Thursday, November 27, 2008

Being Thankful

Thanksgiving is hard to explain here because the notion of "thanksgiving" already exists as a mostly Christian event that typically raises money (I think for the church hosting the event--haven't quite figured it out). For example, I was invited to a Mother's Day Thanksgiving this coming Sunday at the New Harvest Ministries, and the invitation is an envelope--so you know right off the bat that this is all about the collection plate. The parade and "Medical Sunday" I wrote about in October was also a Medical Thanksgiving. This makes describing American Thanksgiving a little more difficult. As I told my friend Lisa last night, Halloween was easier to explain because it was an entirely new concept. Plus it's easy to convey in pictures, unlike Thanksgiving, which is a typically American display of overindulgence (in the best way possible, of course) coupled with awkward family moments. Yes, it is also a nice time to have the family all together and to remind oneself to be thankful for what one has. None of this comes out well in pictures.

So, when I say that today is Thanksgiving to the nurses and administrators, it doesn't really come across. Maybe partially because I'm in a country that survived the bad end of colonialism, while American Thanksgiving is a celebration of the arrival of the very kind of people that brought colonialism in the first place. It's sort of weird to explain the history behind it, and it always reminds me that America is in fact a settler colony. The difference between the success of these Anglo-Saxons (and other foreigners, of course) and those that were in, say, Rhodesia/Zimbabwe or South Africa or those French in Algeria is that our forefathers managed to kill off such a large portion of the indigenous population that resistance was easier to quell. That's the simplified version, anyway. And again, sorry to be an obnoxious historian on Thanksgiving--as a foodie, I love the holiday, as a historian, I feel the need to bring this stuff up. I apologize.

But here are a few things that I am thankful for:

--The patients on the ward and the ones that have gone home. They are my emotional stability and the reason that I can get through the frustrating moments. I was looking at pictures of the women who have gone home (I even dreamed that one of them had come back last night), and it made me so happy to think of them getting back to their lives but still sad that I wouldn't see many of them again.
--Gmail. Although it's always dumping me, there is no better way to bother people at work and bombard them with questions about their lives. I do not think I'd have made it this far without it, and the idea of trying to do this without internet or computers is daunting--Thanks, digital age.
--Rat traps and bug spray. Not a lot of explanation needed, though I did try to kill the world's largest cockroach last night and missed, which was not ideal. There was also a wasp the size of my thumb in the kitchen--jet black with an orange warning circle on its butt--but I was too much of a wuss and had to have our caretaker, Amara, kill it.
--Really good fruit and pretty decent bread. You have never tasted a banana until you've gotten away from those nasty American one-variety tasteless ones and tried the fat little yellow ones, the red spicy ones, etc, etc, etc. The papaya here? Amazing. I am so excited for mango season, I don't know how I'm going to make it to March, when the first ones are ready. The handmade Fula bread is pretty nice, especially toasted in the oven.
--My friends and family back in the US and around the world. Some of you have been better than others at keeping in touch, but I love and miss all of you and can't wait to see you all again.
--Being here. Yeah, it's cheesy, but I feel so lucky to be in Bo doing what I'm doing. I love it here. Again, all I have to do is to walk down to the ward and see all the patients sitting together laughing at the television, or remember driving through villages with our speakers blasting outreach advertisements while women scramble to write down our number with their fingers in the dirt, or dream about the plans for a ward garden that will be started in January, and that's enough for me--it beats getting stared at all the time, or being seen as another foreigner with endless amounts of cash, or having my head bang against the car window as we navigate a bad road.

I know it's been a tough year economically, which always dampens the holidays, but I hope all of you (Americans at least) are having a good day with family and friends and that you take time to think about what you're really thankful for. I won't get into one of those self-righteous "be-thankful-for-what-you-have" rants, no worries.

Oh, and to end, I have to put two very nice opinion pieces in the New York Times about Thanksgiving history and food. Two of my greatest loves.

Tuesday, November 25, 2008

Sutures

In my inventorying duties, I sorted thousands of surgical sutures (the needle and thread that you use to sew up a patient) into grey plastic bins by a tiny number at the top of each packet. These were homeless sutures that had been taken out of boxes or that had fallen out or that were rescued from boxes that were falling apart. At best, a tedious enterprise. I spread them out over the living room floor in a carefully-constructed system so that each bins of sutures of the same type (silk, prolene, chromic catgut--my favorite) were touching and unlike sutures were not. This task satisfied my compulsive list-making sickness but reaffirmed that I have a difficult time with small repetitive tasks. We finally got them over to the office today, a somewhat anxious procedure for me as we had to put the topless bins in the car to be jostled around on the bad roads. Fortunately they all made it, and they were counted and stacked into neat rows and inventoried. Actual "packing" into the storeroom is pending, but I am triumphant as I write that, barring earthquake or civil unrest (both pretty unlikely), we have won the suture war. My war against the insects, however, is not going well ever since our d├ętente failed in early November. One step at a time.

Friday, November 21, 2008

Catching Up

Wow, it's been a long time since I've posted. Since Barack Obama won the election, I've been out on a mini-vacation to the Banana Islands off the Freetown area coast, attended countless meetings, ridden government buses for a total of 18 hours, and attempted to make cookies, which came out weirdly cakey from the powdered milk and margarine and blackened on the bottom from the intense heat of the oven, which does not go much below 400 Degrees Fahrenheit. Not sure what you're supposed to cook in there, though it makes great toast.

We've now sent off twelve patients and gotten I think 10 more from various outreach programs. We sent nurses out to the rural areas, and they recruited patients through advertising on the radio and driving around in the car with a megaphone blasting, as well as collaborating with our outreach coordinators and various friends in the public health/medical sector in different regions. Some patients were sent solo and picked up at the lorry park, others came with nurses, and some are staying home until after the holidays and the local chieftancy elections. Which is good because it means that these women are voting and are passionate enough about voting to put off their medical problems.

Banana Island was a strange, almost eerily sleepy place. The trees were imposing but beautiful, old buttressed cotton trees that shaded the beaches. We had to cross through the jungle to get to the best beach (Big Sand Beach). I saw vines crisscrossing up trunks and choking the trees, so incorporated into their hosts that I couldn't tell where one plant ended and the other began. Tiny flowers peeked out from the dark soil, and termites demonstrated their presence in jutting mounds and in the fallen branches on the ground that had been eaten from the inside out, so that they were left as sawdust in the shape of branches. The water was warm but cool enough to stay in for hours, the high salt of the water making it easy to lie, toes pointing upwards, and float on the waves. I managed to borrow a pair of goggles for a few minutes and watched subtly beautiful fish--small but bright, or large but only colorful when they caught the light the right way. The tideline detrius was not what one typically sees at the beach--shells, kelp, bits of styrofoam and sea glass. Rather, it was jungle castoffs from the trees threatening to overtake the water--vivid green praying mantises, small red bugs with huge antennae, leaves in various states of decay, and strange seed pods and plant buds plucked off by wind and driven into the water. We ate fresh fish grilled for us on charcoal fires and lobsters caught in traps and stored, live, until dinner. We swam at night, using the moon and the bonfire lit for us to keep our bearings and slept all day on the beach between swimming and volleyball (I didn't play--not a great game for we shorter ones). Like many things here, it had that element of decay or of recovery that I've sensed in parades and ramshackle buildings and the little kerosene lamps lit for nightmarkets. I also traveled out to the village of Charlotte outside of Freetown before heading to Banana, and it was much the same--old, mossy walls, rusting zinc-walled Krio houses, a shaded garden of found objects, plants potted in old shampoo bottles and benches made of car scrap metal. Children fishing with string and a bent nail. There was also a waterfall.

The new patients are quiet but already seem to have integrated into the "family"--they're getting their hair braided, carrying water (still no water at the hospital and the Bowser water trucks can't come today because the dam has some problems that has prevented them from being filled), watching soap operas. We're trying out best to fatten them up for surgery. We also have a new baby on the ward, who is going to be named Julia, I am told. I find this completely terrifying--there is something very scary in having a little life named after you, especially when you did nothing to merit it. The baby is huge, her head still deformed a bit from the natural birth, but the labor was quick, I'm told.

The calm or feeling of commonplace-ness that surrounds these births is also so new to me. The mother started feeling pains at 7pm, waited until midnight to tell the nurse, who waited until 4AM to tell the doctor that she was ready to deliver. It was treated like no big deal, and the mother was up and walking around just a few hours later and was out carrying water today. Women routinely do hard manual labor in their later terms, walking long distances with heavy loads for the market or fetching water. I know this is all healthy and fine, but it's so funny compared with the lack of this commonplace-ness in the US, which is partly because you don't see as many pregnant women or hear about as many births. I've been around more pregnant women in the past couple of months than I have in my entire life, though I guess it's cheating a bit since I'm in a hospital. All the same, I see tons of pregnant women walking around on the street just on my drive to and from the hospital. I once tried to compare the number of pregnant women I see everyday to the number of men I see urinating in public, but it was too hard to count because there was one or the other or both at every turn.

So, things are changing and progress is being made. My own activities have been relatively uninteresting--inventorying, writing documents, signing things, etc--but I feel like we're getting there, or getting somewhere. Sorry for the long delay between posts--I'm hoping the internet at the hospital continues to hold out, because otherwise it's hard to stay up-to-date.

Tuesday, November 4, 2008

Staying Out of the Hammock

I feel so far away from the U.S. here that I can't accept the election is today and that in a few hours, the polls will open. There is constant talk about the election--everyone has asked me whether I'm voting for Obama or McCain--and the radio has been buzzing with it, especially the BBC, which has termed it "the U.S. election--the vote that effects your world." It's amazing and a bit embarrassing that people here know more about the election than I do and actually listen to the campaign speeches. It really shows how prominent the U.S. is globally and how important this vote is, not just for we Americans, but for everyone. It actually makes me a little sad that I'm not home to witness this, "the most watched election in history," though I'm so apathetic at this point (heartbroken would be more like it) that probably I'd be even more removed than I am now if I were back in Ojai. I was listening to the BBC's special "Black in America" series this morning. The segment was on Morehouse and there was a discussion about MLK. I was shocked upon remembering how recently the entire nation was essentially at war over civil rights. A couple of days ago, thinking about the psychic damage that civil war inflicts on a nation and the differences and rivalries that still exist between North and South, and realized the American Civil War wasn't that long ago either. In Senegal I sadly corrected friends of mine who said that they wanted to go to America rather than France because there was no racism there--that we'd solved that issue with the civil rights movement.

Race in Sierra Leone is a strange thing. There are definite colonial throwbacks, where white people working for the NGOs have instituted behaviors and have expectations of treatment that I find extremely uncomfortable. Being given more food during parties and gatherings is one example. I've been called "a real African lady" because I do some of my own laundry, occasionally eat local food, (very) rarely wear African clothes, and carry things around, like shopping bags, chairs, and other items, both heavy and light. I'm not tooting my own horn here for being such a good person that I carry my own bags; what I'm trying to say is that the expectations of what expats/white people are capable or willing of doing is very low because many of those pumoi (the Mende word for foreigner) don't do anything for themselves. It's actually a little frustrating at times to have everyone on the staff smile at me encouragingly because I was able to figure out cooking okra all on my own. This frustration comes out of embarrassment that the people who come here to work for NGOs allow others to do the things they should be doing for themselves. I'm not saying everyone who comes here to volunteer should do all their own laundry (I'm certainly not capable of washing my own sheets by hand), but I think that there is a fine line between seeking out help when you need it and becoming a neocolonialist. The image (that I've already evoked) of French colonial administrators getting carried around in hammocks on their tours through "the bush," while lines of forced porters carry their clothes, phonographs, pernod, carpets, and tents behind them, never leaves me.

Furthermore, I've had confusing conversations with a few merchants of Lebanese origin (most of them were born in SL but don't have citizenship--a sticky subject). They consider themselves Africans but hold themselves apart, generally speaking, and there's a continual "us and them" mentality, even for the black Sierra Leoneans that have worked for them for years. One Lebanese diamond merchant said that the reason why Sierra Leone was "backwards" (his words, not mine) was because they kept their "superstitious" beliefs. Another Lebanese shopkeeper said that "they" can't be trusted because his workers steal from the shelves. In both cases, I didn't know what to say. There's also some tension in this of class/economics, since the Lebanese community has a fair amount of influence, despite its lack of citizenship (and vote, I think--I keep hearing different things) and has cornered the diamond market. Most of the merchants we buy bulk food from are Lebanese, and every "supermarket" has a Lebanese son behind the register.

I think about all of this often but don't have much concretely figured out. What I've written here feels clumsy. Race and racism is complicated here, as it is anywhere. The system is always different and is always subject to the history of the place. Racism in France is different from racism in the U.S. is different from racism in Sierra Leone. I try to be aware of my behavior, speech, and expectations, so that I don't end up in that "us and them" mentality that is so easy to accept, especially as a foreigner as well as being of a different race. And I continue to seek out what the different communities think of each other here. And, I keep washing my own underwear by hand because that, I can do on my own.