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.