Party!!!

Yesterday Joe went with one of the cooks at the apartment where the guys stay and shopped for food for a party.  They got a bunch of red snapper and some shrimp.  Together they grilled fish and shrimp, fried some fish and cooked some with some traditional spices.  Joe also made coconut shrimp.  Mark did some veggies after soaking them in chlorine.  Someone made an impressive cheese plate with some cucumbers and tomatoes, and Joe bought cake and ice cream from a Lebanese bakery.  All ARC were invited as well as some Samaritans Purse workers from next door.  Beer and wine were had by many and it seemed all had a good time.  We raised a glass and pondered our part in the Ebola crisis which so far is minimal.  It was super ironic that we were celebrating on the day Ebola fighters were named Persons of the Year by TIME magazine.  We decided that for some it is a reward, and for us a mandate.  We are ready.  A few will be going to Fish Town maybe tomorrow.  I really hope to be one of them.  I wish I had some pictures.  If Joe posts some I will poach them and post them here.

A little more insight

We had dinner tonight with a woman who has worked for various NGOs for 35 years.  She currently works for on whose primary focus is food security but whose focus was forced to shift to Ebola when the current outbreak happened.  She had worked in other parts of Africa when there were Ebola outbreaks but never, of course, one of this magnitude.  She has been in Liberia for about a year and a half so has see this outbreak from the beginning.  She told of the early days, you know a couple months ago, when the official response was to give families a home kit of gloves and bleach and a little education.  Epic fail.  Then isolation centers were set up.  They included food, shelter, and latrines.  There was no testing so it was impossible to tell which of these sick, crammed together folks had Ebola and which did not.  The epidemic continued.  One county was way ahead of the game and closed its borders.  One could not enter without a chlorine wash and a temperature taken.  It has been 54 days since they've had a case- easily longest In the country.

We learned of a neighborhood called Watertown which is much more remarkable than the neighborhoods we have been seeing on our walks.  She said literally you cannot walk through the neighborhood without walking through people's living rooms.  I couldn't believe it so I asked if she was being truly accurate, no exaggeration.  She swore it to be true.  That neighborhood was quarantined off for a brief time because of the close proximity of the residents.  The quarantine was short lived and ended after some rioting of the essentially caged people.

She also shared with us some of the problems in Liberia.  They should be a able to grow lots of fruits and vegetables and we have seen some but their farming methods are inefficient which is just as well.  If they grew a ton of produce there would be no way to get it to market.  There are few roads and those that exist are in terrible shape as we have witnessed personally.  There is no industry in Liberia.  Any facility that has electricity is run off generators.  There is no community power source.  Without the industry the job possibilities are few and far between.

Liberians value education but the last war took a toll on the education system.  Now kids teach kids instead of teachers teaching kids.  It will be at least another generation before the PTSD is down to a normal level.  The trauma of war and then the Ebola tragedy has played havoc with the country's mental health.  

That's enough.  Liberians are a cheerful, friendly, tough as nails people.  According to this woman they are transparent.  Government is transparent.  There is corruption but it is blatantly open, so at least everyone knows what's going on.  I guess that's something.  The world led by the U.S. is crucial to Liberia.  It seems everything here is globally funded.   Not sure what the future holds for this country.

On a lighter note I touched the Atlantic Ocean today.  It is way warmer here than in Maine.  Imagine that!

Here are some pics of Monrovia from atop the hotel where we ate tonight.

One road to the beach.

All those round things are water cisterns for the buildings water system.  There are wells, too, but many buildings have a network of these tanks.

Oh those long Monrovian days

I found two walking buddies for 630 am.  They are the public health nurses but they will be going to Fish Town probably tomorrow to scope things out.  They will go into the community and see what their needs are.  It is possible we could fill more than one need there.  The walks we have had in the last couple,days have been great.  One of the women is a missionary brat who grew up in Liberia and who still teaches a few weeks per year at the nursing school here.  She knows the place inside and out.  As a result of her comfort here we have ventured into some of the neighborhoods.  You go off the car roads and down these paths that must be torrential rivers in the rainy season.  The paths take you between the very closely approximated buildings each of which clearly houses many people.  Dirt everywhere, but still clean.  They have brooms which are used to sweet the dirt floors and roadways and yards.  Things are pretty tidy in their own way.  One neighborhood this morning was pretty swanky because it had water.  That is a community water source that consisted of a concrete island with several spigots to get water from.  I asked about sewage and apparently pooping is done outside and then swept up.  From there it is thrown with the trash much of it ending up in the gutters where it washes into the sea.  I posted an article on Facebook about how even in this type of seemingly dirty lifestyle it is important to look good. Hair is immaculate, white clothes are brilliant white and clothing is always pressed.  The article is right on.

Here we sit

I have to say this stint in Monrovia may be a long one.  There is really nothing to do to contribute to the ETU.  We have a team meeting tomorrow morning and a follow up with the medical director by Skype on Tuesday.  There may be some tasks that come out of those meetings.  Hopefully.  One project is to find a medical provider for us for if we have some non Ebola problem that needs care outside of the knowledge of the group.  It is not the cost that is the main obstacle but access.  Looks like we may need to pay a monthly premium to be covered under some of the clinics here.  On top of that is the cost of care, but to even be seen we will probably have "join" the clinic.  

This morning one of our members almost needed said services.  We were walking this morning and a couple guys came screaming around a corner carrying long planks on their motorcycle.  They came too close and the boards struck my collegue in the arm cutting her skin.  When we got back she tripped over a planter and fell backward.  She could have easily slammed her head on the concrete.  Point being she came twice close to needing medical care.  

The rest of the walk was fantastic.  We got off the main road and wound our way through these very tight rubbled paths among houses and shops.  The whole place is dirt, but these families live in solid structures, not flimsy fall down shacks.  Still there are no doors, no painted walls, no decor.  The paths are rough and the remnants of sandbags are everywhere.  During the rainy season many of the homes become flooded and the paths become rivers.  Back on the main paved road the gutters are a 3 foot deep concrete trench.  Apparently these overflow as well.  The people in the neighborhood were outside selling peppers, shaving, bathing, eating, and hanging out.  The paths were narrow enough and there were enough people it really felt like we were invading their space.  Pictures were out of the question.  Apparently the neighborhood was a middle class neighborhood.  Wow.

Washed my own laundry in the sink today.  Not much else to do so the couple hours it took was no problem. 

Went to a market downtown yesterday and bought fabric. We can use it to decorate at Fish Town when we finally get there.  On the bed is one example.  I bought several bright colored pieces.  This is the fabric the saris are made from.  Lots of color wrapped around the women often clashing, by the Western eye, with the blouse and head wrap.

More fabric.

Public works

We are back in Monrovia and I just happened to get the super deluxe hotel room.

We are here while the rest of the team goes for their hot training- the part of the training in which you enter the ETU and treat patients.  When they are done we will be ready to go.  Unfortunately the ETU won't be quite ready and the tent city, our accommodations, won't be either.  Three public health folks are going to Fish Town next week to see how we can help the community with health care even if we don't have many Ebola patients.  Just getting the ETU up and running is valuable so if there are patients we can get them properly isolated preventing spread.   We don't know when we go, we don't know what we will be doing.

So Monrovia is notably cleaner than the rural areas.  I noticed that today.  Monrovia has trash pick up, the rural areas don't.  In the small towns there is always a mound of trash visible somewhere.  Littering is just the way.  There is no organized place to put trash.  Can you even imagine how many plastic water bottles are scattered around this country?

I am getting more comfortable walking around the city.  As I walk I am usually the only white person in sight. The beggars are clingy.  There are many men right here who lost limbs in the wars. They work hard crutching around following very closely for several blocks begging for money.  Trouble is, once you give you are a target. Happened to me the first day back.  Gave to John from Guinea and he became George from guinea the next day.  He must think I can't tell them apart.  We are in a targeted area because there are tons of health care workers and NGO staff and UN troops staying right here.  The CDC office is two blocks down.

On my walk today I saw curb painting and gutter sweeping taking place.  The painter had a brush and was swatted way down painting the black of the alternating yellow and black curb.  Another guy was hand sweeping the road right inside the curb.  Then he shoveled up the sand and dirt into a wheelbarrow.  That both had warning green safety vests on but the driving here is crazy.  I was worried for them even though they seemed perfectly relaxed.

 

The rest of the ETU

The sign into the ETU.  The road was already in place because it leads to the Leper colony.  Still an active colony.

Everything you enter you get foot sprayed and wash hands.

Water supply.  These are the tanks for the .05% chlorine spigots.  That's what we washed our hands in.

The survivor wall.

My group was involved in the discharge of this patient.  

In some down time I was honored to paint the hand outlines on the wall.

On the other hand here is the graveyard.  Over 175 patients here.

New graves are dug daily though they are probably taking a break because the number of infected folks has thankfully gone down.  They are preparing for another spike around Christmas and right after because visiting home is huge here at Christmas.

The morgue with a cart to haul the bodies too big to be carried.

Ambulance geared for the road.  Takes about 20 minutes to spray it down with chlorine prior to letting or getting the patient out on arrival to the ETU.  Takes another 20 minutes to get it ready to go again.

Boots hanging to dry.

Little house where someone can stay for a short time upon discharge until transportation home is arranged.  While we were there a 7 mo old boy was released a day before his mom.  He stayed there over night with a survivor working for the ETU.

That's it.  Good bye bong.  You were a great teacher.  Back to Monrovia!

Life.

Today's blog is about life for an expat in Liberia.  You saw our dorm room.  Here is the dorm kitchen.

In the center is some of the fruit various people have bought to supplement the meals.  This was our best meal so far.

I am not kidding.  90% of the meals have been white rice in the big compartment, in the upper left is a quarter cup of beans like refried beans or cooked greens in oil and spiced chemical burn hot.  In the upper right is typically the boiled egg usually with a dab of ketsup and a dab of mayo.  We did get one small slice of pineapple yesterday and we have gotten a tiny slice of watermelon twice.  Twice we had a type of oatmeal for breakfast.  The bread in the upper right of this meal is a sweet shortbread.  There is some oil or spice or something that makes all these meals smell the same.  It is a smell that I find repelling so for the first time in my life I have had to force myself to eat.  

Here is me doing laundry in the sink before I knew we only had to set it out in a bucket and they'd do it for us.  It dried outside in the sun lickety split.

You can't really see in this disappointing photo but Cuttungton University's mascot is the scorpion.  That implies to me that they exist here.  Shaking my shoes before donning every morning!

Tons of birds here.  Not a clue what they all are.  I should have brought binoculars.  Rookie mistake.  Trees are flowering some.  Looking up here you see many very large trees with gorgeous flowers pointing to the sky as if their purpose were for something other than beautifying the earth for us vertically challenged humans.  Can you imagine?

Emmanuel Chapel on campus. Some of the women staying here went to chapel here yesterday.  They sang My Country 'Tis of Thee all four verses.  Apparently they sing it every Service.  One of our Liberian teammates said the flag was designed in the US and the constitution is practically a duplicate of the American Constitution.  Liberia was first settled by freed American slaves.  White wisdom thought they'd be happier here than in North America.  They didn't go to the trouble, of course, to take the people back to their native lands.  They just unloaded them here.  So these American people displaced the western African indigenous people just like the Europeans did in North America.  I haven't seen it but apparently there were some homes built in the southern US antebellum style like the settlers were used to from whence they came.  I think that might be true in Harper, a southern coastal city we may get to see.  It is about four hours south of Fish Town and the city from where we will get our supplies.