Saturday, 19 December 2009

Photos! stuck in mud & view from balcony





Political Correctness

Just does not exist here. They would not recogise it if it bit them in the bottom. Every time we leave the house we get 'oporto' yelled at us, mainly by children but sometimes by adults as in 'oporto, come over here!' Oporto means white person. Lots of us find it very wearing after a while.
Itry to hear it as my name or as hello, but it does not always work. why has my type gone funny? Sorry. Can you imagine what would happen if we yelled ’black man’ all the time in London?

They can’t tell us apart at all as we all look the same to them, as they will very cheerfully tell you. They sometimes call the Filipinos ’ching chong’, thinking they are Chinese. My housemate Annette is Filipina and people think she is my daughter.

They have a totally different of concept of body image, too.  Not long after I arrived a man asked me if I was English and when I asked him how he knew he said it was because we all have fat bodies! He meant it as a compliment as that is what they like. Fat=prosperous. When we went to Tiwai island 2 weeks ago and slept in tents, the man said the fat one (me) should have the biggest tent. Again, a compliment in his terms but not in mine. For anyone who does not know me, I could certainly lose some weight (and am over here) but I am not grossly overweight. I don’t get upset really but it gets irritating.

There is no privacy at all here Life is lived on the steet in public, like a goldfish bowl.  It is hot and most of their homes aren’t good, so it’s much better to be outside. Meals are taken outside from a communal plate. They think we are really odd eating inside, behind our compound wall. And maybe we are.

They watch everything we do, which some expats have failed to grasp unfortunately. My housemate Celine (who returned to Canada yesterday) told me when she first came here she went for a drink at a bar and was told the following day exactly what she’d had to drink and who her companions were. Still,  the upside is that if you can’t find your friend you just ask anyone ’where my paddy?’ (friend) and they say she just went into the bank.

Who needs CCTV cameras? 

Saturday, 12 December 2009

Food

Before Food, my apologies for the delay in contacting anyone. Internet access has been a nightmare recently and I won't bother you with the details. I am currently borrowing the modem stick (as a dongle is called here) from some friends who are currently in the UK and I cannot access my email account for some reason, so I hope you all find this.

So to the important subject of food, glorious food. Not so glorious for me here, but I am losing weight. When I first came to Makeni, I could not sort out at all how to find food. There is a very scary market which is really crowded with motorbikes weaving in and out and you go through to a covered bit where the food is. And no motorbikes in there at least. But there was not much there, just sweet potatoes, some onions, a few beans. I did see a butcher but did not dare go near it. How I longed for Borough Market. There are stalls out in the streets where they sell fruit and some vegetables and, of course, food is very seasonal here. But then they do this odd thing of having about 10 little stalls along the road but they all sell the same thing! So if you want oranges and onions you have to walk about half a kilometre in 30 degrees plus heat. But then St. Mary's opened. I did write before that it is like Harrods food hall to us (or was it Fortnum's?) but please don't think of that too literally. It is more like a small Somerfield with some household goods in it. But it was such an improvement. It is relatively expensive and will put some of the small traders out of business but the goods are much better.

Today for breakfast I had oatmeal (porridge to us English) which is made from quick cook oats in a tin. I have not had fresh milk since I came to this country and we have dried milk, so I make some up with hot water and put on the porridge and add some maple syrup. Then I make instant coffee with the rest of the milk. My housemate Celine and I walked to St. Mary's fairly early this morning to get some things as we have friends coming over tomorrow. We got 2 bottles of red wine (quite good) as we cannot chill white: no fridge. We found some sliced processed cheese and got very excited and bought that (yes, really) and they had a plate of small, not brilliant tomatoes in the chiller so we got those too. I bought nice bread outside and when we got home we had bread, cheese and tomatoes. And really enjoyed it. I had only had 2 slivers of tomato in sandwiches since I had been there.

I also bought what they call Irish potatoes, to distinguish them from the more common sweet potatoes and I am having garlic mashed potatoes tonight and I shall start when I have finished writing to you, my dear friends. I have no protein to go with them so I may open a tin of green beans. Oh, yes. I very happily spent almost 3 pounds sterling on a tin of
Ambrosia rice pudding a few weeks ago and am hording it for a rainy day. Also, I have had some fresh pineapple which I bought 2 days ago for about one pound 20 pence, which is the equivalent of 2 days pay for a manual worker.

As I said, we have no fridge and in fact it is more sensible to have a freezer. Then you put the generator on in the evening and the freezer functions as a fridge, as fridges don't like to be on for only 4 or so hours a day. In fact, it is pointless. We cook on a 2 ring hob which is powered by calor gas, and we can now get this from St. Mary's (they do ice cream too). When I got here you had to get calor from Freetown (115 miles away). Some people cook on kerosene which stinks to high heaven and most of the locals cook on open fires. Picturesque but medieval, I think.

Tomorrow our friends will bring some food as they like cooking and have better facilities. We are planning to go and get some haloumi cheese and fry it with garlic (no grill) and make some potato salad. And drink wine!

Did you know you can freeze eggs? I had no idea until the St. Mary's man (Lebanese, like most of the enterprising people here) said that the ones we had been buying in the street were frozen ones imported from Europe. His are fresh farm eggs. Egg boxes are unknown here and you carry them home in a plastic bag. You can imagine the results. I often put them in my crash helmet. I also buy Heinz baked beans (there are strong rumours that St. Mary's will be stocking bacon. I wake up hallucinating that I smell it frying) and I have HP sauce. I have started eating Marmite! I hate it but treat it as medicine. Oh, yes, I got some marmalade today, too.

If you have a vehicle, the common way to shop is to pull up outside the shop (small, open fronted shack really) and yell 'bread!" or whatever you want and they come running over. I think I will try it outside Waitrose when I get home and see what happens.

They have also recently opened a new restaurant, which is the best here. Again, do not get too excited as all things are relative. The service is much better there as the man who owns it spent 5 years in London and understands the concept of customer service, which is generally unknown here. You can go even to the 'posh' hotel (not very), order something very indifferent, wait half an hour only to have them saunter up and tell you they haven't got it.

When I come back home, I am going to eat bacon and eggs and drink fresh milk. I shall eat clotted cream until it comes out of my ears. And no doubt regain any weight I have lost. I had thought I was not particularly interested in food. Oh but I am!

Friday, 13 November 2009

Work


It is time to write about work. I have been avoiding it but think I can do so no longer. It may not be for the faint hearted amongst you. I work short hours; I usually get to the hospital about 9am, sometimes later and leave by 3. Today I left about 1.30 as I had had enough. No-one chases me and I am deciding my own work. My mission (should I choose to accept it; oh no, I have already) is to increase the capacity of the staff in maternity and to provide on the job training. So I spent the last 2 weeks observing and just trying to understand what is going on. I don't think I have succeeded in that, but maybe it will come with time. My main concern is the maternity ward, as the ante natal clinic runs fairly well. The Mat ward has anyone on it who is pregnant, in labour, delivered or what ever. So today we have 12 out of 13 beds full with cases from abortion (illegal here), to post natals of about 3 weeks. We have very little equipment. I saw that baby checks were not being carried out and so I started training staff how to do them and in the first 2 days we picked up one septic baby and one with birth asphyxia. The first one got the only suitable size cannula for his IV, so when the 2nd one needed an IV line we had problems. Then we found one in my office, but the dr. missed the vein first so had to use the same one again. Then I saw the following day that the cannula was in the baby's foot; it must have been the same one as we had no others. I read before I came out here that medical care for mothers and babies is free. Let me tell you it is not. They pay for their paper notes when they come in, they pay for equipment and drugs. A few drugs are supplied by the hospital but they run out quickly. So the babies only got some of their antibiotics as the parents could not pay for the full course and this is bad practice as regards resistance to anti biotics. They both improved. The delivery room is terrible; high hard tables in an unclean room. Everything is unclean. There is one bottle of 'soap' in the delivery room and we wash our hands with chorine water. There is nothing to dry them on. None of the toilets flush or have soap. The patients go outside to the loo. We have electricity only when the generator is one (for operations) so it goes without saying there are no CTGs or drug pumps or anything like that. I have not yet seen a birth here (pain relief only for CS) so that will be interesting. The reason I left early today was that we had a 21 year old in who had delivered her first twin on 11th Nov. in the afternoon in a maternal and child health post out in a village somewhere. She came in with someone in a uniform of sorts who had done the delivery (so I think not an untrained trad. birth attendent) but the second twin was not yet born. What followed was not good. The baby will certainly be dead. Why leave her for nearly 2 days before coming in??? She was transferred out just before I left to another local (and better) hospital. Still with the baby unborn. My aim is to get some organisation into the ward before I can do anything else. It is run by unqualified staff and the odd student, while the midwife in charge is elsewhere (often asleep). They do not allocate staff to patients, so 'care' is extremely haphazard. Drugs don't get given, sutures not removed etc.etc. They have wonderful staffing levels; 10 staff for 13 patients (excluding me) but they all move about the ward together like a shoal of fish. The consequence is that no-one has any responsibility. There are other things; labours of 6 days resulting in ruptured uterii, eclamptic fits. It's all good learning!

Monday, 9 November 2009

My weekend

Was the last post a bit negative? This will be more positive, I promise. I will describe to you my last weekend as I can't quite get round to telling you yet about work. I have also neglected to tell you about my house mates: Kiki who is a Dutch nurse and is staying here until she can go to her placement about 15miles away, Annette who is a nurse tutor at the Northern Poly here in Makeni (from the Philipines) and Celine from Canada, who does the same job as Annette. So that's us.

Annette had some friends going to Bo, which is another city (town really) some distance away, I don't know how far, but when there is a ride, it's a good idea to take it. So we met up in Makeni: Father Edgar (priest), two Marias who live in Yele (part way to Bo) and me. Oh, we also had a chicken in the truck (live). We had a fun journey to Yele to see the lovely house there where the Marias live - facing the river in a lovely setting - and then we all went off to Bo on these roads that are like nothing on earth! Full of pot holes that even a 4 wheel drive found difficult to negotiate. We met an 'unofficial' road block - a tree across the road - which is how some people earn money here. Edgar got out to pay and pointed to me, the man smiled and waved. He was apparently telling him it was my birthday (it wasn't) and he let us off cheaper. Then we stopped to buy some massive grapefruit at the road side. These cost 100 Le each (6000 = 1 pound sterling) and again there was pointing and smiling. It was my birthday again! I said to Edgar: "for a priest you tell an awful lot of lies" and they all roared with laughter. And that was what the whole trip was like; lots of laughter. Philipinos like to laugh and eat and are great company. So we arrived in Bo and went to where we were going to stay, but after a couple of hours I was offered the chance to ride home again that night with Edgar and the 2 Marias as far as Yele, so I took it. The alternative was to get the poda poda (rickety old bus) back the following day. We dropped off the Marias and Edgar and I continued on the bumpy roads. We found the road blocked by a truck at one stage and just managed to squeeze past it. The front wheel had fallen off. No maintenance here, you see. There was a man lying on the bonnet and I thought he was dead, but no. It seems that is what they do: the truck breaks down and you sleep on the bonnet till help comes. Help was not us, in this case as we drove on. It was a journey Father E described as the night I drove through Sierra Leone with a crazy priest and he wasn't wrong.

The sky here is wonderful at night; no mains electricity means no light polution so you can really see the stars and it is wonderful.

Also good: twice last week I got motor bike taxis (how we get around in Makeni) and when the driver found I was English said how wonderful being colonized by us was and we are all family. I joined the public library when I got here. On my second visit, the motor bike taxe drove me straight up the front garden right to the front door and the library man said to me "hello Anne". I have never been remembered by name in a UK library before. But then I have probably never been the only white library member before either!

Wednesday, 4 November 2009

Everyday life in SL

So still no photos and I am sorry about that but I will try very hard to get some up soon.

I am now in Makeni, having arrived here nearly 3 weeks ago now. It was a nice journey up here in a decent vehicle (don't get many trips in that so we enjoy them when we do travel in it). The country is really beautiful, very lush and verdant with mountains (or big hills maybe). The human georgraphy is not so great! Makeni has city status but if you come from somewhere like London, it's just a town. I live in a detached single storey house in a compound: ie it is surrounded by a wall with a locked gate. There is razor wire atop the wall and spikes on the gate. In Sierra Leoneon terms, it is a good house; we have four bedrooms with the master having an en-suite bathroom and verandah and study. The other bedrooms share a bathroom. We have a kitchen, dining area and sitting room. There is also accomodation for servants out in the back yard. We live much better than our neighbours over the road (shanty type dwellings) but don't think of my housing in western terms! Maintainance is not a readily understood concept over here. You build something and then that's it! You leave it to its own devices. So our loo has not been flushing (buckets again! Where would we be without them?), the 'shower' is a trickle, we have no mains electricity in common with the rest of this town, so no fridge/freezer, tv etc etc. It makes life boring.

To those of you I told I wanted a simpler life: I was wrong. It is not simpler but just difficult in a different way. We buy rice, for instance, loose and this means you have to pick through it to get out the stones and insects! It took me about 45 minutes to work through a bowl for 4 last week. The shops are not what you would consider shops for the most part. There are a few Lebanese supermarkets (not much stuff in them) and the rest is stalls by the side of the road or bits for sale on people's verandahs. I didn't recognise some of them as shops at first. The food here is very limited and the cost is going up all the time. That is ok for me but not if one onion costs about a quarter of your daily income, as it does for most locals. Life is hard here; I can and will come back but not everyone can. I am so glad I was born in the developed world.

Transport is a nightmare. We (the Brits) left a railway behind which was dismantled. I don't know why. Hardly any of the vehicles on the road are road worthy. When one of my house mates and I came back from Freetown last week we paid for the middle row of a 3 row vehicle. The driver got 2 men in the passenger seat and four in the row behind us!

I don't want anyone to think I am not ok: I am. It is just all quite strange and I have so much to learn. Time is doing very odd things; I really feel I have been here at least 3 months or so and can't believe I was in the UK a month back. I will try to write about work next time; that's a whole different ball game!

Thursday, 15 October 2009

Second installment

Our water had disappeared the last time I wrote. This meant I had to learn how to do a great deal with about two thirds of a bucket of water and I am now going to pass this on to you, gentle reader, in case you should ever be in the same situation.

So - you will need your bucket of water, another bowl and a small bowl for scooping up water. Set the bucket in the shower tray, take out about one third and place in the other bowl. This small bowl your washing portion. The rest is for rinsing. Dunk your head in the rinsing one till your hair is good and wet. Apply shampoo and lather it up. Then wash your body using the water in the soapy water bowl. You will find that the shampoo runs down you and this helps. Scoop some water out of the clean water bucket and rinse your hair, the apply conditioner if strictly necessary and rinse this off. When you are happy with your head being as clean as it can be, rinse the soap off the rest of you. If you can, catch any water or if there is any left in any bowl or bucket can be used to flush the toilet. Don't overdo the shampoo.

On Tuesday and Wednesday this week I was at a workshop at the Ministry of Health about the training of Community Health Workers. It was helpful to see how the meetings were run. And I also met someone from the Medical Research Council who are building the new midwifery training school in Makeni. It seems they have been ordering teaching aids and computers, so things look quite positive. I may be spending some of my time there. Today we went to the office for a security briefing with the man who deals with such things. I don't want to worry you all but you can maybe imagine with all the poverty around here, crime is a problem. We got back to the house to find our external door is actually locked now, so that's an improvement. We do have a steel door to the flat and a wooden one inside that.

My good news of the day is that I am supposed to go to Makeni tomorrow (Fri). I am looking forward to that and think it will be good to be 'up country' as they say here. I bought some stuff for the Makeni house to take up tomorrow: it's from a Lebanese supermarket and is way too expensive: about £20 for a small frying pan! One of the 2 paediatricians in SL is paid US$400 per month, if that puts it in perspective. I'll see what I can get from the road side stalls. One strange thing here (among so many - I often see men walking with toilets on their heads) is the seemingly 'high class' bedroom and dining room furniture that is on sale at the side of the roads. You go through these very slummy areas with the rubbish and open drains and, lo and behold, there is a bedroom suite which you would expect to see in Walworth Road, SE London (ie not to my personal taste, bit fancy).

House mate just came in saying there is a mouse at the bottom of the stairs; just like my flat in London then!

Monday, 12 October 2009

I have arrived!


Here I am in Sierra Leone. I arrived in Freetown last Friday evening after an ok flight and I had been quite worried about not being met and all those things. However, it was all fine; the driver was there and I was on the first helicopter out over the estuary. It seems the airport is on the other side of the water from the city because that is where the British airbase was and they used that infrastructure.

What can I tell you about the helicopter ride? I hadn't been on one of those things before and it was quite an unnerving experience. It was old, probably ex-military and not a little scary. We sat 10 each side on benches with the luggage on the floor in front of us, covered by a mesh. You just knew the mesh could not possibly hold those suitcases in place if tested by adverse conditions. Fortunately it was not tested and we landed without mishap after much shuddering and juddering. Then the ride over the pot holes in the road was interesting; the driver was testing me on my Krio and was very impressed that I know 'how de body?' and 'I tell got tenki' mean 'how are you?' and 'I'm fine'.

So I am living for the moment with Henning and his wife Fiona. We live in a fairly large apartment on the first floor at the west end of the city, which is the poshest bit. This is a relative term: it is not what you would consider swanky at all. The photo is a view from the balcony. The night I arrived the mains water failed; that was 3 nights ago and we suspect and hope it may be back on now. We don't want to get too excited about it as it may go again. We buy drinking water in plastic bags and get water for other things from a stand pipe down the lane. This may sound picturesque but the lane is a pot-hole riddled little street full of litter and stones and it involved climbing over a narrow step and walking alongside an open sewer to get the water. Now I know what water shortages would mean for us in the developed world; it makes life really difficult and you devote a lot of each day worrying about it. I so remember soaking in deep, bubbly baths in the UK. Well, I actually wouldn't want to as it is so hot I am sweating all the time anyway so a cold shower might be the thing. Dream on.

We did a tour around Freetown on Saturday (not very much to see, really) and ended up at the beach. Sunday also saw us ending up at the beach. Today I went to the office with another new volunteer and we did some of the induction I missed as I was delayed in coming over. I am hopeful I may get to Makeni on Friday.

I am happy here; everything has been fine and the big worry is water but I know that so many of the rest of the world have that problem every day. Things are relatively cheap but as there are 6000 Leones to the pound, they always sound expensive. The taxi rides are 800 L and that is the main way of getting around, apart from the poda-podas (mini buses) which cost the same but take you further. My impressions are of lots of noise all the time; music is only played at one volume and that is LOUD. We have had some amazing thunderstorms. It is the end of the rainy season and our verandah looks out towards the bay; tonight we had a show that was something like I imagine the Northern lights to be, with 3 or 4 patches of lightening cracking though dancing clouds of rain mist. The legacy of the war is still apparent, with amputees in the streets and it seems the people hoped that things would improve rather quicker than they have done since they regained democracy. There are so many NGOs here; someone told me 20% of all vehicles in Freetown are NGO ones. We all wonder how that looks to the people in the slums.

Ok, so I will sign off now and hope to add some photos and things later. At the moment I have mains electricity but won't in Makeni, so I will have to see how it goes.

Anne

Thursday, 8 October 2009

Getting things working

I had great trouble getting things to work but now this blog works - not the address I wanted but it is good enough.

Thanks Paul