Monday, November 28, 2011

EMI CEO Jim Hall

Earlier this morning, our CEO here at EMI, Jim Hall, went home to be with the Lord. He was 57. Jim passed after a very brief bout with the reoccurrence of his melanoma cancer first diagnosed in his foot in Sept 2010. He had been given the all clear for just over a year, but unfortunately, the cancer returned aggressively in mid October.

Jim and his wife Nancy had flown to Florida to be with family a week ago Saturday and at that time he was doing fairly well with the help of medication (for pain). On Tuesday they had their family Thanksgiving dinner. But that night, he suffered a stroke and lost mobility on his left side. His symptoms then progressed rapidly, and his communication became less and less. By Saturday, he was no longer responsive and it was clear the end was near.
We are all in a bit of shock here that things happened so quickly – it was just earlier this month when we learned that his cancer had spread and that he’d be stepping away to battle it, and he joined our office Thanksgiving party a week and a half ago on the 18th seeming like the same old Jim.
Perhaps it’s an answer to our prayers that he didn’t suffer on and on, as he was getting more and more uncomfortable with each day. Nonetheless, it has struck us all pretty hard here at EMI as we process no longer having Jim around.

I know when someone you don’t know dies it’s hard to imagine what kind of loss it is for those close to the person, but I can tell you that Jim was a pretty special man. He led this ministry with an open hand, never grasping on to the power of his role or making anyone feel as if they were beneath him. He was a consensus builder, and as such, a very good listener – yet he was a man of deep conviction and could make good decisions quickly. He was equally comfortable meeting with leaders of different countries around the world through the years as he was hanging out in his swimsuit in Uganda with us and throwing our boys in the pool. He had a disarming nature about him that made him a friend to all who had the privilege of getting to know him.
I think what struck me most personally about Jim was how comfortable he was in most any situation. He was anyman to everyman, and was not at all challenged by someone thinking differently than him - in fact he seemed to enjoy the differences amongst people. His faith was strong, and as such he didn’t seem to have any of the typical hang-ups with this or that nuance regarding faith matters. He had a very personal and open relationship with God and expressed it in a way that was very natural and unrehearsed. In a few talks I had with him about God, he never claimed to have a full understanding of God and how He works in the world, but he trusted Him implicitly nonetheless based on how he had seen Him work in and through his own life. When he led our morning devotions in the bible, it was always done in the manner of "let's see what God has for us in His word this morning" as opposed to an instructional tone that might have placed him above those he was speaking to.
Of course I believe every one of us is a sinner that falls short of God’s standard. However, when I think of what Jesus might’ve been like here on earth I am reminded of so many of the qualities I saw in Jim. And in the same way that the disciplines must have felt abandoned and somewhat lost when Jesus left them abruptly at the height of His ministry, I think we at EMI all feel the loss of not having the time we thought we would have with Jim. Of course, EMI will go on. It is afterall God’s ministry that is not based on any one person. But even so, Jim will be a very difficult person to replace and his loss will be felt throughout our ministry for a long time.
We would appreciate your prayers here for the entire EMI family, and especially for Nancy. They both (Jim & Nancy) have been very solid in all of this, confident in the hope that lies ahead for Jim as he prepared to pass into the presence of God for eternity.

Sunday, November 20, 2011

End of Semester update

It's nearing the end of the 'semester' here at EMI (we call them semesters because we match our project seasons up roughly with the college schedule here in the US). That means projects are getting ready to finish, interns are wrapping up their time, and project leaders are ramping up for next semesters trips. Here is a summary of what's been going on at EMI as well as around the Crawford household recently...

EMI's CEO, Jim Hall
It's been a tough last few weeks for EMI. Our CEO, Jim Hall, had to step down a couple weeks ago after learning that his melanoma cancer (diagnosed in Sept 2010) had come back and spread to a number of spots and organs. We were all heartbroken to learn this news, as Jim had been given an all clear just this past August. Jim is a great leader whose relational style and steady demeanor have been a huge blessing to our organization for the past 3 years. Jim was a big factor in Alisha's and my decision to stay on with EMI after returning from Uganda. Jim is feeling pretty poorly these last few weeks because of the cancer, so please join us in praying for Jim and his wife Nancy, and all of EMI as we deal with this tough situation. They have traveled to Florida for the Thanksgiving holiday to be near family, and it's possible they may stay on to pursue doing treatment there.

Project complete
The Sierra Leone hospital assessment project report is completed, bound and in the hands of the ministry. My intern, Mike Corsetto (a UC Davis grad!), did a great job in helping get the report out the door over a month early! Mercy Ships has already expressed their gratitude for the team's work and will be presenting the report at a number of health care conferences in West Africa in the coming weeks. It could potentially be a significant new avenue for EMI as more healthcare ministries find out about us and our ability to mobilize engineers to come assess and make recommendations for the many struggling hospitals in the region.

Horn of Africa Drought and Famine
Something else that's been occupying my time the past few months has been the drought and famine in East Africa. The biggest humanitarian crisis in the world right now is the drought-induced famine going on right now in Kenya, Somalia, Sudan and Ethiopia, where 12 million people are being affected by a severe lack of food and water due to consecutive record-dry rainy seasons there.
I have been coordinating with some of EMI's Disaster Response partners (CRWRC and Food for the Hungry) to mobilize 5 volunteer engineers to the region to work on such projects as rainwater collection programs and water source rehabilitation. My job has been to coordinate and track our volunteers during their mobilization. Anytime there are desperate people, the situation can be volatile. Tribal rivalries fighting over water and food can get violent, and a couple of our volunteers had to be evacuated in once instance due to the breakdown in security in one area.
All EMI volunteers have now returned home for the time being, though the impact of their work is still be realized in the area as water sources are being restored to provide desperately needed supply to the people in the region.

Next project
Well, if I would have posted this last week, I would have told you about my upcoming trip to Guinea to do the next round of assessments for Mercy Ships at the two government hospitals in the capital city of Conakry. But last Thursday evening, just hours after purchasing the team's airfare, I received notice from Mercy Ships that they were having concerns about the upcoming elections in Guinea that were now being postponed until around the time our trip was scheduled in early February. So, I spent the next hour contacting the our travel agent's emergency agent and was able to cancel the tickets for a small fee. Had this change in plans not come when it did, it could have cost the team hundreds of dollars each to make the change.

So, after a lengthy discussion with the Mercy Ships off-ship program directors, we decided to change the trip back to Sierra Leone to assess the three rural hospitals scattered around the country. This trip had been scheduled for our May/June trip cycle, but we felt it was best to switch given the unrest in Guinea. So, back to Sierra Leone I go come February! I'm excited to see more of the country - especially after just having read the book "A Long Way gone", which was written by a former child soldier about his experience in the civil war there that ended in 2002. If you are at all interested in West Africa, or in learning more about the atrosity of turning children into soldiers that is happening more and more all over sub-saharan Africa, I highly recommend this book. As a warning, it's not for the faint of heart!

Home and school
Alisha and the boys are off school this week for Thanksgiving break. Soccer season just ended for the boys so we are happy to have our lives back! We have really struggled with how to push back against the culture of busy-ness back in the States. We really miss the slower lifestyle we lived in Uganda, yet we're finding it's very difficult to try to mimic that lifestyle here. Just having the boys do 1 activity makes our life seem like a rat race - we had 7 practices and 3-4 games per week, with soccer on 6 out of 7 days of the week. And that's just one activity - most of the boy's friends are doing 2+ sports at a time. Of course, it's great for the boys to play a sport, but it comes at the price of having any kind of regular family time together. We're still trying to figure that one out.
Alisha's work is going well - she's teaching 5th grade once again. She does miss the lower grades sometimes, but is content where God's placed her for the time being. With Brodie in 5th grade at the school (in a different class), it's been a real blessing having her in the position she's in. She gets to be Brodie's history teacher too.

Tuesday, October 25, 2011

Sierra Leone - Parts IV and V of V

The EMI team

(More pictures at end)

Monday Sept 12:
It felt like a typical Monday morning on the ship this morning. The weekend is mostly off for people on the ship (from my estimation), so things were pretty low key. But Monday morning, by 6:45am the dining area was bustling with people with a very ‘back to work’ atmosphere. For our team of course, we worked through the weekend so the only difference was breakfast started at 6:30am instead of 7:30am.
The report is coming along really well - we may come back to the office 90% done. That would be great, and would allow intern Mike to work on a number of other projects for other project leaders who have a backlog of open projects. For me, it would allow me to get an early start on recruiting for my February trip as well as work on a few other small projects I would like to get to.
This afternoon, intern Mike and I took a ride into town with our Mercy Ships host Dulce, who is Honduran (though she sounds and seems as American as we are). She has been here for a year and a half and hosts all the visiting teams. She is very outgoing and has made our time here very fun.
Anyway, we went to town to meet with a local ministry whom our CEO Jim Hall led a trip for a year and a half ago. They have almost built Phase I of the project so we had hoped to make it out to the project site to see some pictures. Unfortunately, the day we were going to go it was really stormy weather out so they had to cancel. So instead, we went to their office downtown to meet with their construction manager. It was a good chance to connect with a past ministry and get some good feedback from them as to what we did well and what pitfalls they encountered. We’re trying to do this more – connecting with other ministries (past or future) to learn how we can do what we do better or to better select future projects by meeting the ministry in country ahead of time.
At night, everyone worked on wrapping up their report sections and powerpoint presentation. This could be a very different type of presentation, as there is the potential for a lot of people to be there. They have opened it up to everyone on the ship, so who knows who will come. Either way, this represents an entirely new direction for this ministry so interest is very high with the leadership. I am very glad that we have such a well qualified and experienced team to answer questions from a bunch of doctors!

Tuesday Sept 13:

Presentation day! It’s what we work up to the entire time we’re here, so naturally the team was excited and a little nervous all day as we made final tweaks and edits to the presentation. We also did a complete mock run-through of it, which I had never done before on a trip. It was really helpful as we then all critiqued each other and did more fine tuning.
At 6:30pm, we all gathered in the room, and by 7pm around 50 people had come into the auditorium for the presentation. Overall, the presentation was really well received. The 50 people who showed up were people who didn’t have anything to do with the on-shore programs dept., which was encouraging that people from across the many departments of Mercy Ships were taking interest in this new direction of work.
But our presentation was also a bit sobering, as the precursor to any work to be done on these hospital sites is something that is extremely difficult to do: developing a maintenance and operations program to sustain the existing facilities. Right now, if something breaks or isn’t working, either nothing is done about it or an insufficient fix is fashioned.
A sad example of this happened today. The power at the children’s hospital was operating in single phase (instead of three phase), which means the power was only coming through one line. This results in a brown out, or low power. The problem was in the panel as the connection from the city was too weak to supply full power. So the maintenance worker wanted to shove his screwdriver into the connection to give it a better contact. This actually could work, however it also is extremely dangerous and could have killed him and the 4 people standing next to him.
Well, unfortunately, while all of this was going on, the hospital wasn’t receiving enough power to operate its equipment. Two small children who were on respirator machines passed away because of the brown out. Stories like that are maddening and unbelievably tragic. But unfortunately, it is an everyday occurrence. The estimate we were told is that about 4 children die everyday at the hospital, and typically the reason they die is a very preventable or treatable reason.
For our team, this has made our work seem like it has very real life consequences, but it also has driven us into deeper questions about the huge obstacles there will be for our work to have an impact. We can design a pretty system that looks good in a presentation and feel really good about ourselves, but if we don’t step back and think through the more difficult issues we will have little chance of making an impact.
The deeper, difficult issues on this trip have to do with the maintenance at the hospitals. The maintenance staff don’t seem to fully grasp the vision of their role in providing healthcare at the hospital. There doesn’t seem to be a connection for them (by our estimation) between them keeping the septic system up and running so sewage doesn’t back up on the site and the overall quality of healthcare being provided. Or, when the power goes out, they don’t seem to be connecting the dots that they are now more important in the lives of some patients than their doctors are.
But the reality is, the maintenance people at hospitals are critical to the overall success of the hospital. So right now, as raw sewage spills out on the hospital grounds the hospital’s ability to provide healthcare is being undermined. These are some of the issues we’ve been discussing – How do we change the culture in the maintenance departments at these hospitals? How do we encourage a training/mentoring program? How do we get them the tools they need to do their work? It’s made for some great conversations this week amongst our team, and ultimately will lead to our assessment report being much more practical and useful for the ministry.

Part V of V

Wednesday Sept 14:

Today was our closing day, and we decided to go to the most popular beach in Sierra Leone – ‘River No. 2’. It’s a spot on the Atlantic Ocean where a River enters into the ocean directly, without any kind of widening at the end. The beach along the ocean just north of the river is pristine white sand.
However, about 10 minutes after we arrived, the skies opened up and it rained pretty much the rest of the day. A bunch of the team went swimming in the warm ocean water anyways – everyone but Joe and I actually got in and swam. So what was to be a full day with dinner afterwards ended up being a half day at the beach with us returning to the ship for dinner. It was still fun, and we got to do some souvenir shopping at the beach before leaving.
After dinner, we had our closing team meeting, where we have everyone share their high/low points, something God taught them while they were here, and then any prayer requests they have going back. Then, we take turns sharing encouraging observations we’ve made or things we’ve noticed about the person one person volunteers to pray for that person before we move on to the next person. One by one, we let everyone share.
This meeting is always a favorite for EMI volunteers as they get to share and hear feedback from other team members, as well as to give feedback to others. This one was no different as we have had such good team unity and bonding. Tomorrow begins the long trek home. From the time we leave the ship until I get home is scheduled to be about 40 hours – yikes! But having Alisha and the boys there waiting for me at the airport is all the motivation I’ll need to get through – I miss them a ton and can’t wait to be back home again with them!

Travel Sept 15-16:

What can be said about 40 hours of traveling on airplanes? It was long and brutal but in the end all worth it to see Alisha and the boys! We did head into town during our layover in Brussels, which was fun. I know very little about Belgium, other than waffles! So, when we were in town, we stopped in and ordered Belgian waffles, so I've got that box checked. It was fun, but honestly, I think Eggo waffles are better. Please don't tell Belgium I said so. :)

Intern Mike and I with the Contractor for a previous EMI design project.

This humongous 'Cotton Tree' downtown is highly revered in Sierra Leone. It is the symbol of freedom for the city of Freetown. According to legend, back in 1792, when the first African American freed slaves were returned to this region, they met at a large tree and had a feast of thanksgiving for their new freedom.

The water in the swimming pool on the ship is kept very low to keep it from splashing out when the ship rocks back and forth from the sea.

Joe presenting his structural findings.

A pretty large crowd (about 50) showed up for our presentation.

The team arriving at the beach - it was really nice, with fine white sand...but the rains were soon to follow after our arrival.

River No. 2 beach is a beautiful spot.

My first time touching the Atlantic Ocean.

River No. 2 - what a romantic name for such a beautiful river. ;)

The team enjoying our only local meal of the trip - Barracuda with Rice. It was pretty good!

Joe was mezmorized to sleep by the peaceful playing of Dan's Irish flute!

Pouring rain all day made the dirt roads on the trip home a lot more treacherous than the trip there.

The rainy streets of suburban Freetown.

We thought we had car trouble in one of the vehicles, but it turns out the warning light was just malfunctioning. But a group of engineers hovering over a car is a scary situation to be in. Joe thought it was the spritzer falve. Geoff insisted it was the capacitor.

Thursday, October 13, 2011

Sierra Leone - Part III of V

The storms make for beautiful sunsets in Freetown, Sierra Leone

Saturday Sept 10:

Today was a bit of a day on cruise control. The team is feeling good about where we’re at so the urgency of getting through the work has relaxed a bit. The data gathering at the sites is mostly complete, so now it’s a matter of compiling the information into recommendations and writing the report.
When we woke up this morning, it was a very gray and rainy day. I had been scheduled to go out to visit a previous EMI project site that has now been constructed, but because of the foul weather the Liberian man who was to pick me and intern Mike up called to say that the trip was cancelled. So, we all worked on the report around the lounge areas of the ship. After lunch, I took 4 of the guys into town to do souvenir shopping. It’s always fun to see the different personalities of the shop vendors in different countries around the world – some places are more aggressive, whereas some are passive. In Sierra Leone, the vendors are a little more insistent than in Uganda, but overall they are still pretty passive.
After shopping, we ate and worked a little more on the report. Overall, it was a much more low-key day since no one had to go to the sites. It’s always nice to get to that point of the trip when the team realizes that we have ample time to complete the project, so people can relax a bit and enjoy the experience a bit more. Good conversations are much more likely to happen once people don’t feel stressed about the work.
One of the things our trip has brought out in the group is a discussion about relief and development work in places like this. The problems we see are so wide and deeply layered that it’s hard to imagine our small group of engineers making any progress at all. But as Mark Thompson, Mercy Ships’ program director, said on day 1 of our trip, when you’re faced with a seemingly hopeless situation as these hospitals appear to be in, you have two choices: you can do nothing, or you can choose to try to do something.
We keep coming back to that statement. Ultimately, our job certainly includes thinking and talking about these things in order to make sure we’re giving our best and most intelligent effort possible in the situation. But ultimately, it is really up to God to do the impossible. If you’re not sure what I mean by impossible situation, here’s one example (out of many) of a situation we’re facing at one of the hospitals:
The sewage system at the main hospital in the country consists of a few septic tanks that catch the sewage solids and allow the liquid to seep out into two pipes that drain directly out to two places: 1) the Atlantic Ocean; and 2) a fishing village on the beach (which is completely covered in several feet of trash).
Well, the septic tanks are all plugged and therefore there is a constant spillage of raw sewage out onto the hospital grounds. These tanks are located out where the hospital laundry services are located, so the service workers are out hanging clothes while standing on soggy ground with raw sewage scattered and floating around. In some places, the sewage forms large ponds (2-6 inches deep) that the workers must navigate through to get in and out of the laundry building. Of course, not only is this sewage, but sewage from patients in the hospital who have highly infectious diseases. Obviously, the hospital is creating new patients all the time simply by staying in operation!
So from our standpoint, to come in and make recommendations for fixing the septic tanks ultimately would, as one of our civil engineers bluntly pointed out, result in the sewage systems actually transferring the sewage to the ocean and fishing village quicker! What a hopeless situation – even the solution results in significant health hazards!
Well clearly, the long term solution we will be recommending will include a massive overhauling of the existing sewer system, including a treatment facility that will clean the water before it is discharged to the ocean and village. But can you guess what else protrudes from the ocean front wall just meters away from the hospital’s drainage pipes that spill into the ocean and village? A pipe that’s three times the size of the hospital’s pipes where the city’s sewage system drains out! Hopeless!
Ultimately, we have to persevere, and realize that though we’ll only be making a small dent in the problem, at least it’s a start. Who knows, perhaps others around will be inspired by the hospital’s efforts to stop these practices of dumping raw sewage into the waterways. As the main hospital in the country, it seems important that they at least make this attempt.
Oh, by the way, did I mention that the water below the village is routinely filled with people bathing and doing laundry?!

Sunday Sept 11:
Today was the 10th anniversary of 9/11. I can’t believe it’s been 10 years since hearing the news on my car radio that morning on my drive into work. The televisions in the dining hall (where we’ve set up our makeshift workstation) have been playing the memorial events in New York City live all day.
As we sat here working, the background noise has been the solemn reading of the names of all the victims. I paused for a few minutes to stand there and watch as family members read the names of their loved ones. I imagined what it would be like if one of my boys was there reading my name. It made me sick to my stomach to think about the terrible tragedy that day was for those families.
I prayed for them to have comfort from God, though I’m not sure how you comfort someone on that level of despair. To have your whole existence altered forever – how do you find hope in that situation? If my family were taken from me I think I’d lose the will to live. At that point I think trying to pick up the pieces to move on with your life would feel selfish and even disrespectful to your lost loved ones – as if you were turning your back on them for the selfish reason of trying to be happy again. I think that would be my humanistic response.
I am thankful that to date, I have not had to go through that level of despair in my life, and I pray neither me nor my family ever has to.
I know God is there with us in those situations, but I don’t think God’s plan for our life includes such tragedies. I know He shows up big at these times, but why He chooses to step in and prevent some things while sitting back and allowing other things is something I’ll never fully understand about Him. I don’t believe He orchestrates such events on earth though, as it would be contrary to His divinely good nature. Somehow, in some way, I think God limits Himself, and in a way subjects himself to the horrors of sin in our world despite His ability to intervene.
Of course Jesus was a good example of this, as He hung on the cross and allowed himself to be tortured and killed all the while possessing the full power to stop his own suffering in an instant. So why would Jesus, who is God, subject Himself to such terrible forces that could be under His control if He desired? And why would God the Father do the very same thing in our world today? I think the answer could only be one thing: relationship. For Jesus, it was for the purpose of gaining us salvation, paying the price for our sins. Similarly, for God the Father, I think He does it for the sake of having true relationship with us. In other words, God limits his own ability to prevent evil from occurring in order to allow free will into the world such that we can choose to believe in him and come to know Him intimately.
If God were to intervene and control each and every aspect of life here on earth, would he really have a true relationship with us? Or, would we simply be doing what he preprogrammed us to do from before time? My belief is that God is able, in some mysterious and complex way that I can’t begin to understand in my finite mind, to both be in full control of His creation and at the same time be grieved to the point of crying and feeling sadness and despair as that same creation continues to make choices that have consequences that He oftentimes limits Himself from preventing.
I realize my view of God is a speck, just like anyone else’s is. (Maybe my speck is even a little smaller than average!) I have no desire to redefine God’s nature so I can understand Him, only to do my best to interpret and understand the small aspect of his nature that He chose to reveal to us in the Bible. Someday, every human who arrives in Heaven will see and feel the wonder of an infinite God…and realize just how limited their understanding was and that overall, their perception of who He was and how He works was somehow skewed from who He is (I certainly count myself among that group.)
I realize this doesn’t have a lot to do with the project – today was a day where we sat around the table working on the report so there wasn’t much in the way of exciting stories anyway. But in light of the 9/11 anniversary, I thought I’d share some of my thoughts on how to reconcile these tragedies with the notion of a good and loving God. I certainly recognize that others have very different beliefs about God’s nature. I look forward to one day all standing together in Heaven and laughing together as we think back on how simplistic our thought capabilities were here on earth!

In-between storms - it's amazing how much rain this place gets!

Joe and Geoff "working" with Intern Mike watching, approvingly.

The crowded streets of downtown Freetown.

(L to R) Sandra (the doctor who works at the Children's Hospital with another ministry), Intern Mike, me and Joe

Downtown Freetown

Driving through the streets is more about carving a path through people rather than cars.

Sunday, September 25, 2011

Sierra Leone - Part II of V

Downtown Freetown, Sierra Leone. The stormy clouds pack a punch - on average, Freetown gets over 26-inches of rain in the month of September alone!

Part II of V

Thurs Sept 8:
Today I went with the civil engineering team over to the far site, Connaught Hospital. Connaught is considered the top medical facility in the country. There is so much I could write today from our 4 hour visit to the site – the wastewater conditions were some of the worst I’ve seen on a trip: Raw sewage flowing out of the septic tanks right where the workers walk to hang laundry. The small amount of sewage that makes it into the designed system simply drains out into the ocean at the bottom of the site.

Believe it or not, this is the road we took each day to get to the far hospital. At times we had to stop for several minutes while people cleared their stuff out of the way so we could pass through. Remarkably, it's a two-way street!

But instead of telling all the stories related to that stuff, I want to share something else that happened since it had a bigger impact on me. At around 8:50am, an hour and a half after we arrived on site, as we walked through the center courtyard of the hospital I heard a young woman begin to wail in one of the hospital wards. It slowly got louder, as she was running/crying out of the building, through the courtyard and out the front of the hospital. The half-hearted cry and running struck me – it seemed that she was so emotionally devastated and physically spent that she couldn’t even muster the energy to do either full-hearted. Of course, I immediately wondered how I might feel if someone close to me died. But I was haunted by her cries, and I wondered, beyond the normal grief of a loss, what this death might mean for her? Will this be the day that her life changes forever? Undoubtedly. But with life being so difficult here, will she ever be able to recover?
Was this the loss of her husband, and now she has no means of supporting herself and her children? Will some of them be neglected and left to fend for themselves on the street, or sold into sex or slave trade? Or maybe she’ll have to sell herself for the sake of her family?
Or, was this the loss a child, and now she has to go on without her beautiful little toddler? Maybe this child was the one bright spot in her otherwise very dark and difficult existence.
Was it her sister who died, perhaps the one person who has been her rock in life since they were young girls? Had they clung to one another to survive the death of their parents at a young age? Or maybe she was the one lifeline this woman had out of her abusive marriage? These are all such common stories for the people who live in this tough place.
I don’t know the exact pain this woman was feeling, but something in me felt that it was a loss that cut to the very core of her existence. The depth of her half-strength sobbing created a momentary quiet in the otherwise bustling courtyard; I think everyone could sense that this was a monumental loss.
I’ll likely never see her again, but I’ll pray for her every time I think of those brief, haunting moments where I saw her at her rock bottom point. I’ll also pray that the work we’re doing will somehow, someway make a difference in this place. Maybe our clean water and sanitation design will prevent someone else from getting sick, and thereby save their loved ones from the agony this poor young woman faces now. It would be so easy to see the situation here and conclude that it was hopeless and therefore not worthy of any rehabilitation effort. But seeing people like this woman reinforces my belief that when faced with situations like this, if you have the ability to help you can’t just sit idly by.

The walkway at the far side of this picture is where I saw the woman, exiting the building on the left and heading right out of the campus. I snapped this picture later in the day - earlier the hallway was about 3X as full with people.

Later in the day, we were at the other site and I spoke to the Western missionary doctor who works there in a consultant’s role. She mentioned that it had been a tough week, as they had lost several kids there. The reasons for some of their deaths were frustrating to say the least – some had died because they hadn’t been given an I/V to be fed even though the hospital has those tools readily available. Why weren’t they fed? Essentially, it comes down to people not believing that they can make a difference by doing their jobs responsibly. Tragedy is a way of life here, and it almost becomes expected.
So what does this all mean? Is the situation really hopeless? As one of the Mercy Ships guys said at the beginning of the week: “The deficits here are massive. So we have a choice: We can do nothing, or we can at least make an attempt to do something. We’re choosing to try to at least do something, anything, to help.” We agree, and we’re honored to be partnering with them this week, equipping them with the technical knowledge needed to do the work they’re setting out to do.

Seeing the conditions of the wastewater system on site at Connaught Hospital was disheartening, especially given my experience earlier with the young woman crying.

Friday Sept 9:
I think I need to introduce the team before the trip is over! It is an extremely talented and experienced team and I feel very blessed to have them here as this is a very high profile and challenging project.
Dan Mason – a civil engineer from Indiana with over 30 years of experience. Dan travels multiple times a year to Africa to do development and mission work and is very familiar with working in this context. Dan runs his own design and construction business and has incredible knowledge and practical advice to offer to the local maintenance workers here.
Marlin Keel – another civil engineer with over 40 years experience. Marlin is a quiet and humble man, but has great wisdom and experience, including his participation on the EMI trips that did hospital evaluation work in Liberia in 2007 and 2008. Marlin has been the city engineer for Nashville, TN in the past and current holds that position for the city of Mt. Juliet, TN.
Austin Hewitt – a civil engineer from North Carolina with around 10 years experience. Austin has written hundreds of assessment reports for all types of facilities, so his experience with the formal report writing side of things will be a huge asset for us.
Bruce Brubaker – From Pennsylvania, Bruce is actually a Mercy Ships volunteer for this trip, but in every way he is functioning as another member of the EMI team. Bruce’s practical knowledge in civil engineering has been a big help to us.
Wes Turner – an electrical engineer with nearly 40 years of experience and multiple EMI trips under his belt, Wes’s knowledge and confidence to work in the developing world has been a great asset and brings a lot of legitimacy to our team.
Geoff Watson – Geoff has nearly 15 years of experience as an electrical engineer from North Carolina. Geoff’s knowledge well exceeds his 37 years, and his fun personality has been great for the team. He has a great laugh!
Joe LaBrie – my brother-in-law, a structural engineer from the Los Angeles area. I’ve known Joe since I was 5, but the team has quickly learned how impressive of a person he is. His energy and enthusiasm for being here has been a welcome addition to the team, and his well-spoken and passionate demeanor has clearly resonated with the ministry. Joe’s ability to communicate in a way that makes you hang on his every word has definitely won over both the team and the Mercy Ships guys.
Mike Corsetto – intern Mike has been a great help to the team, and he has proven to be a very capable engineer and person. No task is too small for him, and no task is too big for him. He’s a very talented and intelligent young man and has impressed us all in a short time. Also, he's a UC Davis grad - so with me and Joe there are three UCD grads on this team!
This really is an impressive team and I feel honored to be working with them. They also are a lot of fun to be around, and team bonding has been effortless.

The team, from left to right: Joe LaBrie, Dan Mason, Geoff Watson, Bruce Brubaker, Wes Turner, Austin Hewitt, Marlin Keel, me, Intern Mike Corsetto

One note from the day – while we were walking around the children’s hospital today, we heard another person wailing – this time a mother who had just lost a young child. It again was haunting to hear the depth of despair, but this time the people around the hospital seemed to show little reaction. In talking with the local on-site missionary, she said on average that 4 young children or babies die at the hospital every day. Oftentimes, they are dying from very simple things that could easily be prevented, such as hypoglycemia and not being given an I/V or the medication they need (even though it’s available). Or as it relates to our work, a lack of basic sanitation is causing people to become sick, or the lack of water supply is limiting the quality of care that can be given, or the lack of consistent power to the hospital prevents the necessary equipment from running. The hospitals have the equipment and basic infrastructural pieces in place, but in large part they have just not been maintained or operated properly. We could easily come in and fix a number of things that are causing the problems, but without the buy in of the hospital personnel the systems would just break down again.
It’s so frustrating to see these people suffering and dying on a daily basis for reasons that often could be easily addressed. But it does underscore the need for us to lay out the technical solutions needed so that when the human resource and mentoring issues are addressed, the infrastructural systems can be restored as well. The structure and content of our report is beginning to take shape in our minds as we are identifying where the short-comings are with the water, wastewater and electrical systems at these hospitals.

Tuesday, September 20, 2011

Mercy Ships project trip - Sierra Leone

Part I of V

Travel days Sept 4-5:
Leaving for trips is never fun for me. My past fears of leaving home come crashing down on me as the hours tick down to departure. I know the term ‘depression’ is a very real condition that plagues people so I don’t want to minimize that by using the word flippantly, but the dread I feel of having to leave Alisha and the boys sets me into a depression-like state. I know it’s irrational and not what God would have me feel, but it’s very real and a real area of growth for me to pursue. It’s far worse than the actual leaving itself, which is quite ridiculous when I think about it after the fact.
Overall, the travel was fine. All the flights were fairly smooth and uneventful – exactly how I like them! We had 5 flights in all, so it was a very grueling trip. Denver to Chicago to DC to Brussels to Banjul (Capital city in The Gambia) to Freetown. Including our team, there were 31 Mercy Ships people arriving on the flight – all but one of us got our bags (a young Mercy Ships gal didn’t get one of hers). Stepping off the plane it felt like Haiti – quite warm with oppressive humidity. It was also raining off and on, which made maneuvering our bags from spot to spot a little tricky.
We gathered in the parking lot, which was quite chaotic, and somehow piled all the bags and people into cars driven by local guys and drove 30 minutes on very dark, half-dirt roads to the ferry dock. We arrived at the dock about 2 minutes after the “nice” ferry left. So, we had to take the “other” ferry, which seemed a little sketchy (I later learned onboard that this company had lost a ferry here a couple of years ago after overloading it. A few hundred people drowned in the rough sea water.) So, after an hour and a half wait in the hot, humid and very still air, we took the 45 minute ferry ride across the four-mile wide river mouth. The Ferry was packed with Sierra Leonians, with loud music blaring on one level and a documentary about the civil war there blaring out a tv on another level! After the ferry docked and we waited for the swarm of people to get off, we carried our bags out into the light rain and divided into 8 landcruisers owned by Mercy Ships and drove the final 15 minutes to the ship. So all told, from my front door to the ship was exactly 35 hours.

Welcome to Sierra Leone, Joe! (My brother-in-law Joe joined me on this trip. Joe is a structural engineer who has specialized in hospital projects for nearly 30 years. It was so fun to have him along, though I'm pretty sure the first few hours after arrival were a bit of a shock for him, this being his first time in Africa.)

Waiting at the airport after arriving. The fact that there were 31 people total from Mercy Ships arriving made things way more complicated and hectic than it otherwise would have been.

It was quite the chaotic scene in the airport parking lot. People were coming up to us and trying to take our bags from us so they could carry them for us (and be paid for doing so!). Then trying to get our bags onto one of the several vehicles scattered amongst the crowd - I was sure we were going to mistakenly put it in the wrong car and never see it again!

This picture in no way describes the discomfort of this shot on the ferry, waiting for it to depart. The air in the room was so warm, humid and still, not to mentioned crowded with people and blaring music. Shortly after this the team scattered throughout the ferry to search for cooler or at least moving air!

The top floor on the ferry - it was so warm and crowded in the room. It was quite a heavy dose of culture shoved in our face right from the start! Good fun.

The locals crowding their way off the ferry arriving in Freetown.
But walking on the ship, the immediate contrast of the cold and dry, air conditioned air was an amazing relief from the warm, heavy and sticky outside air. I don’t think angels were actually singing, but it sure felt like it to me! The ship hospitality people took charge right away with paperwork and process orientation. It is impressive how well organized they were and how thorough the systems they have in place are.
So after a very long journey, Joe and I were shown to our room – which was like a small little hotel room with our own bathroom. We were exhausted, but neither of us could hold back the giddiness of relief we felt after walking on the ship and seeing where we’ll be staying. We finally hit the hay just after midnight.

Unpacking our bags that first night, the smile of relief on Joe's face says it all. We could see right away that we would be living like kings on this trip. One of the first things Joe told me when we reached our room is that he had definitely chosen the right trip to come on!
Tuesday Sept 6:
Waking up in the morning after a full night’s sleep was a huge blessing. I still couldn’t get over how nice it was to be sleeping in an air conditioned room with a fan on – actually we had two fans on! The normal ‘gut check’ I have to do when I wake up on trips was not there – it is nice having Joe here with me, and coupled with staying in a nice, comfortable place it definitely softens the blow of being gone from home.
After breakfast (cinnamon rolls –are you kidding me?!), we had an opening meeting with the team and then programming meeting with the Mercy Ships guys. It didn’t last nearly as long as typical programming meetings simply because this is a different kind of trip – assessing and recommending water, wastewater, and power system improvements for the three hospitals.
We then met Dulce, our Honduran host who will be our main point of contact while we’re here. She’s a fun gal with a great outgoing personality.
Dulce gave us a tour of the ship and it was impressive – over 450 people housed on the 500-foot-long ship, a library, several lounges, a full cafeteria, a cafĂ© donated by Starbucks so Starbucks coffee is served free with very cheap specialty drinks, full laundry services, and a small swimming pool up on the top deck. All of this of course exists to sustain the families who live on the ship to work in the fully functioning hospital down on deck 3.

Meeting with some of the Mercy Ships folks to kick off the trip that first morning.

The Starbucks cafe on the right with the ship store in the background. This mid-ship area was the main lounging area on the ship and where we spent a lot of time on board.
The hospital on deck 3 has 6 surgical rooms where they do eye surgeries, orthopedic surgeries, and facial surgeries (mostly to remove tumors). They work in conjunction with the local hospitals, helping to fill in the gaps that exist as well as to work on catching up with the huge backlogs there. They also provide training for local doctors on the ship and employ a number of local people to work on the ship. They are typically docked for 10 months, during which time 3000 people receive their sight back with corrective surgery that fixes their blindness from cataracts. What an amazing ministry!

Leaving the ship and entering 'the real world' was also a very stark reminder that we weren't in America. The difference in the air on the ship and the "fresh air" outside couldn't have been more drastic - the ship had cool, dry air from the A/C, and outside was warm, extremely humid and heavy air, with plenty of airbourne dirt too.

Preparing to head out from the ship to the hospital sites. Mark Palmer, our Mercy Ships contact person, is in red. Ryan, a long-term Mercy Ships volunteer who works off-ship on various development projects, is squatting down. Mark is Canadian, and Ryan is South African.
In the afternoon, we took a tour of the three hospitals in town to get an idea of what our scope of work will be. The water, wastewater and power systems will be our primary focus, as well as a structural evaluation of the buildings to make sure they are worthwhile of system upgrades.
Traffic in Freetown is terrible, so it took an hour to get to the one hospital that is 3 km (2 miles) from the ship. The other two hospitals share a site that is about a 10 minute walk from the ship, so that will be convenient. We met the important hospital players and introduced ourselves as we took a brief tour of the facilities. Doing an assessment of one of these hospitals in the 10 days we’ll be here would be a huge task. Doing THREE assessments will be a major undertaking. Fortunately, we have a very experienced team here (3 engineers on our team have over 30+ years of experience) so I am really excited to see them work their magic! Tomorrow begins the real work.
One other nice perk about the ship is that it has a phone with a Florida number. People on board can purchase a $10 phone card to call home (using the phones in our rooms!) for about 3-cents per minute! So tonight, I got to talk to Alisha and catch up with her and the boys. Things are going well back home, though the boys are always a little ‘off’ while I’m gone, and Alisha’s job is 10x harder. I do miss those 4 special people!
Weds Sept 7:
Today we broke up into two teams to visit the sites. I went with all the civil engineers and one electrical engineer to the ODCH/PCMH site. The site has two hospitals on it, but shares water, sanitation and power systems so we are treating it as a single site. We spent the day with the local maintenance guys who showed us around the property.

Walking up 'Bad Boy Lane', between the ship and the closer of the two hospital sites (about 1/2 mile). I suggested a name change for the road to help improve neighborhood pride!
The water, wastewater and power systems on the site are not functioning well, and we saw several instances where simple solutions would make a big difference. Some interesting observations from the day were:
* The main site electrical panel has no cover and sits about 20 feet from the front of the hospital. Our electrical engineer pointed this out to them as an immediate hazard and life safety issue. If anyone got to close, the power could ‘arc’ over to them and they would be dead.
* In one location, a septic tank on site had been overflowing each day. They discovered that a nearby break in a water line was filling the tank with water. To ‘fix’ the situation, the maintenance crew installed an overflow pipe that allowed the top of the tank to drain into an open-air, concrete drainage trench that runs through the site (in other words, allowing raw sewage to flow openly in the trench). Earlier in the day, one of our engineers had observed a woman who was washing clothes with the water in that ditch reach down and scoop a handful of the water into her mouth for a drink (probably assuming it was just rainwater).
* We saw several situations where the hospital had equipment (generators, oxygen systems, etc.) that was not working and had been out of operation for months or years. One generator had never been used before, just setting there next to the panel in one of the power rooms because they had run into difficulty in hooking it up.
* In one of the children’s wards we walked in, it was heart-wrenching to see all the young toddlers laying sick in their hospital beds with their mothers layed out on the ground or a small chair, sleeping beside them. I felt for these poor mothers, who love their children no less than I love mine but are unable in many instances to get their children the care they need. What a hopeless, terrible position to be in – I can imagine few things being worse.
* One little boy had a large tumor growing on the front of his face, beneath the skin at his cheekbone. The tumor disfigured his face in a manner that caused his left eye and cheek to bulge out significantly to the side of his face. I asked and the doctor said he had a form of cancer and would begin radiation soon. He was very smiley though, and I could tell his attitude on life was way happier than I know mine would be if I were in his predicament.
One positive thing about our visit is that there is a young Dutch doctor, Sandra, who is working there in partnership with the hospital. She actually grew up on a Mercy Ship as an MK (‘Missionary Kid’) and is now a doctor herself, having lived in Sierra Leone for nearly 6 years now. She works for an aid organization that has an office at the hospital, providing support and working on improving infrastructure with the local hospital doctors and administrators. She is doing great work there and is a perfect example of how missionaries can and should be partnering with locals to meet the needs of the people. She is very thankful that our EMI team is here to help sort through some of the technical issues that she has been working on while feeling deficient technically since it’s out of her area of training.

Sandra, the missionary doctor, shown here with the EMI water engineers figuring out the water delivery system on the site.

A pretty well designed water tower supporting two water tanks...both tanks sit empty due to broken pumps.

Very nice laundry facilities at one of the hospitals...except for the fact that they broke down over a year ago and haven't been used since. All hospital washing is now done by hand.

Some of the laundry is done in these trenches...the same trenches the septic tanks drain into.

Also, in the evening, we had a very productive meeting with the main Mercy Ships players. We were able to each share our expectations for the project and communicate that we’re all on the same page – what a crucial development for our team and the ministry to see that we’re all of a singular mindset on what our team is doing here. What a blessing it is to be working with design professionals who truly are at the top of their field.

The trash (including medical waste) dump site out back of one of the hospitals. The trash beach in the background is part of a housing development. The water is the Atlantic ocean, which in this case is serving as a major trash depositing spot for the city of Freetown. The pollution is staggering.

...trash from a different angle.

Figuring out the water storage system on top of the roof of a 3-story building where the main water tank is located.

A couple of the many open trenches on the site, designed for rainwater runoff, but being used for the sewer system as well. Obviously, that's not good.

Talking through things while we tour the site

Wednesday, August 31, 2011

Sierra Leone trip

This Sunday, September 4th, I fly out on my next project trip to Freetown, Sierra Leone!

I described the project in my previous post so if you want to learn more about it, see below under 'Late Summer Update...".

The 'Africa Mercy' - Mercy Ships' floating hospital that has been docked in Freetown, S.L. since January 2011. We'll be staying on the ship and heading into town each day to assess the three hospitals (pictured below). ...It goes without saying that our accommodations for this trip will be "slightly" more comfortable than on most other EMI trips.

As always, please pray for Alisha and the boys who are left behind. In many ways, the sacrifice they make during these trips far exceeds anything I have to endure. The craziness of our Summer has now given way to the even crazier-ness of the Fall! School and soccer are both back in full swing so free time is at a premium and just getting through the day is an achievement. With me gone for nearly two weeks, Alisha will more than have her hands full getting the boys out the door for school in the morning and shuttled around town for practices in the afternoon/evenings. In some ways, going on the project trip is a respite for the expense of Alisha's schedule being turned upside down! So please pray for her and the boys.

Of course, we'd also appreciate your prayers for me and the team's travel and time in Sierra Leone. This is a very different kind of EMI trip, and our scope of work for our time in-country is pretty aggressive. Pray for safety in travel, health as we tour the three government hospitals there, and efficiency and wisdom as we try to do our best to serve the needs of Mercy Ships.

The weather is also not ideal right now - it's the end of the rainy season and they get a huge amount of rain there (on average, 26 inches of rain in September alone!). Pray that our efforts won't be hampered by bad weather.

Here are some pictures of the three hospitals in Freetown, Sierra Leone that we'll be evaluating. Each campus has several buildings, so these are just a few of the many buildings we'll be looking at.

Ola During Children's Hospital

Princess Christian Maternity Hospital

Connaught Hospital