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 In the heart of Dakar, Senegal, at the Department of Infectious Diseases at Hospital Fann, gardening takes on a new purpose. It is a purpose derived on the needs of the patients treated there. Many patients treated in this public facility are poor. Of the 90 beds housed here, nearly two-thirds of patients are afflicted with HIV/AIDS.
Most people living with HIV/AIDS (PLWHA) at the Department of Infectious Diseases at Hospital Fann have major secondary infections attributed to HIV/AIDS, including tuberculosis, chronic bacterial diarrhea, meningitis, septicemia, etc. In general, by the time they come to the hospital to be treated, the infection has reached advanced stages and the patient is already experiencing a significant loss in weight. In addition to their pathology, many cannot afford to meet their daily quantitative and qualitative nutritional needs. As a result, many patients are malnourished and a sufficient diet is unattainable. The advantages of proper and adequate nutrition with PLWHA is well known, the problem, especially in much of the developing world, is how can it be attained and implemented.
 In early 2004, Professor Salif Sow, Director of the Department of Infectious Diseases at Hospital Fann had a possible solution. With the help of the Senegalese governmental organization, the Centre pour le Développement de l’Horticulture (CDH) and two hospital janitors turned gardeners, the project was underway. The goal was to develop a local source of vegetables to supplement the diet of PLWHA at Hospital Fann through the development of a garden.
Located adjacent to the main Infectious Diseases building, an approximately 1,200 square meter garden was constructed. Included in this space were six above ground improved beds, a 240 square meter space covered with a drip irrigation system, and 18 tables ranging in size from .5 to one square meter.
Over the course of the next year, it was realized that more had to be done for the project to be beneficial. The existing garden was in serious need of improvements in order to increase the quantity and quality of vegetables produced as well as their diversity. Crops were heavily infested with pests. The gardeners were lacking some crucial technical skills and other skills needed to be fine tuned. Also, the project was experiencing funding issues that made it difficult to purchase needed garden supplies such as fertilizers, seeds, tools, and insecticides.
In Spring 2005, through the leadership of APCD for Agriculture/Urban Agriculture Famara Massaly and Urban Agriculture Volunteer Steve Bolinger (2005-2006), Peace Corps/Senegal was approached to assist the Department of Infectious Diseases and CDH in revitalizing this project and making it successful.
Work was undertaken to do this. Through the collaborative technical expertise and training capabilities of Peace Corps and technicians from CDH, hospital staff designated to work on the project, and the use of a Special Projects Assistance (SPA) grant, the initial vision of Professor Sow was finally provided with adequate means to become a reality.
 The garden took on the shape of a non-traditional one. Micro gardening techniques such as the use of an alternative soil was used. This was done because good soil was lacking at the site and unsafe. The alternative used was a combination of peanut shells, rice hulls, and pebbles supplemented with nutrients. Also, alternative growing containers such as tires and pvc piping were integrated into the project. Through the addition of more tables, water hydroponics, revitalized and additional raised and in-ground beds, greater supplies, and increased technical skills of the local gardeners, by Fall 2005, the garden size doubled and garden output grew exponentially, with a capacity to produce nearly 850 pounds of vegetables a month.
In order for this output to meet the needs of the patients and reach them, the vegetables were prepared into meals in an onsite kitchen. Daily, vegetables were taken to the kitchen to be prepared by a cook hired for the role.
With the success of the project also came the extension of the vision. PCV Steve Bolinger (2005 – 2006) felt the calling to do more than just what was being done at the Department of Infectious Diseases. In Spring 2006, Steve with the assistance of PCV Sarah Koch (2005 – 2007) created the non-profit Development In Gardening (DIG). While Steve Bolinger left Peace Corps to focus on the work of DIG, work at the Department of Infectious Diseases at Hospital Fann continued.
PCV Justin Land (2006-2009) took over for Steve in Spring 2007 and continued to work directly with counterparts from CDH and the hospital. Focus was put on continuing to implement the project plan and increase the knowledge capacity of the hospital counterparts. Hands on training was done with the cook involved with the project to expand her knowledge in food preservation and the utilization of vegetables not commonly used in Senegal, yet highly nutritious. The purpose of this was to try and diversify the diets of the patients and optimally meet their nutritional needs.
With success growing over the course of time, wear and tear on the garden also occurred. The elements of Mother Nature hindered the physical sustainability of the current garden design which was initially unforeseen. Termites not only infested many of the tables, limiting their effectiveness but also destroying the siding of many of the raised beds. Also, time had taken its toll some of the garden’s exterior walls.
 Through the financial support of DIG and the Department of Infectious Diseases progress could be made. New cinder block raised beds were constructed by the garden team. Also, a new wall was built, increasing garden security and aesthetic beauty. The physical sustainability of the garden was now in the right direction. Landscaping was integrated into the garden’s entrance. The technical expertise of the local gardeners was growing as well, adding to the overall long-term sustainability of the project.
Attention grew substantially on the gardening project at the Department of Infectious Diseases at Hospital Fann over the course of time, attracting international attention and high profile visitors and delegations from around the world. Also, it attracted local Senegalese, many of whom came to expand their agriculture knowledge. On a daily basis, patient’s families and friends would stand on the balconies of the Department of Infectious Diseases and just look below them at the garden, sometimes talking to the gardening team, providing a sense of serenity and calmness, not often times found within the doors of the hospital. As the attention grew, so did the realization that more needed and could to be done. The idea spread.
Development In Gardening (DIG), with collaboration from Peace Corps and support from NGO partners, started this push in Fall 2006 with the implementation of a gardening project at the Centre de Traitement Ambulatoire (CTA), an outpatient center providing to the needs of PLWHA at Hospital Fann. Expanding from just meeting the nutritional needs of PLWHA, this project supported gender development, income generation, and acted as a therapeutic tool to the outpatients involved in the project. DIG expanded to another facility in the southern part of Senegal and currently is growing internationally.
While DIG has been pushing the idea outside the borders of Senegal, Peace Corps has continued developing and extending the vision here in Senegal. Through collaborations with work partners and local counterparts, gardening work by Volunteers has expanded to several hospitals dealing with not only PLWHA but also the needs of all types of patients. Pushes in home gardening is also underway with impoverished PWLHA and their families to make proper nutrition attainable in their homes and help increase their quality of life.
Much like healthy plants, the vision instituted early in 2004 by Professor Sow at Hospital Fann has grown and branched off. Through the work of Peace Corps, our work partners, our counterparts, and others, we as a collaborative front have been able to connect those with a need with the positive benefits of gardening and making it a resource in the fight of individual, local, and global problems.
PCV Justin Land
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