Monday, April 30, 2007

A Taste of West Africa...

...in five true short stories:


Hospitality: One evening, a few of us girls were trying to go out for dinner at a Lebanese restaurant on the other side of Monrovia. We happened to be leaving at the same time as one of our OR translators, Vicky, so she flagged down a cab for us all to share and haggled with the driver for a decent price. When she asked us how we were getting home, we told her we would just take another taxi. Concerned, she said to wait for her outside the restaurant after we were done; she showed up right on time in another taxi, came with us all the way back to the ship (about 20 minutes), and then finally took another taxi home for the night. It made me think – my thoughts went something like, ‘oh how nice of her; I would NEVER even THINK of doing that. Is that bad?’


To the point: Conversations with Liberians are notably bereft of euphemisms. If I miss a free kick in a soccer game, the fans say, ‘You play bad. Why?’ If it’s someone’s birthday soon, they say, ‘It is my birthday. What are you going to give me?’ If I have a zit on my cheek, they say, ‘Your skin is bad!’ And if I gain a few pounds (ok maybe more than a few), my soccer captain tells me, ‘You look two-month pregnant. With triplets.’


African Time: Last Sunday, I was supposed to meet up with one of my Liberian teammates at 2pm at the gate to main road to go see her house. My friend Kristen who works on one of our construction teams was supposed to meet a hired worker at the gate so that she could teach him how to read English, also at 2pm. And another crewmember, Renee from Guinea, was waiting for a friend that he had met who wanted to come tour the ship – also at 2pm. The three Mercy Shippers arrived at the gate promptly at 2. By 2:30, Kristen and I assumed our friends weren’t coming, so we went back to the ship, but Renee, being West African himself, stayed to wait longer.

At 4pm, I saw Renee arrive at the gangway with his visitor. We later discovered that Kristen’s visitor had actually come, but at 8 that morning. My teammate just plain old never showed up. None of us was particularly bothered, or surprised; this, my friends, is African time.


Friends: It’s very easy to make friends here. When you meet a Liberian, they will shake your hand with a finger snap at the end (hard to describe – ask me to show you when I get home), ask for your name, tell you their own name, then tell you that ‘You are my friend’ (often followed by a marriage proposal or a request for contact information). This Sunday, I went to a local church that I had never been to before, the Jamaica Road Evangelical Fellowship. I sat next to a little old lady bursting with energy, who led a church-wide dance party during the praise and worship; at the end of the service, she handed me a piece of paper with her name and address. A few minutes later, a man with a tailor shop told me that I should come by next week so that he could make me a dress. And on my way out, another woman asked me if I am married (no) or if I have a fiancĂ© (no), because ‘I like you for my son.’ All in a day’s church service…


Remembery: I’m often amazed at how well - and for how long – the people here remember the things that we tell them. I think it may be a consequence of simplified lives, minus the over-stimulation to which we technologified people tend to expose ourselves.

One example: All the UN soldiers wear these distinctive powder blue baseball caps that I’ve been coveting since I got here. Five weeks ago, I had a sudden flash of inspiration while walking by the Ghanaian UN soldiers who guard our gate, and asked if there was any way I might be able to get my hands on one of these hats. One of the guards, Seidu, told me that he would try to get me one next time they were being issued, and asked for my name so that he could bring it to me. I gave him my name while thinking ‘yeah right, great talk, seeya again never!’ and 30 seconds later had moved onto more important thoughts (probably something along the lines of, ‘mmm, fried plantains taste gooood…I wonder how they would taste with ice cream…mmm, ice cream tastes gooood…).

Two days ago (five weeks later!!!), I was paged to the gangway – and imagine my surprise when there was Seidu, immensely proud of himself, holding a brand sparkly new powder blue hat in a bag with my name on it!

Monday, April 23, 2007

Suffer the Little Children...



The children of Liberia have suffered dramatically for the atrocities of preceding generations. Unknown numbers of children were orphaned, abandoned or separated from parents or relatives during the war. The lucky ones lived, and now the orphanages are overflowing.

Bowie Buverud is a crazy Norwegian welder/biker/bus driver with wild curls and a braided beard who has led efforts with other crewmembers to sort of adopt the Fatima orphanage, located just outside Monrovia on a beautifully fertile plot of land. The orphanage is run by an elderly woman named Mother Young, who rules 180 children with an iron fist (it’s incredible, really – she raises her hand and the place goes from deafening to deathly silent). Like the rest of Liberia, Fatima is a place that reeks of sorrow mixed with hope. Although many of the children are true orphans – often either from the war or from AIDS - a good number of them were simply abandoned by parents incapable of feeding them. We’ve been visiting the orphanage on Saturdays to spend time with the children, and a girl named Signa who was here last year went home to Norway and raised enough money to start building a dining hall and latrine; an agriculture project has also been started, so that eventually they will be able to grow some of their own food.

Mother Young is an amazing woman who has devoted her life to loving and caring for these children, but she simply has had no resources to work with and as a result the conditions in the orphanage are horrendous. 40 boys sleep in one room the size of my senior year bedroom at Yale, three or four to a musty, urine-soaked mattress. Keeping the children fed is an endeavour of faith, and although they receive some food from an NGO, the delivery is sporadic and they never know if there will be enough for the next day. Many of the children have obvious health issues – skin diseases, umbilical hernias, crossed eyes, and facial disfigurements. One of them, Jimmy, came to the ship last week for a hernia surgery, but he is the exception, and most of them will go untreated.

Most Liberian orphanages face the same difficulties as Fatima, and to compound their problems, the government and some international agencies are now attempting to implement stricter regulations for orphanages. This means that many of them are in danger of being shut down (‘shut down’ means they can’t receive food shipments or any other form of help from NGOs or the government) because of poor conditions and the high proportion of children who have living parents or relatives who theoretically should be able to take care of them. This might make sense in a completely detached hypothetical way, but in reality the relatives – if they can be found - have no interest in acquiring another mouth to feed, and the poor conditions are impossible to overcome without adequate funding (rock and hard place?).

To hold the children after hearing these things and seeing how they live is to invite emotions that will change you forever. They have nothing in the world save the ratty, wreaking clothes on their slim backs, and maybe a pair of flip-flops (often broken). Mother Young and her panel of fellow matriarchs (all dressed in white and named Elizabeth) do love the children indeed – but the women are getting old, and there are just too many children. Not surprisingly, the kids are starved more for affection than they are for food. As we drive up in the Mercy Ships Land Rover, village children start running beside the car and word of our arrival reaches the orphanage before we do. They start chanting Bowie’s name – BO-WIE! AH-AH-WEE! – and crowd around the car, a sea of white teeth and wide eyes. Searching hands reach out for ours, they stroke our skin and pet my hair, fingering the Greek Orthodox cross around my neck, hungry for loving touch.

Sometimes we’ll play games with them, like soccer (or a variation thereof, i.e., kick the ball and chase it, try not to trip over kids or bushes) or Miss Mary Mack, if I can remember the words (you know you’re old when you’ve forgotten the words to Miss Mary Mack). One time Lucy and I learned how to cook pepper soup from some of the older girls (I’m SO good at pounding hot peppers with a stick, you have no idea), and last Saturday the children took us down to their ‘creek’ where they all wiggled out of their clothes as if they had caught fire and dove in before we knew what was happening.

Most of the time though, I’ll just sit, holding them on my lap and simply being with them, which I think is what they crave the most. When it’s time for us to leave, they get a little quiet and their faces fall, and as we drive away I always feel as though a piece of my heart has broken off and been left behind.




"Suffer the little children to come unto me, and forbid them not; for the kingdom of God belongs to such as these" - Mark 10:14


Note: In response to the dire situation of many orphanages in this country, some ex-Mercy Shippers have actually moved to Liberia and started a group called Orphan Relief and Rescue (http://www.sharingonline.org/orphan-relief/); although there are only five of them, they’re doing what they can to help – take a look!

Monday, April 16, 2007

Bong Mines (and more pictures)



There aren’t very many options for weekend outings here in Liberia, so we have to get a little creative. One of the most popular Saturday trips amongst the Mercy Shippers is the train trip up to the Bong Mines.

The Bong Mines are up country about a 3 hour drive, or 2 hour train ride. The area used to be home to iron mines and a massive electrical plant that supplied all of Monrovia and the surrounding towns, until about 17 years ago when it was attacked at the beginning of the war. They (either the rebel forces or Taylor’s people, can’t remember) wouldn’t allow the operators to put it on bypass, so all the machinery promptly broke and nothing has functioned since.

The train from Monrovia to the Mines, however, is back in operation, making the trip once a day and carrying some small cargo. The last time the ship was here, some of the crewmembers got to know the guys who operate the train, and started a new fad of taking Land Rovers on the flatbed cars up to the Mines. So, last Saturday, I joined a group of 20 or so other crewmembers in an early morning trip to the train tracks, where we drove the Land Rovers onto the train, climbed up on the roofs, and settled in to watch the country go by.

The Liberian countryside is a lush green jungle dotted by typical Africa villages – a few huts in a clearing, connected by footpaths. Most of the people we saw waved as we rode by, after an initial look of confusion to see a bunch of white people on top of cars, on top of a train; the children usually shrieked and ran towards us, arms flailing wildy. We were also waved at by some women taking their bucket showers outside, and a gentleman in the middle of doing his business by the side of the tracks – people are very comfortable with their bodies around here. There was a noticeable lack of wildlife in the jungle, which I was told is attributable to the prolonged war – not because ‘all the animals left during the war’ as one girl put it (I can just see them, a long solemn line of animals refugees fleeing the violence), but more likely because they were eaten during the widespread food shortages.

Bong Mines itself is an eerie place. The colossal skeleton of the power plant sits in a vast valley, stripped bare of everything but its steel frames. The mines have filled in with water, making two or three crystal clear lakes. It was next to one of these lakes that we parked the Land Rovers, unloaded our picnic lunch and set up a tent to shield us from the sun. The whole area seemed dead; the air was still and heavy, and there was nothing alive in the water except for some gray mossy plant-type stuff (I’m sure that was alive – it even tried to eat me a few times, and I only narrowly escaped with my life.) We also found it much harder to swim there than in a normal lake, though I’m still trying to figure out the physics of that (any ideas?).

Despite the unnatural aura of the place, it did have a striking beauty, and we had a lovely time. I spent most of the day in the water, floating around on noodles taken from the ship’s pool and jumping into the water from the surrounding cliffs (ok everyone else jumped, I mostly just floated). On the way home my friend Kristen and I further confused the locals, as if they weren’t already confused enough by the whole white people/Land Rover/train thing, by playing the ipod game most of the way back, which consists of sharing headphones and finding songs you know the word to so you can shout them at the top of your lungs.

All in all, the trip was a great way to explore some of the countryside, understand better why exactly there is no electricity around here (and won’t be for a while), and enjoy some ironic beauty in the midst of Liberia’s ruins.

Thursday, April 12, 2007

Update from the Chop Shop

Some notable excerpts from the surgical schedule for this week (Chop Shop = the operating rooms, according to one dry-humored nurse from New Zealand). Don’t read while eating, and don’t try this at home:

Naval hernia repair – 17 year old male. There are a ton of kids running around with belly buttons that protrude out almost like a banana, some as big as 3 or 4 inches. It’s a result of weakness in the abdominal wall where the umbilical cord used to be so that the intestines kind of hang out, and it usually disappears in children by around 3 years old (from what I can gather online), but it may require surgical repair if it doesn’t fix itself naturally (I’ve been told that it’s exacerbated by incorrect cutting of the umbilical cord, hence the high incidence of it around here, but I haven’t been able to confirm that). Of course, surgical repair is rare in West Africa, so there are a whole lot of belly buttons around that give new meaning to the term ‘outty’, and Mercy Ships takes some of the worst cases to fix.

Removal of bullet from leg – 41 year old male. Pretty self-explanatory. Gun shoots bullet, bullet hits leg and stays there…

Creation of anus – 1.5 week-old infant. Yeah, ouch. Apparently some babies are born without an anus, a condition called imperforate anus, and if they’re lucky, there’s a pediatric surgeon around who can make one for them. If they’re not lucky, they can live for a little while but not too long, and they have other problems during their short lives that I won’t get into. This tiny baby was certainly lucky, as an American pediatric surgeon was in the country at the time, and we happened to have a child anaesthesiologist on board to make the operation possible. Oh, and the baby’s name: Surprise!

Release of ankylosis on right mandible with temporalis muscle flap – 24 year old women. This woman had a disease called Noma when she was 4 year old, which when it goes untreated basically eats at your body, usually your face. The right side of her face was kind of caved in, and her jaw was fused shut by the Noma; she’s been eating through a hole created by several knocked out teeth. The surgeons removed part of the mangled jaw and then used a muscle flap from the top of her head and a piece of bone from the side of her eye to recreate her right cheek, filling out her face and allowing her to move her jaw again – for the first time in 20 years!

Note: I’m trying to describe these conditions as accurately as possible, but strangely enough there’s very little information about, for example, how long a baby with imperforate anus can live without surgery – these sorts of things going unattended in a first-world country is so absurd that the survival rate without treatment isn’t even an issue worth mentioning…

Tuesday, April 10, 2007

How to Start a Business in Liberia

Gas Station: Fill some jugs with gasoline. Buy a funnel. Sit by the side of the road.

Car Wash: Find a river near the road. Make a sign that says ‘Car Wash’. Buy a sponge; soap is optional.

Barber Shop: Buy a razor and find a chair. Set up shop near all the other people with razors and chairs.

Music Store: Obtain a wheelbarrow, a stereo with a speaker (the ones that look like megaphones), and some tapes. Tapes may be used or bootleg. Pile them in the wheelbarrow, tie the speaker to the wheelbarrow, and play tapes really loud while walking around Monrovia.

Super Sterilizer AWAYYYY!!!

My Sierra Leoneon supervisor Dorothy is on vacation, so I’m the new head sterilizer. I’ve started calling myself the Super Sterilizer and humming superhero theme songs whenever I enter the operating rooms. This behaviour is a direct result of the fact that I spent five days in a row last week either on the ship or on the 400-yard stretch of dock in front of it, and only encountered direct sunlight once on Wednesday when I took out the trash, and then again Friday night when I finished work a few minutes before sundown. Point being, I didn’t have much to write about except for skin meshers and dermatomes, so I stole someone else’s story for the week.

Chris is a Canadian (almost American, but not quite…here I digress) who recently started working in medical supply and is planning on going to med school. As far as I can tell, he spends most of his time playing hide-and-seek with his poor boss, and can usually be found hanging around the OR, entertaining us in the sterilizing room or peeking in the operating rooms to see what’s going on. He had Thursday off and went out to work with our land-based Eye Clinic; he came rushing into the OR upon his return to the ship to tell us of his adventures.

Characteristically, he had wondered off from the Eye Clinic to the nearby Redemption Hospital and asked if he could see their OR. Seeing his Mercy Ships scrubs, they brought him right in without further questioning and let him watch three Caesarean Sections. The first delivery was the fourth child of a woman whose previous three babies had died; this was her first living child, and even better in a culture like this where the male offspring of a woman is a reflection of her value, it was a son.

The second operation was on a woman who had already had 17 children, with 10 of them still alive. The doctors decided during the surgery that they were going to tie her fallopian tubes to prevent any further pregnancies; when Chris asked if they had asked her permission, they informed him that ‘No. But it is good.’ Chris then asked if he could take a picture with the surgeon after the operation, and the agreeable surgeon said that of course he could take a picture, and in fact he could take it right away. So everyone in the room stopped what they were doing and turned to smile in the middle of the operation, the surgeon still holding the poor woman’s ill-fated tubes.

Medical ethics, oh my...