Exit Stage Left

On March 31, I left Sierra Leone after ten intense weeks of living with Dr. Barrie and working on two health care projects. I hoped that my final day in Sierra Leone would be both stress- and sweat- free, but Freetown was relentless until the moment I boarded the plane.

My flight out of Lungi airport, located across the bay from Freetown, was scheduled for midnight. Just before 7:30 p.m., I finished washing up and zippered my bag. The last light was disappearing over the hills, and Dr. Barrie and his family were praying by candlelight in the common room. I stood by discreetly for a few minutes and then paced on the balcony a times. Ten minutes passed, and the traffic outside looked menacing. They looked deep in prayer, but I wanted to say goodbye. Finally, their prayers ended. I hugged everyone—Dr. Barrie’s wife, mother, mother-in-law, grandmother-in-law, son, daughter, cousins, and sister-in-law. Many aspects of Sierra Leone would be easy to part with, but I was truly sad to leave these people.

Dan, Dr. Barrie, and I hopped into our vehicle for the short ride to the ferry terminal, but we could not even pull out onto Mountain Cut. The traffic was gridlocked, and the last ferry was scheduled to depart in twenty minutes. We got out of the car, each of us carrying one of my bags, and started walking. With sudden inspiration, Dr. Barrie hailed a passing motorbike. Dan did the same, and soon, with heavy bags on our backs and across our laps, we were weaving in and out of traffic and riding down the center line between immobilized vehicles.

By this time, I had completely sweated through the clothes I would be wearing for the next forty-eight hours. Otherwise, traffic had finally opened up and we were zooming towards the ferry terminal. Our three motorbikes arrived one after the other, and we all laughed in relief. But three men shouted that we would miss the ferry if we didn’t run.

We left Dr. Barrie behind and ran through the terminal and out the other side. The ferry was backed up to a concrete loading ramp leading into the water. The boat was inching away from the ramp, and the boat’s loading stand was lifting. Dan ran ahead to get on the boat, and I struggled with my bags. I watched Dan jump three feet up to the platform and thought I’d never make it. I got up to the base of the ferry and was looking up in defeat when three young men from above grabbed me, bags and all, and lifted me effortlessly onto the boat. They let me catch my breath before demanding a small token for their deed. Then they disappeared into the crowd on the lower level of ferry.

The ferry was completely full of people and their goods and belongings. We sat down on the only empty bench, but soon found out why it was empty. A crazy man stood by and shouted about ice cream for the entire ferry ride. We finally arrived on the other side of the bay, and I caught a local taxi for the last ten kilometers to the airport. For a little extra, I got the front seat in the car. Four other people piled in the back, and we were on our way.

At the airport, generators were running, check-in was smooth, and my flight left on time. I wrote my own baggage ticket, making sure that the letters S-F-O were crystal clear. A man took a picture of my passport with a digital camera. After a completely manual security check, I walked out onto the tarmac in the humid darkness. I was sweaty and exhausted. Culture shock began when I stepped inside the airplane: air conditioning, magazines, light. We were all disinfected with a light aerosol spray, in accordance with WHO regulations. And with that, we were hurling down the runway. I slept all the way to Heathrow, and it was the best I had slept in three months.

Posting!

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Thanks!
Anne

Let There Be Light, Please

Even as I watched from the plane during our descent into Freetown, I took notice of the darkness below. Dim lights lit the runway as we landed, and the roar of a generator took over the roar of the plane when we disembarked and stepped off the tarmac into the airport. As we made our way from the airport, we passed houses with single kerosene lamps marking their doorways. Drinks stands and food vendors used small generators and candles to do business.We arrived in the early hours of the morning to the home of Doctor Barrie, our Sierra Leonean host for the next few months. We hauled our suitcases up a dark stairwell and lit candles once inside. Dr. Barrie's wife brought us some rice and we ate a late supper in the darkness. From my room, I could see the outline of the mountains out the window, and I watched pedestrians loiter in the dark streets below. The roar of a few generators persisted throughout the night. Sometime in the early morning, I noticed the light bulb in my room was illuminated. The electricity was on for two hours before going off again. Last night, when we arrived home, and the electricity was on yet again. I thought I'd take a quick shower while the lights were on, but the minute I sprung to get my towel, the lights went off again. It was shower by candlelight for me. The generators create their own problems. They burn on gasoline, which costs just under five dollars a gallon here. One gallon will burn in a small generator suitable for a house for five to six hours. The generators do not burn cleanly or efficiently, and produce palpable heat in an already-balmy environment. The lack of power dictates every aspect of life here. Factories cannot be built, stifling local economic production and growth. Food is not easily refrigerated in stores or in the homes of local people. Streets are not lit at night. Conducting communication and business are difficult.I'm told that the electricity situation has actually improved in the last few months. A few changes might be responsible. Most noticeably, a new government came to power in November. However, probably more importantly, the World Bank and International Monetary Funds recently cancelled some of the country's debts incurred during the civil war. Before, the government was spending two thirds of the GDP each year to pay off the debt. Now, the funds are free to spend on development, and one result is that Freetown buildings have electricity for at least a few hours on most days.Today there was no electricity, though, so Dr. Barrie turned on the generator for the evening. One reason was so we could get some work done, including financial planning for the next year and the creation of a baseline health survey for 196 households of war amputees in Kono. A second occasion for light was that his mother just arrived home from a pilgrimage to Mecca, and many family members congregated in his apartment.In the evening, it's an odd state here in Freetown. Sounds of generators, car horns, and loud music compete in the street, and people hang out in the darkness. The hiking headlamp I threw into my backpack at the last minute might just turn out to be the most useful item I packed.

Next Stop Sierra Leone

In October, 2007, when I saw Dan Kelly for the first time in three years, we had a lot of catching up to do. I had worked in China for two years, first as a teacher then a travel guide. I decided to apply to medical school and moved to San Francisco to pursue that goal. Dan had finished 3 of 4 medical school years and started a non-profit organization to fight extreme poverty. He had spent six months in Sierra Leone putting two projects in motion.

We started where any old friends would start: pints of beer. Questions, stories, insights poured forth for hours. The conversation continued over the next month, as Dan completed his internal medicine sub-internship in San Francisco.

Meanwhile, I finished up my own medical school applications and considered the timing of a spring trip to Sierra Leone. In fact, ideas about Africa had taken seed almost a year ago when, in an email, Dan casually suggested I come out to help with the projects. Dan doesn’t say anything casually, though.

While Dan was in San Francisco, I asked question after question until I realized that there were a lot of details that I wouldn’t grasp until I went. Just before Thanksgiving, Dan returned to the Bronx to complete his medical school work. I booked a plane ticket to Sierra Leone with a January 11th departure date.

Now, that date is a few days out. My parents’ raised eyebrows and lack of comments on my trip has turned to enthusiastic support as they have learned more about the projects I’ll be working on. I’ve enlightened many United Airlines ticketing agents about the location and pronunciation of the small West African country, population 6 million. And I’ve learned much about the people, culture, and history of a nation that ranks last on the United Nations Best Countries To Live In list, published in November, 2007.

Next week, these conversations and articles will fade into the shadows of reality. Sierra Leoneans face a host of development, health, and reconstruction issues following the recent civil conflict that ended in 2002 with thorough disarmament by a UN team. I will be working in the Kono District to turn four cinderblock walls with a roof into a community clinic, with clinical and public health programs for farmers and their families in the area.

All my experiences are shaped first by my own nationality and culture, but second, and more prominent in my mind, my experiences in China. I’ve done endless comparing in my mind between the place I know and how I imagine Sierra Leone might be. I imagine I’ll gain even more perspectives on development issues in China by having a new example for comparison. The two countries are so different, yet face similar problems: disease, infrastructure issues, corruption, lack of venue for change, widening gulf between rich and poor. In short, both countries face problems of development, and I hope to gain radically new perspectives on poverty and development in Sierra Leone.

I’m also nervous about my personal health and safety. I deeply want to help others, but I also have a healthy sense of self-preservation. I will be exposed to a host of diseases. Will my malaria drugs do their duty? Will my face mask and gloves protect me from tuberculosis or typhoid? If I’m sick, can I get help? Everyday life will pose a challenge as well. Www.weather.com rated the daily UV index as 10+/extreme. My pale skin says ouch. Vegetables are difficult to come by. There are about 600 miles of paved roads in the whole country. All the while, these hardships are likely to be trivial compared to those faced by the people who live there. I expect perspective to be powerful.

As far as safety goes, the media doesn’t bring much good news back from Africa to the United States: genocide, election riots, AIDS, mobilizing warlords, famine, and the winter 2006 Leo DiCaprio flick, “Blood Diamonds.” Currently, Sierra Leone is touted by Lonely Planet as one of the safest places in West Africa, though that can’t be a tough title to claim with the Ivory Coast and Liberia for competition. I’m packing copies of my passport, bringing what little street smarts I have, and kicking the confidence I had in China to explore remote nooks and crannies of the country--at least until I get my bearings.

I also have high expectations for this experience from a different perspective. Whether I’ve been exploring careers, lacking direction, indecisive, whatever it’s called, I’m not anymore. I believe I will be able to unite my varied interests, and that my range of experiences will be an asset to the projects we work on. Furthermore, I hope that I will gain motivation and clarity that will shape my medical education, which begins next fall.

Those are personal expectations. But what about project expectations? I want to alleviate the suffering of individual people. As a teacher, I want to empower people to help and sustain themselves. I want to make a difference. I want to leave in April with a sense that the clinic operation is sustainable. As Jeffrey Sachs notes in his book, “The End of Poverty,” there is a latter of development, and many countries in Africa can’t even get a foot on the bottom rung. For three months, I’m going to join the ranks of others working like crazy to get Sierra Leone’s first foot off the ground.



References in this post:
www.go-act.org
http://www.alertnet.org/thenews/newsdesk/N26420967.htm
Lonely Planet, West Africa
Jeffrey Sachs, The End of Poverty