or garment. White did not even exist in the range of eggshell, ecru, or opal. There was only brilliant, impeccable white, as if those who wore it worked in research laboratories.

One day we watched Karfa's brother oblige their mother and cut a raw leg of lamb into pieces. Khalifa placed the meat on a stack of papers on the floor, then crouched down to score it with a heavy, cast-iron scythe, the blade of which he pounded forcefully into the meat and bone with a hammer. This operation took no little time and muscle. He attacked his job undraped, wearing brown dress trousers, white mules, and an immaculate, pressed white tunic. He neither hesitated about his task, nor did he spatter anything on his clothing.

Khalifa is a highly ranked fencer, often encased in purest white for practice or competition. The man invariably gleams, as many Senegalese men do, their beautiful, crisp appearances transcending in elegance the dusty and unkempt world without.


Lucy and I lunched at her favorite ceep shack one day. The ceep shack is casual dining at its most glorious—and its most infamous, I suppose, if you happen to be a travel nurse. Although we had often passed the site, I hadn't seen the eatery, for when it was closed, it was invisible. Then it existed only as four metal rods in the ground with a flat roof formed by canvas tarps. Even to call it a "shack" was grandiose, for it was nothing but an apparently unclaimed space that the eye traveled right through. The business materialized when the proprietress stretched several bed sheets around the poles. When the little restaurant thus popped into being, then you were welcome to enter and dine.

Inside, there was little room between one splintery wooden table, three rough gray benches, and the buffeting walls. On the table rested two tall plastic tubs with lids, and on their lids sat several nesting plastic mugs. The hostess-cook occupied a little table where she had her pot full of the day's single menu item. When a guest entered, she matter-of-factly ladled stew—it was always stew and rice in Senegal—onto a plate and handed it over, along with a bent fork balanced on the side.

On our particular day, Lucy was hoping for her favorite maffé, but neither of us was disappointed that we received the national dish, ceebu jënn. Lucy made pleasantries in the local language, Wolof, with the woman, who paused from feeding her granddaughter to take our coins. Then we were left to chat with each other while we enjoyed the savory vegetables served atop a small-grained brown rice that's special to West Africa. At the center of each plate was a generous chunk of meaty fish that we shredded and mixed with the vegetable sauce.

Two pairs of men eventually joined us. We smiled and nodded, and they fell silently to their meals. I noticed that they did not hesitate to ask the cook for more sauce when they wanted it, or to pass their plates back for extra fish. No money was exchanged for seconds. Like a contented mother, the cook appeared gratified that they wanted more.

I thought with a sigh of the travel nurse at home and of the anxious way I had incorporated her. Because I had set her aside, here I sat, eating a delicious local staple among people living their lives. Instead of Muzak, I was listening to the rustling sheets, played by wind off the Atlantic that pulled and plucked at them. I would have missed this, clinging to concerns over pestilence? How foolish I would have been to refuse what Lucy was sharing with me, food for memory and imagination. My fears were a spiritual starvation diet.

The only thing lacking was something to drink with my ceep. I understood that the tubs on the table were full of water because I watched the men remove the lids, dip the handled cups in, and drink. They neatly replaced the lids against the flies, and politely put the cups back where they got them, on the lids. Lucy reached for one of the returned mugs when the men were through. "It's tap water, Mom. Sorry," she said sympathetically.

"But the cups..." I stammered, hoping that I misunderstood what was unfolding.

"Oh, don't worry, Mom, it's just the way they do it here. Everybody drinks from them." And she shrugged, drinking deeply from a communal cup. "We can get you some water at home."

I was dumbfounded. But who was I to question anything? The neglected mayonnaise hadn't killed her. I, a mere American Mother, could probably be no more effectual or necessary than the travel nurse. Whether Senegalese germs are scientific or cultural or matters of personal belief, I will never know.

My American daughter had grown an African body. She was comfortable and healthy and had rid herself naturally of medical and maternal voices dispensing anxieties that no longer served her. Her cultural infancy was over. Lucy knew clean from dirty in Senegalese.


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