Home again

So I'm back in North America, as of about a week ago, and now I wanted to write a bit about the future of this blog. For those of you that are new, there are many different stories about many different aspects of my experience in Sierra Leone. I hope it can serve as a resource for people who are considering interning with GAF/NOW, or for anyone interested in going to Sierra Leone, or for anyone curious about what volunteering in a country similar to Sierra Leone might be like. Beyond that, perhaps it's a vanity, but I hope that some of the stories are interesting and thought-provoking in their own right. So if you are new, please take a look around, and don't be confined to chronological or reverse-chronological order. And if you think you know someone who might find the blog interesting, let them know. If you have any questions or comments for me, an email to cyarnell(at)princeton.edu is a good way to get in touch. Cheers, Chris.

Lost Child, Beach, Metaphor

The clinic isn’t very spacious. There is a table in the corner of the patient registration area, and that’s where Katie and I set up our laptops when we need to use them. Lately we’d been using them often, because of the survey data analysis and the business plan second draft.
We usually go to the clinic with full batteries and then work until one of our computers runs out of power. Then we turn on the generator until the batteries are charged, turn off the generator and work on battery, turn on the generator to charge... When the generator is on it’s easier to work because the screen brightness doesn’t matter. But to charge our laptops we need about two hours of generator time, and that costs about 7500 Leones. So we often turn down the brightness of our screens to conserve battery power and use less fuel.
The result is that when we work on our laptops, there is usually a large crowd of kaleidoscopically clad mothers, sometimes fathers, and always children sitting on benches, sleeping on benches, standing silently beside us, or arguing with the registration desk. The children sometimes fight and sometimes cry, although the sickest ones are eerily quiet. And our screens are so dim that we can hardly read anything; we’re typing half blind.
Sometimes I wonder if I turn down my screen brightness so much as a subconscious punishment for working on a laptop while there are so many sick children in the room. There’s a definite level of abstraction to the help that our work on the survey and the business plan provides, and a definite sense of immediacy in the fevered brows of the malaria victims. I can’t help but think about how the mothers and fathers perceive us, typing furiously on fancy machines with our backs turned to the waiting room.
It was our last Tuesday in the clinic. I was working on data analysis, and that means I was squinting at computer code trying to write a program that would print out and save bar graphs with titles and p-values of all 260 different parts of questions on the survey. Katie was editing the second draft of the business plan, which means she was wading through a mess of “Track Changes” comments in a Word document. Bori was manning the registration desk, with help from Mohamed T. Koroma, one of our surveyors who had returned to volunteer.
Then, I heard a woman crying softly. She was down the hall, but moving towards us. She walked past, and then out the door.
“Katie, what’s going on?”
“I don’t know,”
“The women never cry. The kids cry, but the mothers never do.” My laptop felt treacherous, like it was tricking me out of helping where help was really needed. Katie turned to Bori, who was surrounded by three other mothers wearing babies on their backs. One of them was trying unsuccessfully to get her child to stand on the scale.
“Bori, what’s wrong? What’s happening?”
“I don’t know,” said Bori, without looking away from the registration form.
We kept working. I hit another frustrating bug in the program, which should have been simple, and spent thirty more minutes squinting through the code. Then Bailor emerged. He looked tired.
“Bailor,” we clasped hands. “How are you? Did you sleep?”
“Fine. Yeah, yeah, I slept.” He was holding a chart and a stethoscope. “Do you have a pen?”
“Yeah,” I reached for one, but he had already found one.
“We lost a child today,” he announced, while looking down at the desk.
“Oh,” I said, just to say something.
“What happened?” asked Katie.
“Well, I don’t know. I was not treating the child, Yusuf saw this child, and probably it was just too late, probably he came to us too late. I am looking at the charts now.” He walked away.
Katie and I turned back to our laptops, but I just stared at it for a few minutes. I felt the laptops had betrayed us.

Later that night I was very cold. I gathered up all the blankets around me as I lay in bed, under the white gauze of the mosquito net. My teeth were chattering, and I was shivering, but I had no idea why. It was the kind of cold that tingles painfully all down your back and the backs of your arms. So I was curled up in a ball under my blankets.
Slowly, I felt the heat from my core radiate outwards, and my shivering calmed down.
I thought about the child that we “lost.” Bailor’s instinct was probably right; he probably had come to the clinic too late. But it was frustrating, because he probably didn’t have a tough problem. Maybe malaria, complicated by malnutrition. Maybe meningitis; scary but treatable with an intense course of intravenous antibiotics. Maybe just a diarrhea that dehydrated him to death. Maybe a respiratory infection that deprived him of too much oxygen. Bailor never told us, and we never asked. I’m not sure why not.
The bed at Uncle Ben’s is bowl shaped. I was curled up in the center of the bowl. The generator hummed impersonally in the background. Eventually I stretched out diagonally, so that I fit on the bed, and my thoughts dissolved from the lost child into sleep.

On Saturday before we left, Katie, Lois and I stayed at No. 2 River, a beach place south of Freetown. The beaches south of Freetown have easily the smallest ratio of development to beauty that I have ever seen. The sand is white and fine, the surf is enthusiastic, the water isn’t cold. Behind the beaches the land rises quickly into multiple small hills, each covered in a thick layer of jungle. Old growth deciduous trees mix with thick undergrowth and palm trees. However, the road to get to No. 2 River requires at least half an hour of potholes. At some points we were driving through ponds at least a foot deep. It was enough to make Ali, the driver, chuckle and announce “Welcome to Africa.”
It’s the rainy season, so it poured the entire night. It was also very windy. When I woke up on Sunday morning, it was still raining. But I was determined to go for a beachwalk. So I pulled on my rainjacket and walked out.
The sky was grey, the water was grey, and the beach was grey. The foam and spray of the leftover waves from the wind were grey. The tops of the nearby hills were hidden by misty clouds. Even the palm trees leaning over the beach looked grey. It was beautiful.
First I walked north. There wasn’t much beach in that direction. There was another “beach house” as Sierra Leoneans call them, and a few rocks that created more interesting spray, but that was all. So I strolled back towards the south. I was walking with my feet in the surf, so a couple of times I got soaked almost to my waist. Where the surf crashed into the beach it was very sloped, so there were fine lines between ankle deep, knee deep, and thigh deep.
At the end of the beach to the south was the mouth of a river, presumably river No. 2. There was two hundred yards of beach separating a freshwater lagoon from the ocean, and it was at the far end of this little beach peninsula that the river escaped to the ocean. I didn’t know whether the tide was going or coming, but as I stood at the river mouth, the water was flowing both ways. The water from the lagoon was warmer, but the water from the ocean was colder, and together they swirled around my feet. Sometimes it was warm, sometimes cool.
The surf was crashing just outside of the mouth of the river, and so every now and then a foamy whitecap would roll into the lagoon. But then a small succession of tiny waves would ricochet back out of the lagoon into the ocean. They would crash, if six inch waves can be said to crash, at the shallowest point of the river mouth.
Most of the time during the walk I was just watching the beach and the ocean and the jungle all around me. But sometimes I thought about how footprints in the sand are a perennial metaphor for impermanence, and how a drop in the ocean is such a common metaphor for not having enough influence or power to affect real change. Impermanence and inability to affect real change are deep and abiding concerns of Lois, Katie and me. I would hazard that most people worry about them to some degree. But the nature of our summers has made us think about them more than usual.
As far as the impermanence and effectiveness of our efforts this summer, time will tell. The survey itself will not be too useful, but the lessons learned by the interns and the organization during the survey may prove very valuable. The health education had mixed efficacy, but perhaps both the interns and organization have learned lessons that will benefit many in the Kono District and elsewhere. And the health education itself is part of a broader fabric of education wherein repetition is vital. The business plan for the palm oil plantation and mill is ambitious, and in rational terms the project is on sure footing. But the irrational elements of Sierra Leone are difficult to control in advance. If all goes according to plan, the revenue contributions of the palm oil plantation and mill will probably be the most lasting contribution of our summer in Sierra Leone. And if, despite our best efforts, the plan becomes irrelevant... well, we’ll have to make a new one.
But the best metaphor for our efforts this summer is not footprints, not drops, and not backflows from the lagoon. It’s the waves from the ocean. The contributions Katie, Lois and I made and tried to make this summer were the first of many for the three of us. I’m sure that our future efforts with both GAF/NOW and other organizations will have moments of success and futility. There will be lost children, treacherous laptops, and miraculous recoveries. Perhaps more beaches, more revolting toilets, and more rice. More IV changing by flashlight, and more treatment by desperate hope, attention, and prayer mats; there will be more moments of terrifying ignorance against the spectre of death. There will be thoughtful plans, and woefully flawed plans. More mistakes, and more painful lessons. More walks under the African sun, and more crowded “Africa-style” road trips. More potholes and more corruption, more generosity and more eagerness to learn. More red earth, and more blue sky.
So let this be the first wave, if I can carry the metaphor a bit. Here’s hoping that we can contribute more waves in the future, both abroad and at home, after more education of both the academic and nonacademic kind.

Local Tax! Taxtaxtax!

Local Tax

There was a rope across the road. It was actually a few black ropes tied together, with small paper tags hanging from it in random places. There were people clustered around the sides of the rope, and two or three police officers in tan-colored uniforms.
“Hm. Local tax,” I observed, as Katie and I walked towards the rope. It was across the intersection of the Kainkordu and Post Office roads, the main intersection in Koidu Town.
Local tax is relatively new in Sierra Leone. It’s a flat tax of 5000 Le (~1.50 USD) that all residents of Sierra Leone must pay. When you pay, you get a receipt that looks about as official as a receipt from a garage sale, and in order to pass the checkpoints that are (as best I can tell) randomly scattered in time and space throughout Sierra Leone, you need to present your receipt.
It wasn’t our first encounter with the local tax. We’d passed through this same checkpoint the day before, and been allowed to pass without too much trouble.
“Tax, taxtaxtaxtax!” A bunch of men gathered around the edge of the rope looked at us with interest and each started calling out the word tax repeatedly in fast succession. None of them were in a uniform of any kind. However, as we approached and ignored them, the crowd thinned down to one man, who apparently was the man in charge of this rope.
“Hello sir. Local tax!” He said. He was not wearing a uniform either.
“We no faut pay. We no local.” Katie explained.
“No, everyone pay. Local tax, taxtax!”
“No, we no faut pay, we no de reside na Sierra Leone,” Katie continued.
“No, pay, pay local tax. Everyone must pay.” He shook his head definitively. I decided to use a Krio-style debate tactic – raise the volume.
“We no de pay becos we no local. A de reside na Canada, e’ de reside na America, we no de pay. We no de live ya.” Ya means here.
“But you are here right now!”
“Yes, but we nota from ya.”
“But you are not leaving today,”
“That doesn’t matter. We are not residents of Sierra Leone.” I switched to English, because he was using English, and because it’s more intimidating.
“Everyone must pay.”
After our first run-in with local tax the day before, we had talked to Bailor. He had said, “Those guys! They make us look stupid. They don’t know the rules, they don’t know that you pay visas for enter the country, they look like they have no idea what they are doing. I wish I could have talked to them.” We wished that too. It’s really fun to watch Bailor yell at someone who is being ignorant or corrupt.
I remembered something Amhidu told me about officials in Sierra Leone.
“I want to talk to your boss. Take me to your boss.”
“No, I am my own boss, you talk to me.”
“No, let me talk to your boss.” He shook his head. “Do you want to talk to my boss?”
“Yes! Phone him!”
Well, I didn’t actually want to wait for Bailor. We were walking to the clinic.
“Let me talk to your boss or we will leave.”
“Then I will arrest you.” Katie jumped in with an interesting fact from Allan.
“It’s illegal to arrest Americans in Sierra Leone!” It’s nice to be invincible. Unfortunately the man didn’t respond. He also stopped looking at us, so we decided to go. We stepped over the ratty rope and into the intersection, Katie leading the way.
“Arrest them!” The man yelled. I looked back at him, curious. There was a female police officer beside him. She immediately dropped her gaze to the ground, tiptoed around me, and tugged on Katie’s shirt with two fingers. The most feeble arrest attempt ever.
Another male police officer came striding over, and he seemed more in charge. By now we were in the middle of the intersection. He looked at me, and I started explaining.
“We do not need to pay local tax because we are not local. We do not reside in Sierra Leone.”
The police officer didn’t say much, but he also didn’t have the chance, because suddenly we were in the middle of a huge crowd of people, all shouting in Krio. The police officer started listening to another man, and nobody seemed to be paying us any attention. Katie and I exchanged an amused and puzzled glance. An official had commanded our arrest, and instead we were standing in the middle of a huge crowd of people yelling in Krio, none of whom were actually talking to us.
The din subsided for a moment, and an older man stepped towards us. “Please, I know these people,” he said to the police officer. We didn’t know the man. “They work in the clinic in Dorma, they are very good people, here to help, this is all a misunderstanding.” His tone was placating and sycophantic, and kind of annoyed me. It sounded like he wanted to smooth things over because we were special, not because the rules said we were right. He turned to us, “So, you must have some identification, some papers...?”
Well, we had only our National Organization for Welbody ID cards, and I didn’t think Katie had that. Furthermore, that was not how I wanted to work this out, nor did it seem that Katie wanted to settle for ‘special treatment.’
“Thank you sir, I appreciate your help, but we don’t pay local tax because we are not local, not because we are special. Tenki.”
The crowd dissolved back into a cacophony of Krio.
I pulled on the policeman’s shoulder, and Katie said, “Don’t do that!” which was good advice. But I wanted to tell him that we pay about fifty times the local tax for our visas to enter the country.
In a moment, it didn’t matter. The roar of Krio didn’t recede one bit, but the policeman turned to us and nodded that we could go. So we left. The crowd stayed put, yelling and arguing in Krio. Katie and I were bouncing with adrenaline.
“One man said ‘White or black, all must pay!’” Katie told me. That’s frustrating on a couple of levels. On the other hand, it’s nice to be invincible.
Two minutes later we passed Christopher, a Sierra Leonean friend from conducting the surveys. He called out to us “Hey! Christopher, Katie! I hear you have some trouble with the tax collectors,”
We stopped and smiled. “Wow, news travels fast,” said Katie. In the distance we could still hear the dull roar of the crowd yelling in Krio.

Pharmacy

“This, three times per day. You de take’em 8 o’clock, 2 o’clock, 8 o’clock, okay?”
Bailor waved his arms, bounced his head, and generally spoke with his entire body. The gaunt old man in front of him nodded. Bailor looked around and grabbed another small plastic bag full of white and yellow pills.
“Okay. This one, this white one and yellow one. You de take’em two-two, two tem per day. You de take ‘em 8 o’clock, 8 o’clock, okay? One white, and one yellow, four tablet per day.”
“Yessir,” The old man was wearing a white brimless hat, like many Muslims in the area do.
I was counting pills with a spoon. Bailor had asked me to count out thirty pills of ferrous sulphate, multivitamin, folic acid, and something else that I’ve forgotten. The way we do it is by emptying out a bunch of pills onto a piece of paper or cardboard. Then we separate out thirty pills into easily countable piles, say, six piles of five, then we sweep the rest back into the bag. The paper gets scooped up carefully and then gently creased to guide the pills into the small plastic bag.
Bailor held up a packet of oral rehydration salts for the same man.
“Okay, now this one, you faut us clean water. You de get satchet water, you de use’em, and wey you no de get satchet water, you boil water, boil insigh pot and den you drink ‘e.”
I was sitting in the lone chair in the pharmacy, pulled up to a small counter. The walls are covered in shelves, and the counter is just an extension of these shelves. All around the counter were small containers of the most commonly prescribed medications – praziquantel for schistosomiasis, doxycycline for malaria and other infections, various analgesics, generic Tylenol, anti-hypertension drugs like nifodipine, multivitamins, and many other small unmarked pill bottles. A bit higher on the shelf, in front and back to the left, were the packages and boxes of medication. I could see the box of quinine that Bori had broken open to help Samba (earlier post).
“Okay Pa, so how many tem per day you de take dis one?” Bailor held up the yellow and white pills.
The old man narrowed his eyes, opened his mouth, shut his mouth, widened his eyes, and shook his head.
“Two-two, two tem per day. One white, one yellow. Okay?” Bailor looked at the younger man accompanying the patient, “You de understand? You de help ‘em?” The younger man nodded. He was also wearing an elegant brimless hat above a matching colorful shirt and pants.
The back of the pharmacy had a small window, but it was tinted so that the whole room was slightly shadowed, even at 2 in the afternoon. The shadows didn’t hide the boxes in which the medicines came, however. They were apple boxes – ‘Mountain grown from Virgina,’ ‘Golden Delicious’ with an unmistakably cracked Liberty Bell just below. There were also tomato boxes – ‘Sunripe Bell Roma Tomatoes.’
Above the stacked fruit and tomato boxes were the plastic bottles of glucose maintenance and saline solution. They looked like water bottles, maybe water bottles from a trendy new company called ‘D5.’
Bailor bent over pulled the next file from the pile of folders. “Okay, now we need,” he paused and grabbed a rectangle of individually wrapped pills, “we need fifteen of these, cut in half.” He handed me nail scissors, then scribbled on a small plastic bag and pushed it towards me.
I counted out fifteen pills and started cutting them in half, wondering whether it was worth trying to save the dust that fell to the paper after every cut.

Edits and Interesting Posts on Katie's Blog

After speaking with a reader or two, I've added some edits to the two entries on transparency and trust. If you have read them already, please glance at the edits - I tried to make it clearer why what NOW is doing is special.

Katie has a number of interesting new posts, including one that puts into words one of core principles we are learning: how to find balance in various situations in Sierra Leone. Please take a look at perambulating.wordpress.com.

We are entering our last few days in Kono - on Thursday we return to Freetown, and then the following Tuesday we fly back to North America.