26 April 2011

backlog 3: first day to the field and first day at the beach


Erin took me on a lovely day trip to Lakka beach, about 40 minutes drive from our house, for a lazy day in the sun. We parked at a small seaside hotel and found a proprietor to quickly prepare us a lunch of fresh grilled barracuda, before relaxation commenced.

dog's day
The place was fairly empty, with only one or two kids peddling small wares like necklaces and local masks. We set up shop, dined deliciously, and then had a major sighting...the glass eater. Now, I know that there is food insecurity within SaLone, but I've a feeling that very few resort to this!He, covered in body paint and sweat, approached us and encouraged us to watch and snap photos before he began to eat handfuls of broken, green glass followed by handfuls of hot, golden sand. We were both rather horrified and asked him to stop before he put the glass shards up towards his eyes, suggesting he would start slicing his eyeballs, Buñuel style. He stopped, rubbed his belly, and then regurgitated shards into a massive bowl, before telling me he's been doing this since the age of 8. I gave him the equivalent of 50 cents and have had nightmares ever since.Images below; proceed with caution!
glass eater
III
glass eater
II

Within a few days, I took to the field for my first site in order to assess how our tools are being used at Ministry health facilities. As luck would have it, and a bit easier on the eyes and mind than the prior visit, I returned to Lakka to visit the District hospital where I met with the Matron on duty, strapped on my 'Attendance Monitoring' hat, placed my best foot forward, and commenced doing spot checks on various staff supposed to be working the wards of the hospital. Pretty good report, all and all, with a few snaps to boot.
on call, Lakka hospital
reporting to duty, Lakka hospital

25 April 2011

Backlog 2: The end of week one: SaLone sights and Seder.


boarding the
pelican
boarding ‘the pelican’ boat at midnight

The 7 hour flight to London, 3 hour flight to Malaga, 2 hour refueling break, 4 hour flight to Lungi airport, and (after finding the helicopter unavailable) the 1 hour boat ride across a massive bay to reach Freetown at midnight were sufficient indication that my time here in Sierra Leone, and the realities of life within, would be hectic, constantly moving, and full of surprises.

After a full week in country, my amazement hasn’t ceased and I continually find new things to be excited by. Be it the constant availability of mango or lobster at any meal, the architecture, the azure sea viewed from every balcony and window, or the cacophony of Freetown’s horrendous traffic, my expectations have all been either completely off-base or completely exceeded.

The street scenes get me the most riled up every day. This is most likely because I spend an exorbitant amount of time in the car. There are no traffic signs or lights, but plenty of roundabouts and traffic ‘cops’ or directors, who only serve to make the congestion worse. The roads are bad and ‘induced dancing,’ as my lovely driver in Uganda, Nasuru, used to say when the potholes were so bad that the passengers bounced in unison, is the norm. From the time my driver here, the lovely Kebbeh, arrives to carry me to work at 8 am, to our late evening returns home (punctuated by day time meetings with Government officials across town and site-verification visits to hospitals in neighboring districts), I spend a lot of time ogling the sights of the streets. 

IMG_0306

Constant sources of hilarity are the messages inscribed across the dashes or rear windows of other cars likewise stuck sitting in traffic. Many vehicles here have prolific messages splayed across their glass – I’ve seen those ranging from the grammatically incoherent to “do you it go,” to the religiously disturbing, like “covered in the blood of Jesus.” It also seems that everyone missed the memo on correct helmet use, as the many, many folks using Okadas (motorcycle taxis) for transport will don a hard plastic head covering yet they neglect to make use of the neck strap, which dangles by their jaw, unclipped, as they whiz through, with upwards of four passengers, the sitting 4-wheel drives (namely, white NGO landcruisers).

Possibly a more striking street scene to behold here is the mix of architectural styles and bizarre integration of socio-economic statuses across neighborhoods. On one block one might pass 2, fairly large, western style houses protected by cement walls and uniformed guards, a 3rd that was partially completed – maybe 5 years ago – and now sits as a cinder-block-and-mortar -only home of squatter inhabitants, 4 or 5 corrugated tin and plywood shanty-town style shacks, and 1 or 2 mid-sized, wood-slatted, single-shuttered window’d, and zinc-roofed Krio-style houses. While the congregation of all these varied dwellings in one small area is shocking to my eye, it’s these last ones that fascinate me the most. Upon first sighting a Krio home, I blurted out “that looks like it belongs in south Georgia,” only to be quickly informed of the Krio housing tradition and culture brought to Sierra Leone by the thousands of returned slaves that were shipped here after the abolition of slavery (bringing many ‘western’ cultural elements, including building structure and style).
krio
house
krio
house
krio houses
Though I’m still parsing the overall culture and lay of the land, after a week I can confidently assert that Sierra Leoneans are proud and kind people. The scars of war haven’t been as visible to the unfamiliar eye as I anticipated; the scores of amputees we’ve heard of aren’t teeming left and right, the stories of forced conscription and sexual assault aren’t spoken of, and the “dirty face” of mineral mining and the extractive industry isn’t described in such dirty language. The number and breadth of NGOs here does, however, far exceed that which I imagined would still remain ten years down the line. Beyond these NGOs, though, the other facets of the economy, extractive industries included, have been far larger than I anticipated: the ‘market dominant ethnic minority’ of Lebanese business holders is striking – nearly every shop, bar, hotel, restaurant, or other company seems to be Lebanese owned. While this translates to excellent hummos and baba ganoush availability (as well as aesthetic services (at home bikini waxing, what?!) and aesthetically pleasing people), it also speaks about the status and function of local people within the SL economy. I haven’t quite put my finger on it yet, but poverty certainly looks different here than that within other African capitals I’ve visited. Once my finger is more articulately positioned on this, I’ll report back. In the mean time, I’ll share some street side snaps.

headstrong
small
shop
night
ride
construction


Before signing off, I’d be remiss to not mention the pleasantly surprising quality of Life opportunities for expatriots residing in Freetown. I’ve been lucky to shack up with my friend, teammate, and supervisor, Erin, and have taken residency (at least temporarily) at her (and Danielle’s!) abode on King St. Danielle’s sweet kitten, affectionately named Kitty, has taken a liking to me, and I to it, in addition to the gorgeous balcony, hot-water showers, large living room, and well appointed kitchen. Given the availability of the latter, and my love for annually hosting jewish-themed dinner parties, I welcomed myself to Sierra Leone /ingratiated myself with new friends by preparing a Passover Seder for 8. Our abbreviated Haggadah (downloaded from the web) helped order the affair, which felt like an extraordinarily special celebration of freedom, given SL’s own afflicted history. Some special shots of us celebrating freedom in Freetown:

the seder
plate2 glasses
passover people, celebrating
freedom in freetown

Backlog entry 1: Updates, newness, and firsts; week of April 11.


As it’s been some time since my last entry on this here blog, a summary update feels justified. In the nearly two years that have passed, I’ve pulled off a few stunts, with all the most significant having emerged in response to the visit to Haiti described in my last post. In the course of completing my Master of International Affairs and Master of Public Health degrees, I produced my Thesis to develop a new partnership between Columbia University Medical Center and NGOs working in healthcare in Haiti to enable community based participatory research, community-based learning opportunities for future CUMC students, and to support capacity building of civil society in Haiti following the January 2010 earthquake. Beyond the academic blood and sweat devoted to Haiti, it’s worth mentioning (for the sake of digital self-documentation) that I also spent 2010 spearheading a project to get essential medical supplies to the largest private hospital in northern Haiti through the 100 Beds for Haiti campaign. These projects, coupled with new friends and loves, new neighborhoods, and new habits all factored heavily into my life since my last update, and it is the culmination of all of these happenings that has led to my current update. And so, random reader that still has this blog on his or her radar, here I am, reporting back, though this time from Freetown, Sierra Leone.

I’ve taken a consulting contract with the UK-office of an international management consultancy services company that has been sub-contracted to manage a program of technical support for the Ministry of Health and Sanitation (MoHS) of the Government of Sierra Leone. With funding from the UK’s Department for International Development (DfID), the overarching aim of the program is to “improve the financing, management, and delivery of sustainable and replicable pro-poor health services, to ensure the achievement of the [government’s] national Reproductive and Child Health (RCH) Strategic Plan,” for the purposes of reducing the maternal and child mortality rates in this country, which have been cited amongst the worst in the world.  Of course creating these changes requires comprehensive and quality health services, beginning with a strengthened health system, and as such, we are here providing technical assistance within the central level of Ministry, in the areas of Human Resources and Finance.

As the first year of this work, which began in February 2010, involved a massive cleaning of the Ministry’s entire Payroll (of approximately 8500 salaried employees) and the development of an Attendance Monitoring Program (in order to improve and systematize HR functionality), I am primarily here to wear an M&E (monitoring and evaluation) hat and to provide assistance to the Human Resources for Health (HRH) Support Unit which manages the pay and attendance program of the MoHS. While my work with HRH will involve processing monthly data submissions from government health facilities across the country, the bigger objective is training and building the capacity of Ministry staff in the utilization of the varied new processes and tools that have been developed thus far. With an initial contract of four months, I’m really quite excited by this opportunity and optimistic that the end of the current funding cycle in July (hence the four month contract) will be met with an extension or a renewal.

hawa, leah, betty at the office
some of the ladies of the office

The program is certainly a departure from my past work, and some moments feel like bureaucracy building, but it’s fascinating to see it unfolding and I’m excited for all the newness: the questions, the sights, the smells, and the incessant heat that’s mitigated by discovery (AC unit tucked in the corner! College friends spied across the bar! Matzoh for sale at the Lebanese grocery!  Shandies (a refreshing mix of beer + sprite) on the beach! Visits to ‘Country Lodge’ for open-air patio brunches that overlook the city and the sea!)… and for the many firsts that this project presents: my first time in West Africa, first time working for a company, first go directly with a Government, first time in a post-conflict country ten years after war has ended highlighting the massive needs of development that remain after the relief has ended, as well as my first time leaving the US without certain confidence of a necessary return for more school.

peninsular vistas
lunchtime balcony vistas

And on that note, it’s back to work, dear readers. I can’t promise the most regular updates here, as there is ton of work to be done and the worst internet connectivity imaginable, but please do drop me notes/comments/questions and know that I’m aiming to keep y’all abreast as the newness continues to unfold.