SECTION I:
BACKGROUND AND CONTEXT
The Country of Origin
Senegal is known as the “Gateway to Africa”, because of its geographic location on the continent. Senegal sits on the west coast of Africa and is the western-most country in relation to the US. US citizens can travel easily to and from Senegal from major airports, including New York airports. The official language of Senegal is French.  However, other native or ethnic languages (Wolof, Peul, Sérère, and Dioula) are spoken by a large portion of inhabitants. Senegal is known for its historic relevancy, rich culture, and delicious food and is considered as one of the most stable countries in Africa.
Photo credit: https://ontheworldmap.com/africa/africa-map.jpg
The City of Origin
St. Louis is approximately 100 miles north of Dakar, which is the current capital of Senegal. However, when the French invaded the country of Dakar, St. Louis was the original capital of Senegal. St. Louis borders the mainland and is partly an island city and seaport. St. Louis is a United Nations Education, and Scientific Cultural Organization (UNESCO) historic and geographic location (https://whc.unesco.org/en/list/956/video).
Photo credit: https://www.worldatlas.com/maps/senegal
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St. Louis, Senegal Statistics and Facts
St. Louis is named after French King Louis XIV (Louis Caullier) and sits on the northwest coast of Senegal. From New York city, it takes approximately 7.5 hours to fly to Senegal.
In 2022, according to the world population review (https://worldpopulationreview.com/countries/senegal-population), St. Louis's population is 176,000. The weather fluctuates between seasons, ranging from an average of 62 degrees in the cold season to a high of 100 degrees in the hot season.
Most notably, it is known for its colonial architecture. Exports of St. Louis include groundnuts and fish.
Ndour Family History and Background
The Ndour (pronounced n-do-ah) family consists of four people: 1) 40-year-old father, Mamadou (pronounced mama-do); 2) 37-year-old mother, Adama (pronounced a-dome-ah); 3) 15-year-old son, Mbaye (pronounced m-bay); and 4) 14-year-old daughter, Astou (pronounce ah-stow) (see Figure 1). Mamadou comes from a family of seven (7) siblings and Adama has four (4) siblings. Both sets of maternal and paternal grandparents are still alive in Senegal and are very active in their grandchildren’s lives. In fact, Adama’s parents, Adama’s siblings, and the Ndour family are all Sunni Muslim and try to meet at the mosque for midday prayer on Fridays. After Friday prayer, the family cooks dinner together each week at the paternal grandparents’ home.
Figure 1: Mamadou Family Tree.
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Mr. Ndour grew up in the neighborhood of Balacoss in St. Louis, Senegal. Mamadou’s father and grandfather worked as merchants and sold fish to local hotels to make a living. Mamadou’s family saved their money over generations, so Mamadou was able to leave his community and go away to college.
While he was growing up in Balacoss, Mamadou was interested in natural fish fertilizers and fish growing serums. He graduated with a master’s degree in chemical engineering degree, from Cheikh Anta Diop University in Dakar, Senegal. After college, and as a single man, Mamadou settled in Dakar, the capital of Senegal. There, Mamadou met his future wife, Adama. Together, they had two children. Because he was able to secure a graduate degree and respectable job, the family lives a comfortable middle-class life in the neighborhood of Mbao in southern Dakar. Most people may consider the Mbao neighborhood one where rich people live in Dakar. Mamadou’s currently salary is 482,077.83 CFA Francs per month, which is equivalent to $750.00 (US dollars) per month.
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Mr. Ndour has been working as the head engineer at Agrice Sénégal Chemical Company in Dakar for eight (8) years. Mr. Ndour applied for an EB-2 Advanced Degree Immigrant Visa and was recently awarded an administrative position at Praxair in Kansas City, Kansas. The Ndour family physically moved from Dakar to Ohio three weeks ago.
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Mr. Ndour speaks fluent French and Wolof. He does not speak fluent English. His understanding of English is relegated to his job and engineering jargon. Mr. Ndour’s children watch American sitcoms on their smart phones and have picked up on some of the English language and words.
Because of his engineering specialty, Mamadou was recruited to work at one of the largest chemical engineering factories in the Midwest, United States. Purecycle Technologies is in Irontown, Ohio. Before traveling to the US, Mr. Ndour and Purecycle Technologies settled on a salary of $100,000 US. Mamadou could not resist the offer, so he and his family moved to the United States.
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Ndour
Family Current Situation
The Ndour family is currently living in a two-bedroom hotel until they can find stable housing in Ohio. The hotel is close to Mamadou’s job so he can walk or take public transportation. Purecycle Technologies provides a per diem allowance for the family so they can purchase food or go to the grocery store for their necessities. The family is finding the transition from Dakar to Ohio difficult, especially because of the language barriers and religious differences, in addition to the everyday visual, structural, and political differences.
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15-year-old Mbaye and 14-year-old Astou are not enrolled in school yet, but their parents are diligently working with the local school district to get them enrolled in high school. A part of their decision-making process is they would prefer a school that offers English as a second language (ESL) but are only finding schools that offer Limited English Proficiency (LEP) courses.
Ndour
Family Current
Crisis Situation
On a sunny spring afternoon, Mbaye and Astou were at Rosedale Park watching three young boys at the skate park section of the park. The Ndour children were mesmerized by the boys’ tricks and sat quietly watching for hours. After about two hours, one of the boys asked Mbaye, small for his frame, if he wanted to try one of the tricks. Mbaye didn’t exactly know what the boy was saying but he could figure out the boy was offering his skateboard to Mbaye. When the boys realized they could not communicate effectively with Mbaye, the skateboarders tried giving body movement and hand motion instructions. Mbaye had never seen or used a skateboard before but was excited and curious at the same time. Besides, Mbaye had been watching the boys for two hours and felt he could navigate the skateboard.
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Mbaye felt empowered and emboldened to try one of the tricks that involved him skating off the left handrail of the stairwell. Before anyone knew it, Mbaye, at full stride, ran to the top of the stairwell, put the skateboard across the handrail, lifted himself up, and took off. He did not have a helmet nor any other protective coverings for his elbows and knees, and did not anticipate a fall, after all, he did not see the boys fall. Mbaye was thrown into the air about six feet and landed on the concrete and medal stair posts. Before anyone could protect his fall, Mbaye hit his head on the concrete stairs, loud enough for everyone to hear a long thud. Mbaye was unconscious for less than 15 minutes and complained of dizziness, said he heard loud noises in his ears, and couldn’t see his hand in front of his face. His right knee was injured so bad, the boys described being able to see Mbaye’s white bone through all the blood.
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Mbaye and Astou did not have cell phones with them, so the skateboarders called 9-1-1. Other people at the park saw the commotion surrounding Mbaye and came to assess the situation and help in any way they could, which meant attempting to get information about the incident from Mbaye and Astou. Mbaye kept drifting in and out of consciousness and was not a reliable witness. The three boys disappeared before anyone could caption their stories. Astou tried to communicate with the little English she knew. She could communicate to the crowd and first responders her brother was hurt and needed help as soon as possible. An ambulance arrived and took Mbaye to the local county emergency department.
The medical staff assessed Mbaye and determined he needed to be observed in the intensive care unit (ICU) because of the inflammation in his brain and severe head injury.
Mbaye’s Medical Diagnosis
and Treatment
Once Mbaye’s parents arrived at the hospital, they found it difficult to communicate with hospital staff because of the language barrier. The doctor, Mr. Nathan, a Neurologist, who took French in high school, and did the best he could do in this emergency situation to communicate with the family. Doctor Nathan witnessed the following. Mbaye is still in and out of consciousness, has been vomiting, is confused, and says his head hurts. Doctor Nathan wants to monitor Mbaye to see if he has a concussion or worse. In addition, Mbaye’s right knee may be fractured, but x-rays will determine the true injuries.
Mamadou has employer-supplied health insurance, but it has not yet been activated, which leaves Mbaye without healthcare coverage for his injury. The social worker is brought in to speak with the Ndour family about ways to finance costs for their son’s injuries.
Medical Coverage and Insurance
Social Work Duties
This scenario involves a medical social worker with duties that cover patients in an emergency or crisis situation. According to Fenstermacher (2016), social workers in health care settings may do some of the following:
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Manage of caseload of patients in a medical setting or hospital.
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Work with patients and families in obtaining release of information (ROI) documents to receive medical treatment.
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Attend interprofessional meetings with a variety of medical staff, including doctors, nurses, physical therapists, occupational therapists, respiratory therapists, faith-based experts, etc.
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Provide discharge information and procedures, including distribution of medical equipment at discharge.
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Be aware of technology so patients are best informed about how technology will be used to diagnose and treat them; support communication among medical staff, patients and their families; use the Internet to locate resources the medical setting does not provide; complete electronic medical records (EMRs).
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Participate in reaccreditation processes that include responding to questions about key policies and interviewing patients and key medical staff interacting with patients.
NOTE: It is typical for medical social workers to intervene with hospital insurance specialists to secure emergency medical insurance or discuss other payment options. It is conceivable that a social worker in this scenario would work with the hospital’s medical eligibility department. Together, they may contact or engage Mr. Ndour’s company in an effort to secure medical insurance for Mbaye. Alternatively, the social worker may provide resources on low-cost health insurance to fill the gap until Mr. Ndour’s insurance is executed or work with the hospital to reduce Mbaye’s medical expenses or provide a payment plan for the Ndour family.
Social work students and interns will experience different duties based on their whether they are foundation or advanced practice students, their prior experience and skills in a medical setting, their understanding of medical and hospital policies and procedures, their understanding of medical jargon, their supervisor’s assessment of the student’s abilities and capacities, and whether the student is a good fit with hospital needs.