Resurfacing

It’s been so long since I’ve written here. My friend Jim wrote over on his blog that after a long time, coming back to writing to attack the big stories or events or thoughts is difficult, if not impossible. Which is my sorry excuse for this long absence. How do I fill in the gaps from the past months?

Our Book Keeper, Musa, died of a stroke, suddenly and unexpectedly. I turned 23 the next day. A patient gave birth to twins and once the stress of her pregnancy subsided, she stopped leaking urine. An employee celebrated her engagement to our landlord with a traditional ceremony that included the presentation of kola nuts, envelopes of cash handed out to the many relatives of the bride, and three decoy brides before the entrance of the genuine article. We took the patients to an orphanage for Easter and had a “lolly hunt” and kite flying and dancing and singing. We hired a third driver, an administrator, a nursing director. We are in the process of hiring an accountant. I stopped my work as the Acting Administrator and took over as the Acting Finance Officer. I crunch numbers, I think.

Dr. Maggi came and many operations were done and hordes of patients sent home dry or to wait for more complicated surgery. We renovated a ward for skills training and as a living area for those few patients that have become part of our staff. The pump that WAFF donated to the hospital broke. The garden dried up. When the water truck breaks down, the patients carry water from the hand pump installed near our office, which means that they pop their heads in and ask, while watching me read the paper online, whether the pictures of New York Times Op-Ed columnists are of members of my family. The volunteers found a new walk across scorched fields and through tunnels of green thickets to a tiny village close enough to the road that we could hear trucks rushing by on their way to Freetown but remote enough that we were unsure how the nine-months pregnant woman we met would ever make it to a hospital when she went into labor. Many volunteers came and went and are still asked after now that they are gone.

I was bitten by countless mosquitoes, awakened by countless mice, tempted to pet countless dogs. I hit a rooster with a pillow after it crowed too early too near my window. It was the burning season, and I awoke from an afternoon sleep more than once to flames reaching higher than our wall, stopped only by a short stretch of road, taking trees and leaving termite mounds, driving mice and snakes into the safety of concrete houses. It was the first straining moments of the rainy season and I sweated through my clothes several times, waiting in the blackouts for rain to come as a relief to the dusty wind, to the unbearable heat, to the thick humidity, only to be disappointed day after day. It rained and kept me from sleeping as the drops pounded the zinc roof until it sounded like a flood would wash us away. It has not rained since and the strain has returned.

Everything moves along much as it did before, with new things flaring up here and there, with things coming together and falling apart. Things are as they are. Ideas become projects become accomplishments, or they shrivel while still ideas or fail as projects or are shuffled off before they can reach the stage of being termed accomplishments. Patients, staff, and volunteers come and go. I will be one of the ones going, after some time in Morocco. In a month, I will be home.

unfortunately, no medical excuse for gin and tonics

When I woke up last Thursday, I knew something was off. My neck was stiff and my body ached. Helen calls this a cellular ache. Everything hurt—my eyeballs, my liver, my back, my hair. But that was all that seemed wrong. I figured I’d go to work and come home if things got worse. I lurched out of the car and sat down in the office, assessing within the first five minutes that I needed to go back to the house. Once I got home, the chills set in—it was at least eighty degrees outside, and my nose was cold. Anything touching me was painful, but it worse to be out of the sheets. I tried to imagine being suspended in warm air. The door to my room seemed to zoom in and out, and time slowed to crawl. I tossed and turned, sleeping on and off in the morning and awaking once the chills diminished and my temperature went over a hundred and two in a frighteningly short amount of time. At this point, I took some Tylenol, which dropped me down to a comfortable 99.9, lessened the aches, and brought back a bit of an appetite. It also makes you sweat like crazy, so I spent the afternoon drenched and stinky. WALL-E restored some comfort as well, until my computer battery crapped out. I made the mistake of picking up a book we have at the house that talks about all the various diseases that you can catch in Africa, which gave me several hemorrhagic fevers, infections, parasites, and typhoid as possibilities, though I was pretty sure this was malaria. I’d stopped my anti-malarials, figuring that nine months on antibiotics that make you photosensitive would be a bad idea. I had a treated mosquito net and tried to wear bug spray, but that wasn’t enough, even in the dry season. My dad later called me an idiot, which I guess I had coming.

The volunteers came back, and Helen and I decided it would be wise to get a malaria test the next day. I spent the night mostly awake, running to and from the bathroom, which was neither pleasant for me or for Helen, who woke up every time I got out of bed due to the loud creaks the slats make. She was a wonderful nurse, advising me on what to take, giving me the oral rehydrating salts and Tylenol that I of course did not bring myself, making me drink fluids, flipping my mattress, and even offering to give me a sponge bath (I declined). After spending the morning completely limp and wiped out, I somehow climbed into the Land Cruiser, dizzy from being emptied out, and went to the hospital, where our office neighbor told me that she would “pray for my life” so that I could return to my family in the US alive. This was not reassuring.

Helen I went to the Rayan Laboratory with an order from our Medical Director for blood tests for typhoid and malaria. The building was run down, with peeling paint and the black patches of mildew that gather on all walls in tropical climes. There were horrific posters of the oral sores that most often manifest in HIV-positive patients on the wall. I was a bit nervous, given the infection control methods and bedside manner I’d witnessed in various healthcare situations I’ve experienced here, but the receptionist was fast and efficient. I didn’t even wait five minutes before I was sitting in a high chair (I felt like a small child at the dinner table again) watching the lab tech pull out a fresh pair of gloves and a syringe in a sterile package. Helen looked on with hawk’s eyes, which was reassuring. He pulled the tiniest piece off a cotton ball and swabbed my arm. When he put the strap around my upper arm, he apologized. Please excuse, he said. He found my vein faster than any other nurse, doctor, or blood mobile technician I’ve ever had take my blood, apologizing again—excuse—before sticking me. I was struck by how polite this was—so much better than having someone say Ok, you’re going to feel a slight pinch. He then pulled off another tiny piece of cotton and a tiny piece of cloth tape and bandaged what would become a very nice track mark. Despite the fact that there was no sharps container, everything was done very nicely—labels on the vials, new gloves, needle opened in front of the patient, irreproachable bedside manner. The only scary part came when Helen said, just before he stuck me Are you OK getting blood drawn? I thought this was a polite way of saying This guy did something wrong, which was not exactly soothing as the needle was coming closer, but it turns out she meant Are you going to pass out? Which I did not. The results came back a few hours later—right on time, shockingly—as P. falciparum, the most common, most dangerous, and most responsive to treatment of the four strains of malaria. Falciparum can cause brain hemorrhaging if left untreated but is not recurrent.

Contracting malaria made me think about several things. First off, malaria is strange as a concept because it can be taken so seriously and so lightly. At home, malaria is thought of as some terrible, debilitating illness that leaves the victim in a hallucinatory, feverish nightmare. In Sierra Leone and probably most malarial zones in sub-Saharan Africa, malaria is commonplace, something that makes you feel bad for a bit, but not a big deal—people here will often come in to work, and many won’t use bed nets because they are too hot (true) and claustrophobic.

What malaria should be seen as, for both the US and Sierra Leone, for the Global North and the Global South (or developed and developing countries—there is no good term for this), is as the great killer in Africa and in tropical zones around the globe. Malaria kills more frequently in places like Sierra Leone because health and nutrition are already poor and because people who contract it cannot get to health centers or buy treatment, either because they’re too remote or too poor or both. Malaria is not as much of a problem for me, for example, because I have easy access to transportation, several nurses and doctors, and medicine. I’m well fed and in good health. I could probably buy most medicines without a prescription here because of my skin color, for that matter. Malaria does not need to be thought of with panic (I’m afraid my dad was not so happy when I told him I had it), but it does need to be taken seriously. Malaria kills, but it would kill less frequently if there were more health clinics, or if the roads were better, or if hospital visits were cheaper. Or if children could get enough to eat or weren’t sick most of the time with other things—worms, chronic coughs, malnutrition, diarrhea, etc, etc, etc. Malaria can still kill a well-fed, healthy individual; don’t get me wrong. It’s just that everything becomes so much worse once you add in the factors that put Sierra Leone at the bottom of the Human Development Index this year.

After my results came in, the Medical Director told me what to buy (no prescription needed) at the pharmacy. The man at the pharmacy started when I asked him how to take the Artesunate tablets. He laughed, explaining that he thought I was a doctor, and then advised, once he realized I was the patient, that I should be on anti-malarials and sleep under a bed net. Thank you. Even one pill later, I felt better. I’m still not one hundred and ten percent yet, but I’m getting there. The child of one of our patients came down with an undiagnosed fever yesterday, almost burning to the touch and crying out of discomfort. Her mother sharply told her to quiet down.

Why Poda Podas are Trouble and Other Stories

After leaving Banana Island back in November, we dozen or so pumoi on the trip had a bit of an adventure. The poda-poda (a minibus/large van vehicle that can seat anywhere from 10-20 plus livestock depending on your comfort level) named “Make It Rain” that we had hired out for the weekend did not meet us on the mainland at the scheduled pick up time. A call revealed that the poda-poda had not even left Kissy yet, at least 2 hours away with the evening Freetown traffic. After waiting several hours, as the night grew darker and the block party that spilled off the beach and onto the streets grew rowdier, we got a call. The poda-poda was stuck at a police checkpoint due to some paperwork that was out of order. Numerous pleas over the phone to the officer were unsuccessful, so we decided to walk through the party and meet the vehicle at the checkpoint. We were more than a little conspicuous, and though I felt nervous as we walked by, I made an effort to make eye contact, to walk with squared shoulders. Men grabbed at my arms; I yanked them away. After we’d made it through, a small group of young (and inebriated) men followed us, heckling and asking for money. The road grew less lively, the lights disappeared, the houses looked closed and empty. At the bleakest point on the road, the men suddenly surged forward to grab at stragglers’ packs, back pockets, anything, even targeting the larger men in our group. We tried to chase them, yelling for help, but they kept coming back, and in greater numbers. That was the scariest part—their brazenness. I moved ahead, looking for shelter. Cold Drinks, the sign said. There was light. Thinking it was a bar, I yelled for everyone to get inside, but as we entered the compound, a startled family tried to shoo us out. After begging for help, they ushered us into their living room, an unbearably hot, ramshackle space with dirty lace antimacassars on the shabby chairs and phones plugged into every outlet in the wall—a standard business for any house lucky enough to afford a generator. They asked us to stay inside, locking the door behind us. But the windows were wide open. We could hear yelling and scuffling outside. All of us were unharmed, none of us had been robbed, and everyone was calm.

A check of our cell phones revealed that none of us had service in the house, so a few of the better connected among us (not me) went out to make calls to security buddies at the US Embassy, to bosses at the UN Special Court, to the British High Commission, the Ministry of Foreign Affairs, landlords, powerful friends, roommates. Discussions with the household revealed that the men had called professional thieves and that they had set up a roadblock to catch us if we tried to leave. A few rocks thumped against the side of the house and the women and children of the house were rushed inside with us, huddling in the corner as I moved an electric fan, supplied by our gracious hosts, over the room, trying to keep people from passing out (it was that hot). That was when I got scared—what dangers had we brought on this family? Rumors reached us of a woman unconscious outside, possibly injured by a rock thrown by one of the thieves. A trained medic among us offered help, but the family told us to stay inside, explaining that the thieves may have sent her as a decoy to lure us out on the road, since they assumed that we were all doctors (sidenote: once at the hospital in Bo, a sizeable group of angry friends and relatives of a man critically injured in a car accident gathered around the office and vehicles and it was suggested that I leave, since they thought I was a doctor and were beginning to angrily wonder why I hadn’t come out to help yet).

The entire neighborhood heard and began gathering at the house. Eventually, enough people showed up, including the incredibly kind staff at Banana Island, who boated over to help us, to chase the thieves further down the road. The poda poda arrived, and the driver and apprentices tried to nonchalantly high five a few of us, offering zero apologies and even less remorse. After two hours or so, a large truck full of local police arrived, and an hour later, a UN escort of two vehicles. We thanked the family, the neighbors, the well wishers, the children. They seemed ready to see us off but not in any way upset that we had invaded their house. Many of them had turned the situation into a social event, sipping soft drinks, catching up with neighbors, and boasting about their exploits in the “battle” with the thieves. Making do with soda soap, so to speak. This was the lesson learned: despite the poverty that causes criminal behavior in a few in Sierra Leone, the vast majority of the people will protect you, offer you shelter, and go above and beyond as hosts. I tried to imagine what would have happened if I’d been threatened in New York in a similar way, and I can only think that it would have ended a lot worse. Sierra Leoneans don’t stand by idly when someone is in trouble.

The four who were employees of the Special Court rode in UN vehicles; the rest of us crammed back in to the poda poda, which spun out on the gravel in front of the house and almost crashed when we tried to depart. Needless to say, most of us were ready to kill the driver, especially because he acted as if nothing had happened and that none of it was his fault. We pulled out, the UN vehicles in front, then “Make It Rain,” then the truck full of police. We made it back to Freetown safely, having learned that poda poda drivers are always not trustworthy, that block parties should be avoided, but most importantly, that the people of Sierra Leone are good, generous, gracious people, who will offer the best that they have to guests, even ones that force their way in with danger on their heels.

Catching Up

It’s been a long time since I’ve posted. But a lot of things have been going on since my last post that kept me distracted—Dr. Maggi showed up, then my family came to visit me here in Sierra Leone, and then the day that they left, six volunteers arrived from the United States! So, it’s been a very busy month. Dr. Maggi performed about 15 surgeries, mostly fistula repairs. We finally got running water at Bo Government Hospital, since WAFF purchased and installed a pump for the well. This is the first time the hospital has had water since 2004. Unfortunately, it’s also the dry season, which means that the hydroelectric dam that powers Bo and Kenema is running low, causing frequent blackouts. We’re dealing as we can, though the power shortages certainly cut into surgery time and make the office even more inefficient.
One of our patients delivered her baby boy, named Doctor Maggi, in early January, so we have a new little wrinkled face on the ward. We’ve said goodbye to two of our most dynamic patients, Alice and Sama, who have been discharged following successful surgeries along with three others. I feel very close to both of them, and their leadership and liveliness is lacking in the ward. We took Alice back to her village, and though watching her return to her element made it easier to leave, I miss her. She gave us a giant cocoyam, a bunch of green plantains, a large papaya, and a live chicken, which spent its trip in the car trussed up in a shopping bag, its head poking out of a hole in the plastic, its angry red eyes dilating at every movement. Every so often it would go ballistic in the back of the car and roll around squawking and flapping inside the bag. It made me a bit nervous, and Alice made fun of me for jumping away from it when she told me to pick it up and it lunged away in a rustling of plastic and pinned feathers.
While returning Alice, we also looked for new patients in the surrounding villages, and we ended up on a wild goose chase for a prospective patient who walked from one village to another before we could find her. Eventually, as the sun began to set over crowing roosters, goats grazing among the cement ruins of houses burned in the war, and sooty kitchens full of hanging baskets, bunches of dried okra, and stacks of clean pots awaiting the evening meal, we found her. On the trip back, she couldn’t stop smiling and spent a good portion of the trip holding my shoulder and stroking my hair, which had become a rats’ nest in the wind from the open windows.
It was amazing to have my dad and sister come out over their winter break to visit. My dad came to see me when I was in Dakar, so he had some frame of reference for what Sierra Leone would be like, but my (vegetarian) sister had never been on the continent before. Both of them were incredibly patient with the transportation issues of this country (a blog post to follow on transportation, at some point) and the other things that go with visiting a place that has very little in the way of a tourist infrastructure. We went to the Tacugama Chimpanzee Sanctuary to visit rescued chimps, which were very adept at throwing rocks at visitors and were terrifyingly human. We saw endangered red Colobus monkeys at the Tiwai Island Nature Preserve, where we slept in REI tents and ate beans cooked over an open fire. It made me yearn for the Sierra Nevada, where camping is a lot less humid. We ate, in age-old Robinson tradition, good food, trying out grilled lobsters, Chinese noodles, paneers, various experiments from the Bo market, and a lot of fresh fruit. My poor sister had to eat a lot of falafel, which was often the only vegetarian option, as my dad and I gorged on perfectly roasted, juicy chicken with garlic mayonnaise and Lebanese cheese pies, which are a bit like a white pizza. We did a bit of exploring in Freetown and found it too hectic to endure for long, but we watched masked Sande dancers shuffle through downtown waving green branches and followed by women with drums and shakers and bells.
Now we’re at the end of the trip for three of our volunteers, two of whom were working on a documentary film and one who helped set up our garden, which is now full of sprouting cucumber and squash, and little green shoots of corn and peppers. It’s very exciting. We traveled out to Taiama, a village near Bo, for a church service on behalf of the family of one of our consultants, Samuel Pieh, who is directly descended from Sengbeh Pieh, the leader of the Amistad revolt. It lasted four hours, which would test the limits of a faithful person but for me was tortuous, but our visit was made worth it when a troupe of “cultural” dancers, including Sande maskers and other “devils,” a man on a very thin high wire, and many drummers, showed up at the Pieh household. We also drank palm wine with our host, which isn’t too bad in small doses, if you can avoid the bees and other bugs that get into the drink during the tapping process.
Since then, we’ve been gardening, doing arts and crafts in the ward, and sitting with the patients. I’m still working in the office and I’ve done what I can to help our volunteers with educational programs (family planning/reproductive health as well as first aid) get started. I’ve followed the cinematographer and writer team around as they shot various locations and conducted interviews a bit and taken the volunteers to the market and other Bo hotspots. We’ve begun frequenting Georgetown, a local guesthouse and bar right up the road from the house, and it’s been nice to have a bit of relaxation. It’s a very exciting time to be with the program, since it feels like all of this new blood has increased enthusiasm and excitement within WAFF. And it feels so good to grow things that we will, with hope, be able to offer to the patients (or to eat ourselves, if the patients aren’t feeling brave). Watching little seeds push up and fold out leaves is one of the most satisfying things I’ve ever done. We’ve started our compost pile and built up different types of raised beds. The patients come down when they see volunteers heading for the garden and point out the various ways in which we are doing things completely wrong. We listen to them most of the time, since they are professional farmers and we are amateur putterers at best, but we’re hoping our weird experiments and ideas pan out, so that we can pass on some knowledge to the patients as well, with the goal of giving them the opportunity to improve their diets and those of their families once they go home. So, for now, we’ll be the crazy pumoi with our weird raised mounds for gourd cultivation and we’ll keep our fingers crossed that it will work.

Indiana Jones, Granfalloons, and Finding Ways to be Good

As a young child, I dreamed of being an archaeologist à la Indiana Jones. When I was a little bit older, I found out that archaeologists spent most of their time writing grants and begging for money, and my dream of spending my life in secret caves floored with the crunchy, fortune cookie consistency of millions of crawling insects, my path lit by a torch made out of a human femur and my goal some forgotten idol that belongs in a museum, crumbled a little bit. Unfortunately (?), my life has again led me to a job that is entirely dependent upon the kindness of strangers. I don't like begging for money, but donations are essential to the survival of non-profits and non-governmental organizations like WAFF.

I know how hard it has been this year with our tanking economy. I had hoped that out of this experience, the American people as a whole (if not the global population) could begin to rethink the way they spend their money and to look beyond themselves to see the broader scope of shared humanity and experience, if that makes sense. That we are not alone or simple individuals in little predefined groups (Bokononists call these granfalloons), but that there is a whole world full of people that are a distinct part of who we are and how we live. That buying a brand new car or a pair of shoes or the next generation video game is not as important as being with and caring for others. I think, to some extent, that this has happened. The story I recently read about the stampede at Walmart that killed a temporary worker, however, illustrates that we're not there yet. That it will take longer to heal our need for new things, for possession. Consumerism is certainly something that I struggle with everyday, as I covet this or that, as I see how attached I am to my things. All the same, I have to say that one of the best and most thoughtful gifts I was ever given for Christmas was from my good friend Nickole, who donated money in my name to the Save Darfur Coalition.

All that I ask is that this holiday season, or as birthdays roll around, is that you remember that we are all in this together, that we are all a part of the same living, breathing thing. I've long maintained that if everyone made a sacrifice, even a small one, in their own lives, then the world would be a better place--take shorter showers, give $5 a month to the cause of your choice, buy a bus or subway pass for the person behind you, smile at someone, anything. You don't have to be a liberal or a conservative, a Democrat or a Republican or an Independent, a communist or a capitalist, to do this. Anyone can, and almost every philosophy, or political belief, or religion, or whatever system you adhere to, advocates some form of philanthropy or sacrifice or aid to others, whatever you wish to call it.

I'm not asking you to donate to my cause, the West Africa Fistula Foundation. I won't be disappointed if those few of you reading this blog decide that you'd rather spend your money elsewhere. I'm just suggesting that, as the holidays approach, you think about donating money to a non-profit or an NGO as gifts for family and friends. If you want to donate to WAFF, you can follow the instructions on the site here (no pressure, I promise). If you have another organization you'd rather give to, please do so. If this doesn't sound like your bag, then keep doing your holidays as you've always done them. We're all here, thrown together, in this incredibly messy and complicated place, and it's not always pretty or happy or encouraging. But it only takes a little bit, the simplest acts of kindess or selflessness--things that are so small that they seem insignificant--that change everything, that affect everyone. So, take a chance on one of these small acts, and no matter how or where or when you choose to do it, you'll have done something good for all of us.

From Slow Slow to Fever Pitch

This might seem a little silly, but as we were narrowly avoiding the tenth pedestrian who stepped out a little bit too close to the car, bouncing through bad stretches on the road, and trying to keep all of the boxes stacked in the car inside the car and not falling out the windows, I thought of a Disneyland ride based on a typical jaunt through Bo. It starts off innocently enough--you have to clamber into a very tall van while managing about 5 bags, then somehow get your seatbelt on. The car is chock full of people--the nurses, a laundry assistant or two, several neighbors who need a ride to the lorry park--and boxes of medical supplies, which seem to move in a neverending stream from one place to another. The boxes, in fact, look as if they've all been kicked to death, catheters poking out the cracks, disposable gowns about to float out of the ripped top, a bottom or two collapsing its contents all over the floor. Then, we're suddenly climbing up an alarmingly steep hill, wheels spinning madly for traction, stones sending us all flailing. Sharp turns, sudden drops, quick whiplashing stops. Children dart out on the road on the way to school, women carrying baskets wobble a bit towards us, men with no apparent regard for their own safety walk in twos and threes on the narrowest stretches of road, holding hands. It is a ride of constant stress--aren't we coming up a bit fast on that parked truck? Is that baby going to fall off the motorcycle? Why isn't that dog moving?--and quick intakes of breath at the close shaves. Then, all of sudden, we're facing a World AIDS Day parade, coming straight down on us--Get us OUT of here!--and a truck whips around us at the last minute, just before we're about to make our move. We're careening down the street, and it feels like we're going to go up on two wheels at the next curve, and then four motorcycles almost all run into each other in front of us and we brake hard, that feeling of helplessness as I continue to press down on the floor with my right foot, where the brake would be if I were driving. Christmas-themed music blasts out of shops, open trenches leer at the car as if daring us to slip up and get caught in them, police traffic controllers arbitrarily tell us to stop and go (I have seen one stop light my entire time in Sierra Leone, and it was in Freetown). It's a daily adventure getting to work, a series of near-misses and close calls. Everyone seems to have been trained from an early age that pedestrians are supposed to jump backwards when they hear a car horn (I tend to look up, which only further roots me to the spot), and that there is no minimum clearance requirement--as long as no cars are touching, it's all good. Everyone drives and everyone walks like this: courteous behavior is only shown to old women leaving the market and children going to school, and it's beyond dog-eat-dog. Fortunately, the system seems to work for us, for the present, anyway, and maybe our close calls aren't as bad as they seem to me.

Things here have two settings: slow-slow and fever pitch. Slow-slow is what happens when things are inefficient, or a meeting gets postponed again, or when someone is explaining why we don't have something we were supposed to have two weeks ago. Fever pitch is when we're driving, moving heavy things, or just before our Texas surgeon, Dr. Maggi, comes. His visits tend to get everyone into a tizzy of activity, which is of course part of his visit. The rest is for him to complete as many surgeries as he can, and to do them all safely and skillfully (watching Dr. Maggi operate is amazing. I can't explain how nuts it is to watch him essentially make a bladder out of a hole with jagged edges of scar tissue). So, we're about to reach critical fever pitch, since Dr. Maggi arrives tomorrow and beyond his visit, there's the impending return of Helen, our volunteer coordinator and director of program development, with a whole team of volunteers in early January.

Not that we haven't been working hard before, but in anticipation of the transition to volunteer programming, things are starting to speed up. I can't believe it's December, even, though I guess without fire season, mudslides, and Santa Ana winds, it never really feels like winter. Even in New York, when I kicked myself for 4 months for having decided to go to school on the east coast, it wasn't the same. But here, it's just been getting progressively drier and hazier, before the Harmattans set in and bring the real dust from the Sahara and before what I hear are cooler December and January months, cool enough to grow healthy carrots and large tomatoes in the North, or maybe even here. We'll be experimenting when the volunteers come with tomatoes and carrots in our volunteer/patient cooperative garden, so I'll be able to see how much truth there is in that. All I know is that for now, the thunder rattles farther and farther off, the lightning continues to flash, but the rain never comes. Or it comes in little spurts that sound like someone has thrown a bucket of water on one part of the roof. And that I'll be in Freetown tomorrow, and then the December sprint begins in earnest.

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.