Saturday, March 3, 2007

WHAT MOST PEOPLE DON'T KNOW...

What Most People Don’t Know


About the ‘Birthing’ of the CRC in Sierra Leone


If you are in certain circles, you may likely hear some wonderful stories regarding the ‘birth’ of the CRC in Sierra Leone. You may hear that it was a truly international event, with witnesses from Ghana, Nigeria, Zambia, Canada and USA. You may hear of the dedication and sacrifices made by women like Kumba, to work eighteen hour days and sleep on the floor of a ‘spare’ room packed with sixteen others, so as to be on hand to prepare food for hundreds of visitors to Foria. You may hear wonderful things regarding John Phiri, the Zambian pastor, who has come to nurture, encourage and train leadership in the SL church (and, BTW, he is a joy to be around!). You may hear of the forty-three who spent months in preparation to be baptized, culminating in this event. You may hear that people walked for over thirty miles from more than ten villages to participate. You may hear… many things… all true, all good.

What you might not hear is that the road down which trucks needed to come bearing supplies and visitors from around the globe was all but impassable two weeks prior to the event. Only one of CES’s three trucks was equipped to handle the boulders on one stretch of the road, so Bokary, the chief of Foria, ordered a ‘bypass’ to be expedited. You also may not know that the rocks in a nearby stream were deemed too slippery to be safe (several days prior to the baptisms which transpired there) and that a team of young men from the village went out to scrub each and every one. It may not be immediately apparent that for a village the size of Foria, containing just over one hundred houses, to take in close to five hundred visitors, every household needed to welcome guests. Even knowing these extra tid-bits of information may not strike you as all that significant, unless you realize that Chief Bokary is a devout Muslim. Seventy percent or more of Foria’s thousand residents are Muslim. That ratio certainly applies to the voluntary labor that went into preparing the road and streambed. It also applies to the households who welcomed guests.

It’s a mystery to me what factors create religious tension in some parts of the globe but not others. It’s said that greater education leads to greater tolerance but sometimes I think that religious tension in North America is abated by people’s ‘nominalism’ or lack of real passion and conviction about what they believe. In this case, a visit from the chief made things fairly clear. He had been witness to the work of Christian Extension Services (CES) for decades. They had seen how the village’s women could now get clean water from a source near their houses. They had seen that uneducated adults could become literate. They had seen how women trained to become traditional birth attendants had drastically reduced the mortality rate of infants and mothers. They had been witness to the church caring for all people – especially after the war when seed rice was so desperately needed. Therefore, though Bokary and a number of the other influential village elders are Muslim, they committed to holding people of both faiths equally and allowing the church to flourish.

As big a ‘deal’ as the weekend was, I believe that an event can be planned and executed in a matter of weeks if the right resources are allocated to it. An honest celebration of the true birth or inauguration of a church, however, seems to depend on growth from seeds faithfully planted over years. A church that tries to serve as part of the ‘body’ (eyes, ears, hands) of Christ doesn’t emerge quickly, and for this I respect the work of my parents-in-law and others who have given their lives to the task and the hope of its development. Very late in his life, Pa Momorie, the old village Imam and father to Marah, one of Aaron’s field assistants and co-pastor to the church in Foria, confided to Paul and Mary: “When you came, we watched. We watched, and waited to see what you would be like. Mostly, it was good.” This was a big concession for an imam to make – and if stories serve correct, he hadn’t come to this assessment easily.

Being ‘witness’ and ‘testament’ to the grace of God is a humbling endeavor. It’s joyful and scary to see this ‘birth’ taking place, and to know how acutely it will be watched. The words of the pastor who spoke during the ordination of M.B Jalloh and Ben Koroma were insightful as they alluded to this. Essentially: “you (congregation) will know of these men’s failings better than I can ever point them out to you. You can condemn them and smear them into the ground or you can lift them up and encourage them. You must ask for their best and expect it, and help them to become it in the areas where they struggle. The health of the church depends on what you choose.”


Pa Fatelay with his 'Certificate of Baptism': a possession prized so highly that he fled with it and the shirt on his back during the war. He will tell you of the lengths that he went to protect it from rain, fire and other hazards.


So, today we give thanks. And we pray that we, with the whole church, may learn to hold all of God’s people and creation well, putting up as few faulty barriers as possible as God works though us to make himself known.

Saturday, February 3, 2007

THE SUN WILL RISE...

THE SUN WILL RISE; ALL ELSE IS UP FOR GRABS.
Morning View from 'The Round House' in Kabala

I’m a linear thinker. I don’t often really care if plans change, so long as I know what the plan is was, what has been changed, how the new plan will accommodate, and what new ‘destination’ is being targeted. I wouldn’t say that this runs contrary to the way of thinking here – it’s just totally irrelevant. Plans? Why bother? No plan ever works so ‘leave it to God.’ The sun will rise; all else is up for grabs.

So we are facing a fairly logistically challenging couple of weeks. I’ll be leaving to meet Mary and Christy in Senegal in a few days! We will be returning in a week, just a few days prior to the onslaught of major church activity occurring in Foria. Over a dozen ‘toubaboos’ from U.S., Ghana, Canada and Nigeria will be arriving to witness and participate in the celebration of the new CRC. I think it is finally ‘sinking in’ to the event-planning team that it is going to be a really big deal, so now the issues of housing, feeding and transporting the 800 anticipated visitors are rapidly surfacing. So, I’m in my element: making lists, attending meetings, etc., though trying to stay reconciled to the truth: the sun will rise…

I spent the day at the Nar Sarah Clinic yesterday. Theresa was the sole health practitioner on duty, as Peacemaker (‘Peace’) was as a governmental hospital for a conference. The clinic was hopping – though no more than ‘normal.’ I observed the appointments of:

1) A woman with malaria with two children ‘in tow;’ one of which had worms and a bad cough.
2) A young woman in the first trimester of her first pregnancy, along with her husband. She was occasionally bleeding and they were concerned.
3) A child (with mother) who had a terrible burn from boiling water on his stomach. They had been in several times, and the burn was healing well.
4) A pregnant woman with a bad case of worms. She had been waiting until her second trimester for treatment as the drugs can cause miscarriage; but she was having real difficulty eating.
5) Someone coming in for the second in a series of chloroquin injections (to cure malaria).
6) A baby with a swollen ‘fontanel’ (top of head). Theresa asked them to come back the next day to see Peace.
7) A woman in her third trimester, with a series of aggravations.
8) An elderly woman with an infection between her toes (likely caused from standing in stagnant swamp water while rice farming).
9) A woman with major skin irritation.
10) A man with a ‘post-injury’ infection. He received an injection of penicillin and ibuprofen for the pain.

Theresa is the dispenser of matter-of-fact wisdom. She told the ‘expecting father’ to quit making his wife carry water, firewood or pound rice. She doles out very basic medicine, most frequently: chloroquin injections, pain killers, ORS (Oral Rehydration Solution), worm medicine and oral antibiotics. She takes her time though, listening to people and making sure that they understand the treatment. It’s her contention that people often want ‘medicine’ (pills) to make things better, when more healthful practices are really what are needed. “They think that drugs make blood. Drugs do not make blood, they give you energy to find, prepare and eat food. Good food and good diet make blood. If you just take the drugs and don’t eat – they will not help you.” She chastised a few of the pregnant women on this count, telling them that if they did not eat better (and she was very specific) they would die. No one takes you very seriously unless you state things in the extreme.

The conflict between the Fula and the Limba has resulted in a public hearing, which is transpiring in the town square today. I need to amend my last post to say that the ‘truth’ turns out to be somewhere in the middle of the two versions of the ‘story’ I represented. Cows have been killed; this resulted in a Fula rancher killing a Limba boy. No ‘retaliation’ has taken place - yet. The Paramount Chief is in an awkward position, as he is a Limba who is married to a Fula woman. He is one of the two Paramount Chiefs in Kabala (which sits on the border of Sengbeh and Wara-Wara-Yagalah chiefdoms). His inclination was to see if he could wait for things to ‘blow over.’ This precipitated his initial reaction: that the issue would not be addressed until the taxes have been collected for this region. However, the ‘district officers’ (Freetown governmental representatives) were drawn in, as this is a murder case. Thankfully, due attention is now being given to the situation. IMATT, UN officials and others have come to witness the proceedings, as this has been deemed a 'regional issue' with many small grievances (and some big ones) being addressed.

With the help of Aaron and a Sierra Leonean man who works for Red Cross, I was able to secure permission from the police to take a few pictures, which I will put on the website as soon as ‘uploading’ pictures is possible. The pavilion is so crowded that it is difficult to get in to see the actual proceedings, but outside the pavilion, crowds are peacefully assembled in the streets and on balconies of nearby houses with huge banners. One pictorially depicts the shooting followed by an X through a cow, with the header “Enough is Enough.” Others read: “Cows, Yes! Uncontrolled Cows, No!!” (again, illustrated – with fences and cows), “Where are the Authorities?” and “Respect my Place.” I am hopeful that all will go well - though there is some volatile 'talk' in town.

Enough is Enough

Protect Farmers Now!


Well, that’s the news from Kabala-town, where the women are very strong (I tried pounding plantains yesterday) and the men are quite good looking (Paul keeps getting told that he looks very ‘fit’ for an ‘old pa’). Quite contrary to the 7 degree blizzard that many of you are facing in the Midwest, the dusty heat kicking in by 10 AM prevents us from moving faster than a slow stroll. Smiles & winks have replaced pats & hugs as expressions of affection because I am known to growl, ‘too hot!’ I just spoke with Christy Wassenaar who is having a surreal time packing t-shirts and tank tops in the midst of a blizzard – but trust me, you will want them!

Grace and peace to each of you,

Emily

Thursday, February 1, 2007

WILD WEST: PART TWO

Aaron and I have just returned from a short trip to Foria, where he made further arrangements for research on the mountain with Yegbeh, and I experienced more of the wonders of Kuranko-land, including the making of 'country cloth' and the eating of banana rice-cake bread.

We arrived to find Kabala-town in uproar last night. The 'story' floating around for the past day and a half has been that a Limba farmer killed two Fula cows that were perpetually invading his rice and cassava farm - and that the Fula rancher had retaliated by abducting and killing one of the Limba farmer's children and laying it on top of the cow. This precipitated an escalating conflict in which the Limba had gone and massacred part of the Fula family. With the two ethnic groups up in arms, the Fula, owners of almost all of the shops in town, including the 'grocery', drug store, gas station, and the bakers of all the bread sold in the central square, decided to strike.

Joseph Sesay is concerned, as a similar incident with the Fula and the Yalunka led to a short but brutal war 25 years ago. He's been trying to get the 'straight scoop' unearthed, feeling that it's usually milder than the 'stories' and that centralized public acknowledgement of the 'truth' will be the fastest way to de-escalate the conflict. Essentially, the informal stories circulating are growing in tragic and gruesome detail, while the formal story unfolding is much less violent and quite comprehensible.

Most of the Fula in this region originate from Guinea. Even those born in Sierra Leone frequently do not identify themselves as nationals of this country. They are nomadic traders and herders, and don't heed any official national borders. They are 'Fula' above and beyond any other identity. They also, historically, were slave traders in this region back hundreds of years ago. Even though an outsider like me tends to think of this history as 'ancient', you will still hear Fula quip or joke (to the Kuranko, Limba, Yalunka and other people groups), 'Oh, leave me be, you're all just slaves.' Even Kumba, when introducing me around town two summers ago, brought me into a Fula shop with the half joking / half serious admonishment, 'you watch this man. He's a thief. All Fula - thieves! He'll steal your children if you are not careful...' The Fula trader laughed - as he seemed to know and get along with Kumba pretty well, but there is an underlying tension between the people groups.

Apart from 'ancient' history, this tension is fueled by current conflict between agricultural farmers and nomadic herders. Fula typically enter a new region as herders, make as much money as they can on 'beef' and then use this money as the capitol to start businesses. It's an admirable model, with the exception of one critical factor: this is a subsistence farming region and the Fula recognize no boundaries for the grazing of their cattle. Farm after farm after farm in this region has been destroyed. Even farmers that are extremely vigilant and who build extensive fences often find that Fula cows have somehow worked their way onto their farm and destroyed / eaten a whole crop. This type of occurrence pushes the farmers beyond frustration into real despair, particularly as they feel that they have no recourse or advocate. The chiefs, who by all counts should be an advocate for the farmers, are all too frequently known to be 'in the pocket' of the Fula.

One (of many) illustrations occurred in the village of Borehkoro a few years back. The place was absolutely over-run by Fula cows. Destruction of crops including palm oil seedlings, rice and cassava was so extensive and that the Kuranko were at their wits end. According to Robert Jawara, director of C.E.S. (Christian Extension Services), one could not walk at night without stumbling into a cow - even on their front porches eating from baskets of produce harvested from the farm. The villagers finally decided to 'bring a case' against the Fula to the Sa Nieni Paramount Chief. In this case, the 'evidence' was clear; even documented by volumes of pictures. On the day of the trial, C.E.S. organized dozens of people to witness to the proceedings of the trial. They parked (sat) themselves in front of the chief's house and made it clear that they were present so as to make the 'verdict' of the trial known throughout the chiefdom. The Paramount Chief responded by refusing to 'hear' the case; deciding to 'refer' it to the court in Kabala. This precipitated unveiled grumbling on the part of the Fula: that they had "wasted a cow" (used in bribery of the chief).

Today, bits and pieces of the current story are becoming clearer. It seems that the people of Kabala have been pushed beyond the threshold of tolerance in regard to Fula destruction of farmland. This has led to the poisoning and shooting of a number of cows in recent weeks and months. The Fula, confident that the 'law' will be on their side, recently brought a case to court regarding the issue. The Limba, who happened to be the faction accused, essentially responded, 'fine, let's bring this to court but we'd like some restitution for destroyed crops while we are at it,' ...and proceeded to get organized for the trial. The Fula then failed to show up for the meeting. This did not produce the 'results' that they were hoping for, so they have now closed their shops to emphasize to everyone in town how important they are to the local economy with the hopes that people will recognize how much they 'need' and depend on the Fula. This might backfire on them, as (according to Kumba) much 'talk' is stirring among the Limba and Kuranko about how they need to get their act together and generate capitol for 'their own' shops.

It does not appear, despite the rampant rumors, that there actually were any murders this time around, though it does sound as though these stories were 'borrowed' from real incidents that occurred a few years back in a nearby region. The most significant turmoil on the streets is the result of 'strike breakers,' as some Fula shop owners are not quite sure 'why' they are striking and can't afford to do so for very long. Other Fula seem to be harassing those who find themselves in this position. The Paramount Chief of this region, who so far seems to be a pretty smart and level-headed man, has taken the interesting 'stance' that, though it fall within the rights of the Fula to strike, if they choose to do so, they cannot re-open their businesses without collectively getting permission from him. He has also spoken with the 'head' of the Fula and they together have agreed that businesses like the petrol station must remain open, as it is a 'branch' of a company in Freetown that would not agree to its 'shutting down,' and nor would it be a good thing for the whole of Kabala that depends on it.

For us, the consequences are relatively minor: no good bread, no Magram (my favorite tasting brand of bottled water), no other niceties like biscuits, soap etc. We are pretty well stocked and anticipate that the situation will blow over in a couple of days. I'm all of the sudden craving sandwiches though, now that I can't get bread.

This is a LONG standing conflict, and we don't anticipate that this flare up precipitate any real change... but it sure would be nice if dialogue was set in motion to arbitrate disputes and establish policies leading to a greater degree of justice.

We are looking forward to Paul's (Aaron's dad) arrival this evening!

Grace and peace to each of you,
Emily

Sunday, January 21, 2007

THE WILD, WILD WEST


Sierra Leonean Land Rights in the Western Province and Beyond

Downtown Freetown, January 2007


“It’s like the wild, wild west out here,” stated Judy Nelson, Director of DOVE International. DOVE is an NGO that cares for approximately 30 orphans dislocated from families during the war. This assessment was made after spending the past two years battling to retain land and water rights of property owned by the orphanage.

Sierra Leone’s political history is fascinating. I’m doubtful that it is possible to grasp all of the subtle impacts it has had on the country’s development. Forgive me if this email is a bit ‘dry’ but I have recently become very interested in the implications of both ‘formal’ and ‘traditional’ governing structures on land ownership – so you all get to be the beneficiaries of my research!

The return of the ‘Krios’ happened right around the same time as Britain began to explore West Africa. Though the British were not under the same ‘mandate’ to form colonies that other European nations seemed to be, Sierra Leone was of particular interest because of its strategic location on the western coast of Africa and it’s natural port (Port Loko). The Krios were freed British slaves, and came in essentially three waves:

1) In 1787 a group of British abolitionists proposed that the ‘ideal’ way to respond to the plight of newly freed black slaves (who, for the most part, were jobless and poor) would be to establish a ‘free state’ in Africa to which they could be re-settled. The British government provided funding for several hundred blacks, as well as dozens of white Europeans interested in trade, evangelism and the building of the ‘Sierra Leone Company’ settlement. The venture proved a ‘near disaster’ and many died of starvation and disease.

2) The Nova Scotians followed several years later. They were black slaves who had fought for the British during the American War of Independence in exchange for freedom and a promise of land (in America). The American victory forced these ‘loyalists’ to emigrate to the British settlement of Nova Scotia after the war. This land (i.e. climate) proved unacceptable, so when the offer came for them to go to Sierra Leone (with the promise of free land), they took it. This new group of settlers was more industrious and independent than the prior, and managed to breathe new life into the project.

3) The Maroons were the third major group of Krio settlers. They were blacks from Jamaica who had revolted against slavery and maintained independence in the mountains. In 1796, Jamaica was conquered by the British, and the free blacks were shipped up to Nova Scotia. They too requested ‘transfer’ to Sierra Leone, and were granted it near the turn of the century.

The Western Province of Sierra Leone (including Freetown, the coastal region directly to the south, and the mountains directly to the east) became a ‘Crown Colony’ of Britain in 1807. The land was purchased from one of the tribal ‘kings’ of that era (though he initially saw the negotiation as a ‘lease’ and his successor succeeded in getting further payment for a ‘sale’ – which was a foreign concept at the time).

Mid-late 1800’s were the ‘heyday’ of Krio society in West Africa. The British desired to sustain their port and to protect their ‘vision of’ and ‘stake in’ the concept of an African free state. However, it was expensive, and they needed for the ‘Sierra Leone Company’ to ‘cover’ its own expenses. The best way to accomplish ‘self sufficiency’ was to increase trade through the Freetown port. This was becoming increasing difficult - as the French were rapidly colonizing the surrounding regions in West Africa. While not wanting to ‘colonize’ all of what has later come to be known as Sierra Leone, they began to realize that the ‘friendship treaties’ that they had established with the ‘hinterlands’ were not enough to impede regional tribal kings from entering into new land treaties with the French. So, they upped the anty – and adjusted the ‘friendship’ treaties to treaties that declared regions to be part of a ‘British Protectorate.’ The chiefs (in many cases unknowingly) forfeited their right to negotiate with any nationality except the British.

Prior to modern vaccines and anti-malarial medicine, Sierra Leone developed a reputation of being ‘the white man’s grave’ (with good reason). The British did not believe that they had the manpower, nor the finances to govern this new ‘protectorate’ in the same way that they were able to govern the smaller ‘colony’ in the Western Province. They discovered the Krios to be indispensable as members of the ‘civil service.’ The Krios assumed such positions as: teachers, administrators, legislators, etc. for the British Empire. They enjoyed many advantages of this status: income, stature in society and, most importantly, land rights in the Western Province.

The rest of the country had a clearly different status as a ‘protectorate’ of Britain. ‘Kings’ of tribal regions were demoted to the status of ‘Paramount Chiefs,’ as no one within the protectorate could hold a title or status equivalent to that of Queen Victoria. For the most part however, the protectorate was still governed by the chiefdom structure. Krio ‘district officers’ were appointed to each of the five additional provinces, and several levels of courts involving solely chiefs, chiefs and district officers, and solely British district officers were developed to govern the country.

That’s it for my brief history lesson! I should acknowledge that most of this information is derived from reading a nice text available in the Kabala market: “A New History of Sierra Leone” by Joe A.D. Alie. I’ve condensed one hundred and fifty pages down to one – which I hope that you appreciate! This history has implications for current ‘land rights.’

The only region of the country where land can ‘officially’ be owned, bought and sold in independent transactions is in the Western Province. In all other provinces, the Paramount Chief officially owns all of the land. Granted, most people seem to be able to negotiate with the chief to ‘hold property’ with a relatively permanent status, but if a chief were to deem it appropriate, they could reclaim it at any time. Some chiefs are more ethical in this regard than others.

In Kabala, the ‘land rights’ issues closest to our hearts and experience are regarding:

a) Land being used as the site for the development of a new Christian school.
b) Land for Kumba and Joseph Sesay’s new house.




In each of these cases, the land involved is a ‘choice spot’ of land, and there are a number of interested parties. The ‘case’ for a particular use of the land is brought to the Paramount Chief. He will make a determination based on several factors:

1) The sum of money that the person is willing to pay for a ‘lease’ on the land.
2) The intended use: Is there a perceived ‘need’ or ‘desire’ in the chiefdom for this kind of development? If so, this may impact (lower) the price.
3) The person asking… (Does the chief have a good relationship with this person?)

In both of ‘our’ cases, the chief has accepted a negotiated price for the land. This still leaves the ‘lease holder’ in a dicey position until the property has been developed for the stated purpose. If one waits too long, a chief may determine that another ‘use’ is more appropriate and reclaim the land. An ethical chief will, in all likelihood, compensate the individual or organization that has paid a leasing price with the option of alternative land – but the ‘alternative’ is usually less valuable and in less of a ‘choice’ location.

According to Yegbeh, a farmer in Foria, rural land-holders in chiefdoms have fairly secure rights to property once it has initially been acquired from the chief. If one wishes to farm land that falls within the boundaries of a neighboring village, they must secure permission from the neighboring chief and ‘pay’ with one bag of rice (annually). Farms within one’s own village boundary can be farmed with no ‘cost’ and can be transferred from one generation of a family to the next. This is true of housing property as well.

Even in the Western Province of the country where ‘land rights’ seem to be clear, there is much confusion (often caused by corruption). In the case of the DOVE International orphanage property, Judy is constantly fighting a battle. As Freetown has tripled in size (during the war) governmental officials have started to ‘eye’ the surrounding hills as places of respite and retreat from the city. Most of this land is owned by Krios who are unwilling to sell – as the land has been passed down from generation to generation. Judy says that the government has recently instated laws that require land holders to re-certify their ownership of property (requiring a fee) on an annual basis. The paperwork is confusing, and often gets ‘lost,’ enabling the government to reclaim ‘forfeited’ land. Many of DOVE’s neighbors have paid significant sums of money in the fight to keep their land, and have still lost rights – with no compensation.

Outside of the Western Province, people are more and more interested in getting ‘government paperwork’ detailing their ownership of property. Despite the ambiguities of land ownership in the north, people are less concerned about chiefs and paramount chiefs taking their land than they are of the increasing practice of governmental officials coming in and appropriating land that had been ‘secured’ within the traditional system.

Reinforcement of ‘land rights’ is of deep concern. The land holders of Sierra Leone (especially in the coastal and mountainous areas of the Western Province near Freetown) are the vital ‘middle class’ of this country. According to Mary Hodges, a British doctor residing in Freetown, land ownership (and rental) provides supplemental income that enables Sierra Leonean professionals (doctors, professors, etc.) to remain in the country – even though their compensation would be much greater elsewhere. It will be fascinating (to me at least) to see the results of colliding ‘traditional’ and ‘formal’ governing structures in the coming decades – as this collision will have a huge impact on the future development of the country.

Wednesday, January 17, 2007

MOBILITY IMPAIRED

Mobility Impaired: Electrical Fires, MCL Tears and Blown Radiators

As I write, Aaron and I are stranded on the roadside somewhere between MaKeni and Kabala. It’s night… and thanks to the wonders of the ever increasing cell phone range in the north, we have been able to reach Joseph Sesay to let him know of our predicament (a busted radiator), so help will arrive in a couple of hours. Meanwhile, night sounds are emerging – and they are remarkably like night sounds on a summer Michigan night. Lots of crickets.

It seems that in a country known for it’s impediments to getting work done, Aaron and I have run into a particularly long stretch of frustrations and set-backs. My arrival was slightly complicated by both pieces of luggage being left behind in Heathrow Airport for a few days – joining the now 28,000 pieces of luggage that have been delayed or lost there in the past month. Aaron’s blue suitcase (containing research-related content) was lost on the flight that he took on December 10th and has not yet shown up. On arrival, I was greeted by Aaron at Lungi (a nice surprise) as he wanted to pre-empt the plan I had to take the helicopter (which recently suffered an electrical fire) from the airport to Freetown. Instead, we were treated to a much nicer boat crossing – thanks to Aaron’s friend Allen who owns an operates a small tour company and frequently takes NGO visitors on trips out to the Banana Islands.

As most of you are aware, Aaron had a motorcycle accident a week and a half ago which has resulted in a moderate tear to the MCL, damage to the Vastus Lateralis (hamstring) and ‘laxity’ in his ACL. This is going to change the nature of the work that he is able to do for at least the next few weeks, as the 20 mile hike in to the Loma Mountains, steep climb, and rough rocky terrain at the top are taxing even to one in peak physical condition.

Dealing with this injury has provided us with an interesting first-hand experience of the various medical resources available in the country. Basically, with the help of Mary Hodges, a British physician, a Sierra Leonean orthopedic specialist, and a physical therapist residing here with the ‘Mercy Ships’, we feel that we have been able to get a good diagnosis… though MRIs are not available. In the process, Aaron was turned away from clinics by power-wielding receptionists and doctors who appeared less sympathetic to a white patient than SL patients. He was also sent for x-rays (at a fee) to a friend of the doctor – even though soft tissue injuries can not be detected with x-ray. When he questioned the directive, he was told, “you are not the doctor.” Aaron’s case is border-line, and so we are in the limbo regarding the need for surgery for a short while. The MCL and the hamstring injuries should heal just fine within weeks, and then it will be much easier to tell the extent of the ACL injury – if there is one.

One blessing of the forced delay in Freetown (waiting five days for my luggage to arrive) was that we had an opportunity to spend a good deal of time with Mary and Zed, long- time friends of the Kortenhovens and residents of Sierra Leone. Mary is a pediatric doctor with a specialization in worms. She has been working with Njalla University to develop the curriculum for their CHO (Community Health Organizer) program. Before looking it over, I was under the mistaken impression that this was a fairly ‘light’ medical program, focused primarily on sanitation, basic medications and injuries. I must say, I am now in awe of anyone who tries to get through this program and who can practice effective ‘first responder’ medicine with the limited resources available in this country. There is only one CHO that we know of as far north in the country as Kabala – and often, there really is no back-up for this person, except in cases where they are responding to someone with monetary resources to get to a bigger city. The program requires an intensive three years of coursework and it is very carefully formulated. Unfortunately, it is currently only offered in Bo (in the south of the country) and few from the north are able or willing to relocate for that long of a period of time.

Mary believes that (from a medical perspective) the best investment this country can make is in the CHO and CHA programs: making distance learning possible, creating partial scholarships, doing appropriate follow-up, etc. One ‘advantage’ to training people for the CHO degree is that is not a transferable to other countries as a medical degree, so the expertise has a higher likelihood of remaining within Sierra Leone.

I am realizing more and more that expatriates trying to ‘help’ the situation here work with basically two different operatives:

1) Develop personal relationships and try to do the best thing possible for the individuals with whom you come in contact.

2) Develop ‘systems’ that incrementally elevate the living standards and opportunities for many people by one small notch.

It is really difficult to strive for the middle line between these… to develop personal relationships but try to invest time, energy and money in ways that actually serve a whole community well.

Well, the computer battery is just about to die, so it will be just Aaron, me, a broken down truck and the night road until Asmana comes to find us.

Love to all,

Emily