Sunday, February 26, 2012

Sierra Leone II trip – Part II of III

Day Three (Feb 5)

I actually slept really well considering I was sharing a bed with another man! Actually, the bed is so big it really is like a separate bed. Think king size x 1.5, so one of us can get in and out of bed without the other feeling a thing – one of the benefits of a foam mattress. One of the few benefits I should say - ha!

We set out for the Bo hospital campus after breakfast and our morning worship time. John leads worship and Mark from Mercy Ships was able to find a guitar to borrow this week, so that’s been really cool. Since it is Sunday and none of the maintenance workers were expected to be at the site, we decided to do an unescorted walk-through of both the Bo and Kenema sites so we could wrap our brains around the remaining work that lies ahead.

At the Bo site, we once again ran into a wrinkle – the site map from Google Earth that we had drawn was somewhat inaccurate, with a number of new buildings to add. Since we have internet on our phones here, we pulled up the current Google Earth map and fortunately, it was quite accurate. So we’ll have to redraw some of it, but it’s a lot better than having to map it out with a tape measure! It’s amazing how cell phone and internet technology is becoming available and playing such a critical part on EMI trips.

On the Bo site, discussing the existing systems with onsite workers and volunteers, including this Scottish guy (sitting) who is there for a year.

Working with intern Ross on revising the Bo site plan using Google Earth through an internet connection gained by the cell phone network. Incredible to have that technology available!

After a couple hours had passed, we felt like we had at least defined the work to be done at Bo and were confident we had enough time in the next few days. We headed out on the 1 hour drive to Kenema around 12:30pm. The countryside in Sierra Leone is so beautiful – I think one of the most beautiful of the countries I’ve seen in Africa. It’s lush green, though not quite as thick as Uganda, but towering above the bush are palm trees of all shapes and sizes. It really looks exactly like you would picture the jungle areas of Africa to look. The rivers are pretty too, clean (looking) water that flows in large, dark channels with tons of jagged rocks sticking out. It’s no wonder that the mineral mining in Sierra Leone is such a big industry – there are partially emerging rock deposits everywhere. I am looking, but still haven’t found any diamonds in the soil! (I’m joking, but actually, it used to be very common here to just find diamonds around in the dirt).

At Kenema, we were pleasantly surprised to find that our map was very accurate with only a few minor additions. The hospital matron, a short heavy-set woman who seemed like a nice person, met us in her Sunday casual clothes, coming from cooking in her home on-site (many hospital staff live on the site here). She was kind enough to meet with us, but let us know there was no official maintenance staff at the hospital – they were trying to hire some people but have struggled to do so.

The site was in tough shape, similar to Bo, but since it’s smaller we were able to accomplish a lot. And, though she was right that there weren’t any official maintenance staff, there were more than a dozen ‘unofficial’ maintenance volunteers sitting around the site that quickly jumped in to help us as we moved about. I love that about Africa – you can always find someone eager to help you here. By the end of our 3 hours on site, we had made a big dent in our work. Tomorrow we’ll be back in Kenema to finish up there, which should be no problem.

A short anecdotal story: a couple of guys on our team last night got hit up by a prostitute looking for business at our hotel. One guy was sitting out on the patio when a woman came and stood by him trying to get his attention by putting on makeup for 5 minutes and nudging closer and closer to him. She finally bumped his table and then went on about how she was tired of Sierra Leonian men! He quickly got up and left. She then went and knocked on the door to talk to his roommate, but he didn’t answer. Never a dull moment on an EMI trip, though dealing with a prostitute was definitely a first! Sadly, many women here are forced into such business to try to survive.

This mural was painted near the entrance to the Mortuary at the Bo site. We found it funny, strange and a little eerie to have such a cartoony picture on the Morgue entry wall.

Another funny sign that had a dark side - at first glance it's funny to see this posted at a hospital, but upon reflection you wonder how many people have been traumatized, ostracized, or worse because of misperceptions like this.

Day Four (Feb 6)

Today was our day to be in Kenema all day, so after breakfast and devotions time, we packed up and headed off on the one hour drive. The work went really fast – the team is well dialed in to what they are doing and though we arrived a bit late, close to 11am, we made quick work of the site. So around 2pm, three of us actually headed back to Bo to get some preliminary data for our full day there tomorrow. By 5pm, we were back at the hotel and feeling great about the trip so far – two hospitals down and one to go!

The Kenema site, as seen from atop the tall water tank on site.

On top of the Kenema water tower.

Our devotion times have been really good so far. The group has been focusing on having right motives, recognizing that in the end God is far less concerned with our actions (good or bad) than he is our motives. Of course, every point can be taken to an extreme, but by and large God looks at our hearts in most any situation and judges what he finds there. The good example that was shared came from Ruedi (the Swiss electrical engineer).

Ruedi compared King David and King Saul from the bible. King David was someone who in many respects did everything wrong in life. He committed the two biggest sins – adultery and then murder to cover it up. Yet God called him a ‘man after his own heart!’ But King Saul was a man who you could say did everything right in life. Yet, in the end God rejected him because his heart was far from being focused on God. The point for our team was that it doesn’t matter what we do or don’t do, both on the trip or back home. The important thing for us (and everyone) is to make sure we’re doing everything out of pure motives, and don’t shift the credit of our work here into pride back home. I love the team devotional times on EMI trips – it really is what makes the trip meaningful, keeps God at the center of our focus, and unites the team under the umbrella of God’s working in and through us. If this was just a development trip, I think it would be void of most of the true meaning, and in some ways would feel a little pointless.

Day Five (Feb 7)

I’m sitting here in the conference room at Bo hospital today as the team begins the assessment of the biggest hospital we’ve encountered to date. It’s an old campus, built in 1922, and there have been many additions and renovations since. Like most hospitals in the country, it was attacked during the civil war a decade ago. To commemorate this, there is a mass grave in the back of the property. (The civil war was from 1994 to 2003, and was highlighted in the movie ‘Blood Diamond).

The hospital here is pretty rundown looking. The other day while we were here, Pastor Moses helped a mother who had just lost her 15-year old daughter to some sickness, so he called the father with his phone to tell him to come. Hearing stories like that and seeing the condition of the hospital, it’s really disheartening to me that the people here don’t have much hope if they fall sick. I think about one of my boys becoming sick and how hopeless I’d feel if this was where I had to bring him. Not good. I guess it makes me glad we’re here, hopefully helping to make this a better refuge for the sick and suffering segment of society here. Also, since this is a highly muslim area, the lack of hope extends even beyond this life. As the recommendations we’re making eventually are implemented by Mercy Ships, hopefully some of the relationships built in that process can begin to share the light of the gospel with the people as well.

Taking water samples in a surgical room. It's weird to see such an unsanitary environment where people are operated on. You imagine they can only do their best when they often don't even have running water in the sink sometimes.

Back to the trip, one complaint we’ve heard repeatedly going back to the trip in September is that the communication and coordination from the Ministry of Health to the hospitals themselves is poor. One story we were told today underscores this. One of the buildings here is currently torn apart and is undergoing renovations. The work just started one day a couple of months ago when out of the blue workers showed up and started ripping the roof off of one of the wards (i.e. patient rooms). Well, there were 42 patients being housed in the building at the time, including two women giving birth! It was also raining at the time, so the hospital staff quickly scrambled to get all the equipment protected and the patients under cover in a new building. Through all of it, the workers refused to stop working as they were under a contract with the Ministry of Health and had a tight timeline to finish if they wanted to be paid. To me, this just illustrates once again how our work is only one small part of the necessary system-wide remediation work that will be required for real change to take place at these hospitals.

At the end of the day, I think we’re coming to the conclusion that the Bo hospital we’re at right now is in the worst condition of the 6 hospitals we’ve assessed (including September’s trip). It’s an old facility, and with the damage from the war and a perpetual lack of maintenance, it is in pretty poor condition.

Our Mercy Ships host Mark Palmer and I. He's a great guy, even if he talks a little funny sometimes (he's Canadian). Ha!

A good amount of time on-site at Bo was spent with groups of kids following us around. And of course, all they want is to have their picture taken and then to see it on the screen.

The streets of downtown Bo, as seen from the balcony of our hotel.

Our hotel in Bo (the 3-story building with the towels hanging out on the roof).

Day Six (Feb 8)

Today was a milestone in the trip – our last day on the road gathering data. Anytime I’m on a trip, I always have one eye on the calendar counting the days until I get back to Alisha and the boys, so checking off boxes of things to be completed is encouraging mentally for me. Of course, I love being a part of this great work and am so honored to get to work with such top notch volunteers that we get at EMI, but I do miss my family on these trips so it’s always good when things go well and I’m feeling like we’re accomplishing what we set out to do.

We packed up and left the hotel in the morning and went to the Bo site to finalize our data. At the hospital, we once again encountered someone dying. As we were walking near the edge of the site looking at the water system, we heard from within the hospital the sound of a large group of people erupt in mourning. As we watched from about 60 feet away, we saw a body carried out on a slab of wood with long poles on each end, followed by a crowd of about 30-40 people wailing. I asked Pastor Moses if it was hired wailers or actually wailing, and he said they weren’t hired. As we stood watching the scene play out, it was heart wrenching to see the grief. People crying and throwing their arms around, one young boy threw himself to the ground and began rolling in the dirt – it was upsetting to see to say the least. Pastor Moses immediately went over to the people and started helping them, pulling the young boy off the ground and hugging others. He later said he found out it was a 19-year old girl who had passed. He didn’t know what she died of but he said she had been admitted to the hospital for some time.

Of course people die everyday everywhere in the world, but when you know there’s a strong possibility that the person you see dead could have been saved if conditions were better or they lived in another country, it seems more disheartening. It seems so unfair for these people to have to suffer such great loss for things that are either non-issues (i.e. a sanitary hospital to be treated in) for us or else easily solved (diseases that are easily cured in the West).

We also heard a story that even when Western doctors come to help here, they are realizing that their work needs to be consistent with the culture and capabilities of the region. For example, if a woman is struggling in childbirth and the child’s life is in danger, they will likely focus on keeping the mother alive and well and let the child die, having the woman deliver the baby stillborn instead of doing an emergency c-section to save the baby. The reason is that a woman who has had a c-section previously here is in a very high danger zone for future pregnancies. The thinking is that if the mother is saved the first time and not given the cessarian at the expense of the life of the child, she will be able to deliver naturally the second time and therefore the second baby will have a mother. If the baby and mother are both saved the first time by giving her the cessarian, the woman is likely to die the second time, potentially leaving two newborn babies without a mom and very low chance of success in this world. Obviously, there are very serious moral issues to be considered, but I can’t necessarily fault the logic of this philosophy – that is, trying to make improvements that are appropriate for their society and that don’t create additional, unforeseen societal problems.

When I hear things like that, I am just speechless – we are just not faced with those kinds of scenarios back in North America. It must be so difficult for the doctors to have to consider such difficult choices and the longer term ramifications of those choices, and then alter those choices based on those longer term ramifications. It’s both mind numbing and heart wrenching.

The drive back to Freetown seemed long, but at just over 3 hours it was actually an hour shorter than we had been told. It’s a tedious drive, especially because the entire country is now covered in a hazy fog of sand and dust from the seasonal Harmattan winds blowing off the Sahara. It’s really fascinating when you read about these winds, which carry enormous amounts of dust and dirt and sand thousands of miles west from the Sahara. In some years they have been reported as far away as the Caribbean Sea.

All packed up and ready to head to Freetown, we stopped for lunch at a Lebanese restaurant in downtown Bo. There is a heavy Lebanese presence in Sierra Leone - mostly due to the mining industry.

The crowded road out of Bo - once you get out of town the sea of motorcycles disappears - they are only used for local transportation.

The Harmattan winds work kind of like the jet stream in that there are typically no winds at the ground level. However, the dust in the air makes it look like a massive forest fire is burning nearby. Tonight when it got dark, visibility was probably only 400 meters. It made me hope our flights aren’t affected.

But we made it safely back to Freetown, and it’s nice to know the traveling and data collection aspect of the trip is complete. The team is feeling very good about where they are at with their respective sections of the report. The next 4 nights we’re staying in a small ‘beach house’ south of town – that should be interesting.

On the side of the road heading back to Freetown - Pastor Moses wanted to stop to buy a big supply of rice since the price is so much cheaper out of the city.

Wednesday, February 22, 2012

Sierra Leone Trip II (Jan 31-Feb 14)

Sierra Leone Trip II

Part I of III - Travel days (Jan 31 – Feb 2)
I’m sitting in London in a hotel (since I had an overnight layover this time) and I am amazed by two things. One, even though I’ve spent a fair amount of time in the UK over the past few years with EMI, I am once again reminded how different the cultures are. As with many cultural differences, they are subtle and many times difficult to even describe, but they ultimately serve to make you feel very out of place. So when I travel to the UK, I typically try to be quieter, less obvious in what I say and do, and just try to blend in. I do become somewhat of a target for being taken advantage of though since if things don’t go as I think they should, I am very unlikely to buck the system.
For instance, if a sign says something is one price and when I get to the counter they charge me for more, I will probably just keep quiet and pay because I don’t want to be that obnoxious American demanding my rights overseas! (Not that all Americans are obnoxious of course, but like it or not that is the stereotype and I don’t want to reinforce it.) In today’s case, fortunately, the nice middle-eastern woman who helped me at the market in Heathrow airport notified me that the sandwich I’d chosen was not a part of the meal deal, so I was able to go back and select one that was a part of the deal. That’s nice because I’ve learned to take advantage of any ‘deal’ I can find in the UK – with the exchange rate of 1.6+ dollars to the pound, it is easy to spend a lot of money here without realizing it.
The second thing that stands out to me is how much of a mindset shift I have to undergo to go on these trips. The moments leading up to leaving are nothing short of mental torture for me. My anxiety, sadness and homesickness levels all skyrocket to the top and I am left in this state of mini-depression. I can be completely convinced in my heart that the trip is what God wants me to do, but still struggle with my mind not wanting to go. When those two don’t agree, I’ve learned that my heart should be listened to so I follow what it says, but it makes for a very tumultuous inner struggle.
I have no idea how long God will want me to do these trips, I really don’t. But I’m learning that though anxiety is bad, the idea of saying no to our ‘flesh’ in a big way from time to time is a healthy thing, even if it makes us terribly uncomfortable. I hate it and everything in me tells me I don’t want to go…except the peace I have inside that this is what God has called our family to for this time in our lives. Then once I’ve left, even on the road to the airport, 50% of the anxiety is gone. That part doesn’t make as much sense to me, other than once I’m gone I feel like the clock has started ticking towards when I get back home to Alisha and the boys!
So even though the travel process isn’t a direct part of the ministry of EMI, it is definitely the biggest growth area for me. It’s a 3-times per year tearing away of my own agenda, where my security in my family and home is replaced with the security of living in God’s will for my life. Of course, that’s actually the security I live under 24/7, it’s just that I’m able to fake being in control most of the time otherwise. For me, God sees fit to remove the veil 3-times per year. Perhaps if I learned to live that way all the time he wouldn’t have to keep doing it for me 3-times per year! As usual, the overall travel was a long haul – about 50 hours from my front door step to our guesthouse outside of Freetown.

Charting out a plan after just arriving off the ferry in Freetown.
Also, for the first time on one of my trips, one of the volunteers’ bags didn’t make it on the flight, so he was left with just the clothes on his back. He had a great attitude about it – I think I would have been more freaked out!
There were so many familiar images this time, as we took the same ferry across and met Mark Palmer from Mercy Ships on the other side. I kept blocking out the Ship from my mind because everything in me felt like that was the next step! But I reminded myself that I’m very much looking forward to seeing the country this time, and staying on the ship would have made that impossible.
When we arrived at the guesthouse, it was much nicer than I expected – they had power, dinner waiting for us, and an upstairs dorm style room with nice wood beds formed into little cubicles. I stayed up very late getting the unlocked, go-anywhere internet ‘stick’ I bought on to finally work. I did succeed finally, so I was able to email home and let them know I’d arrived.

Good to be back on the bustling streets of Sierra Leone!

Day One (Feb 3)
I actually slept through my alarm and was the last one awake at 7:20am. I scrambled to make it to breakfast downstairs. We did our typical team testimonies, heard a bit from Mark about the project Mercy Ships is undertaking in having us come, and then hit the road for the 2+ hour car drive to Makeni.
After checking into our guesthouse – again, surprisingly nice for this rural of a town – we decided to head straight out for the hospital. We right away ran into a little wrinkle in the plan. The site we had all mapped out and prepared to assess was no longer the hospital! The hospital had moved last year. So after driving around town for a bit, we finally found the new hospital campus a few miles from town. The changed site actually turned out to be a blessing, since it had only be in operation for under a year, there really wasn’t a whole lot that had broken down just yet.
However, we were led around by the worker who works on site as a representative of the contractor who built the hospital. This man shared with us that they had still not been paid for building the hospital. Apparently, the local government officials keep putting the payment off. The contractor is worried that if the building or systems are allowed to break down, his chances of being paid are very low. So, he is paying out of his own pocket to have this man keep things working on site.

The new hospital site in Makeni

The civil engineering team discussing the Makeni water system with the builder's representative on site. Since he had built the site, his knowledge was invaluable to us.

The water system at the new Makeni site was actually very nice. However, because there is insufficent power on the site, the pumps aren't able to operate enough to fill this nice tank system. Also, the pumps that were installed were likely from America, which means they were built to operate at a different power frequency. Consequently, they keep burning out and need replacement. It's startling that a hospital that has been in service less than a year already has such basic utility problems even though the solutions to those problems are relatively simple.

The electrical team (L to R): intern Ross, volunteer Ruedi and volunteer Bill - once again, we had an all-star team! Bill and Ruedi each have over 30 years of experience, yet they worked together very well as a team. It was a great example to the rest of us "young guys" to see such seasoned veterans working together so well.

Structural volunteer Barry with intern Ross

The man shared with us that since Makeni was the former headquarters of the rebel army (RUF) in the civil war, many of the former rebel leaders are now in prominent government positions here. As such, he said the officials are operating according to their own rules and agendas. Of course, this was just one man’s story and who knows if it’s even partially true. He said he was a Christian though, and he seemed very interested in finding out that we were as well.
But it was amazing to me to think that some of the people who committed such atrocities against the country of Sierra Leone have somehow been able to garner for themselves positions of political power. And though Makeni appears on the surface to be somewhat mellow and a typical medium sized African town (reminds me of Jinja, Uganda, a bit), it carries a significant history with it in the devastating war of the past two decades, largely due to its convenient location next to some of the diamond mining areas.
Since we were so productive today and the hospital is so new, it looks like we will press on to Bo tomorrow, a day ahead of schedule. I am really enjoying seeing this country after having read so much about its history after the last trip. Of course the movie Blood Diamond was set here, but the books ‘A Long Way Gone’ and ‘Blood Diamonds’ tell a gripping account of the events from two very different on-the-ground viewpoints. I highly recommend both to anyone interested in West Africa’s recent, volatile history.
One other quick thing – on this trip, we’ve been able to purchase SIM cards for our iphones (unlocked) and computer internet ‘sticks’ and thus virtually have internet access 24/7! It’s amazing the advances in technology over the past couple of years. The speed is not bad though still comparatively slow, but being able to keep up with email during the trip is an enormous blessing. I also am available to Alisha by phone at anytime if she needs me back home. I am convinced that the cell phone (and now phone internet) system of pay as you go is so much better than the proprietary jumbled mess we have to put up with back in the U.S. To remain neutral, I won’t mention AT&T’s name specifically. Ha!

Day Two (Feb 4)
Today, we went back to the Makeni site to finalize our observations there. By noon, each of the disciplines had seen enough, so we pulled out of town a day earlier than expected. The ride to Bo was 4 hours, heading back west towards Freetown for an hour and a half before turning south to Bo. Fortunately, the roads were nice so we didn’t have to battle the usual potholes. It was pretty warm still, in large part because the air conditioner in the car we were driving in stopped working on the first day. It was interesting to see the country side – similar to Uganda but not lush since it’s the dry season. One big difference though is that the landscape is riddled with palm trees of every size and shape. It really is beautiful, and looks very much like what you would think the jungles of Africa look like.

The palm trees were so beautiful, even though the countryside was pretty dry. Sierra Leone gets a ton of rain during the wet season - the wettest time of year (June-Oct) gets close to 30 inches of rain per month!

Hearing from Pastor Moses in the car much of the way was a real treat. His on-the-ground account of the war was so interested. Though he had a couple of close calls, thankfully he and his family all survived without being tracked down by the rebel group who were torturing and killing any and everyone in their path. More about Pastor Moses later in the trip.

Mark Palmer, our Mercy Ships' host, and Pastor Moses, who also works with Mercy Ships on the ground. These guys traveled with us and were a lot of fun to have around. We joked that they were like an old married couple because they liked to give each other a hard time.

We arrived in Bo around 5pm and got checked into our rooms. In some rooms, the beds were bigger than a king size, so to save money and stick together at one hotel, some of us decided to share a room and the large bed in it. I shared with John, the other EMI staff member who came on this trip.
The team this time consists of: me; John Agee, another EMI project leader and civil engineer; intern Ross Yeager, a just graduated electrical engineering student from Colorado Springs; Austin Hewitt, a civil engineer who came on the trip in September as well (it’s a huge blessing to have someone come back this time to help with continuity in our work); Aaron Koonsman, a civil engineer from New York; Bill Baldwin, an electrical engineer with 30+ years experience; and Ruedi Tobler, another electrical engineer with 30+ years experience as well as many EMI trips under his belt and numerous trips to Africa, including living in West Africa for 3 years at one point in his career. It’s a great team and they made quick work of the hospital in Makeni. The next 4 days will be the meat of the trip as we assess the two larger hospitals.

No trip to Africa is complete without a picture with the local kids around all clammoring for your attention. One thing is universal in Africa, regardless of which country you're in: African children love having their picture taken!