Thursday, July 02, 2015

Operation Northern Push

     Operation Northern Push has officially begun. This surge effort focuses on the two districts – Port Loko and Kambia – that were responsible for the large increase in cases we saw a few weeks ago. These two districts are basically on lockdown for 21 days (which we're almost past at this point because I've procrastinated on posting this for so long) and surveillance activities have been increased. We’ve brought in a bunch of new vehicles to deal with the surge and our burial teams are working harder than ever. Putting so many restrictions on movement in these two districts also means that food needs to be supplied to them which adds additional strain. It’s also started to rain a lot more so that’s bringing additional problems as well. Malaria cases will rise which is problematic because malaria looks similar to Ebola initially. The rains have also caused a lot of devastation. In addition to wiping out many of the roads we use to travel into more remote chiefdoms, the rains have also destroyed hundreds of houses across the country. The rainy season is at its’ worst in July so who knows what will happen over the next few weeks. It will be interesting to see what happens with this surge effort. It’s now official that the outbreak will not be over before I leave Sierra Leone. I can’t believe I leave Sierra Leone in less than 42 days!! Actually, I leave one month from today!! Even though I won’t be in the country (although I've been asked if I would come back so maybe I will be...) to celebrate the end of the outbreak, I hope that this surge helps to bring us closer to beating Ebola and that the country can be declared Ebola free soon after I leave.

View of Freetown from the office
      In other news, the President recently announced that stores can stay open until 9pm and restaurants can stay open until 10pm and be open on Sundays!! This doesn’t apply to the two districts involved in Operation Northern Push, but it’s still exciting. Although I think it had more to do with Ramadan than anything else. As I’m sure you all know, Ramadan is a Muslim holiday that involves, among other things, fasting from sunrise to sunset. The sun sets after 6pm so if restaurants and stores had remained closed after that time, people would have been unable to go out to eat or to purchase food. While Ramadan and the related food issue has, in my opinion, been the motivating factor behind the joyful ending of the business curfew, it has also brought some very difficult challenges. As I mentioned, Ramadan involves fasting. This includes refraining from both food and liquids. For burial and ambulance teams working in PPE this is a serious issue. While wearing PPE, you lose a TON of fluids because the suits are incredibly hot. Even people just standing around in them sweat profusely. In a predominantly Muslim country, how exactly do you deal with Ramadan during Ebola? You tell people not to fast, of course. That was the general consensus at the most recent burial pillar meeting. There are exceptions to fasting on Ramadan, but after a quick perusal of Wikipedia, it doesn’t seem that any of those exceptions include “because you’re wearing PPE during an Ebola outbreak.” I’m not specifically involved in this process, but the plan has been to work with Muslim leaders to get them to make an announcement saying that those involved in the response who have to wear PPE are exempt from the fasting requirement. I’m not sure if this has happened yet though. At the very least, we are asking teams to voluntarily refrain from fasting. If they are unwilling to do that, we are asking that they at least drink lots of water during the day. If they refuse that suggestion then I don’t know what the plan is because obviously we aren’t going to fire them. We considered having them switch places with someone who doesn’t observe Ramadan and who doesn’t wear PPE, but this is problematic because only certain people are trained to do certain tasks and, in reality, everyone on these teams wears PPE at some point in the process. Despite all this, I found out that there’s a public holiday when Ramadan ends so it’s all good because I get an unexpected day off a month from now!! But seriously, pray for our teams and everyone wearing PPE during this time because apart from the typical Ebola related concerns, there are now even more health concerns involved in their job.
     It’s been awhile so here's a quick aside about some random things that have happened recently. One day one of the main stories on the radio was about the President going to Germany to receive his annual physical which he apparently missed last year because of Ebola. First of all, I think it’s outrageous that the President goes to a European country to go to the doctors when people here can barely access medical care at all. Also, can you imagine if CNN had a breaking news report every year when the President went for his yearly physical? Anyways, I also saw a dead motorcyclist in the middle of the street. There were huge crowds gathered around the poor guy as we drove by the scene. His body had already been placed in a body bag which is not acceptable because only burial teams are supposed to do that. On a totally unrelated note, I learned one rainy season lesson the hard way...don’t let the cleaning lady wash three of your four pairs of work pants on the same day because they will be wet for the next three days and you’ll have to wear the same pair of pants every day. Thankfully pants never get dirty, right? My former supervisor, Nancy, left on the 14th and Davor is my new supervisor. We went to Country Lodge for dinner on the Friday night before Nancy left and on the way we saw someone washing his clothes in the water that was streaming through the gutter. Meredith took one look at him and said, “Doesn’t he know there’s a river right there?” It was pretty funny, but I guess using rainwater is much safer than getting in a river that’s got all types of parasites in it. I’ve become the sole representative for CRS at the weekly Burial Pillar meetings at the NERC. The meetings have become very interesting lately. We began discussing the possibility of transferring responsibilities for burials to funeral homes. A burial team would still pick up the body, but more traditional funeral practices could begin again. This was done very successfully in Liberia, but Liberia is not Sierra Leone. While Sierra Leone is about 75% Muslim, Liberia is about 85% Christian. Muslims do not use the funeral homes so it is only Christians that would benefit from this new plan. This helped in Liberia because it’s predominantly Christian. Since Sierra Leone is predominantly Muslim, this plan is unlikely to benefit significant numbers of people. Either way, we don’t think we’re quite ready to make the transition to using funeral homes just yet. Personally, I think it’s unlikely to happen at all.  

"Nor Pis Ya Dortyman" sign near the office
     I was in the field last Wednesday, but on the previous Wednesday we went to Martin’s for the weekly Wednesday night dinner party. The theme was Latino Night which wasn’t really my favorite. I’m dying for pizza night. I did meet a lot of cool people including a couple – Helen and Peter – from the Netherlands. Helen has given me some helpful hints about non-touristy things to do while I’m in Amsterdam in August. I also met an older couple – John and Mary – who are from New Zealand, but who have lived all over the world since 1995. John works for the brewing company here. They only just arrived, but they’re so used to adjusting that they can find the positive in just about anything. I loved hearing all of their stories about their time in Thailand, Myanmar, the Netherlands, South Africa and Nigeria. Their kids moved with them when they were younger, but they were living in Papua New Guinea when the kids started finishing started finishing primary school and apparently everyone in Papua New Guinea goes to Australia for boarding school when they get to secondary school age. John and Mary’s kids ended up going back to New Zealand for boarding school, but got to visit their parents wherever they happened to be a few times each year during school vacations. It was really fascinating to hear all about it. On the way home we came across a roadblock. I’m not usually out late enough to experience these in Freetown, but when I am, we usually just pass right through. Not this time. The police officer stopped us and shined his flashlight in our faces and started asking Sasha for money. Once his partner heard what he was doing, he walked away and then things started to get a little tense. I was getting a bit nervous, but several minutes later we drove away safely and without surrendering any money.
     Last week I went up to Makeni for a few days. Davor and I went up together and we stopped in Port Loko for a little while on the way up. The Command Center in Port Loko is a completely different place than it was just a few weeks ago. With Operation Northern Push heating up, there are a lot more British military personnel (they had left a while ago, but they’re back now) and there are tents sent up everywhere. There’s a lot more going on and hopefully the effort will help bring the case numbers down. When we finally arrived at the hotel in Makeni, Davor and I walked in and Elijah, one of my favorite Mena Hills staff members, said hi and then asked, “Do you still want this room?” He was pointing to Room 6 and Davor said, “Yeah, yeah that’s fine.” What Davor didn’t realize is that Room 6 is my room. It’s my favorite room and the staff members know that so when I come they make sure to reserve that room for me. Anyway, when Davor replied, Elijah just laughed and said, “No, No. I’m talking to her.” It’s the little things. Unfortunately, things haven’t been going very well at Mena Hills. John B., one of our favorite employees, was fired because “he was messing with the money.” Now some people may think that he deserved to be fired, but there’s always two sides to the story. At most, John B. took a couple of Cokes and a little money. Everyone here does stuff like that. Just because everyone does it, doesn’t make it okay, but there are other things to consider. John B. is an orphan. He has been raised by the pastor who owns Mena Hills since he was a very small boy. I’m sure the pastor knows that everyone takes some (“small small”) money here and there. John B. just happened to be the one who got caught. The pastor wasn’t making much of a profit so he started looking into things and this is when John B. got caught. The pastor told some of our staff that he “wanted to make some money during Ebola” so he needed to make an example out of John B. That doesn’t seem like the way the pastor should be treating a boy he raised as his own and it was very disheartening for us to hear that his main motivating factor was money. Being the awesome people that they are, our staff members who stay at Mena Hills have tried to help John B. out by giving him some money here and there and there was even talk of hiring him as a messenger for CRS. I’m not sure if that happened, but I hope it does or that the pastor reconsiders and rehires John B. because he’s really a standup guy. I also finally got to go with John (our staff member, not John B.) on his nightly walk. Every single night he walks around Makeni for about an hour. As we were walking, everybody was waving to him and inviting him to come dance or have palm wine with them. That’s the type of thing that makes being in the field way better than being in Freetown. John returned to Sri Lanka permanently this week and I was extremely sad to see him go. When I first arrived, Annisha always told me that John reminded her of her dad and I can see why she’d think of him as a father figure. He was always looking out for us. The first time I went to the field, he was the one making sure that I stayed far away from the burial team members and gravediggers, asking the staff to get me a mosquito net when my room didn’t have one and ordering food for me when I didn’t know what to ask for from the staff at Mena Hills. I think John is the type of person every CRS employee, or every person in general for that matter, should strive to emulate. I look forward to seeing him again when I travel to Sri Lanka someday.

View over Freetown from Hill Station on our way to Makeni #lookingood #rainyseason

UNICEF tent set up outside the Port Loko CCC for Operation Northern Push
     One of my favorite things that happens here involves crossing the street. The streets of Freetown are insane. Okada (motorbike) drivers ignore all the rules (okay, there aren’t actually that many rules here, but they certainly ignore common sense), much like obnoxious cyclists do in the US. There are no stop signs or traffic lights. It’s basically pure madness. There are also tons of little kids on the streets. Unlike in the US where people have gotten arrested for allowing their kids to walk to school alone, kids here are pretty much always walking by themselves. One thing I’ve seen that I absolutely love is little kids crossing the street. If they’re still pretty young, they sometimes get nervous about crossing the street because of all the crazy drivers. When this happens, they will look around with a look that screams “Help me” and a random adult will take their hand, stop traffic and take them across the street. In the US, kids are taught not to talk to strangers, but in Sierra Leone, everyone is like family. As I traveled back from Makeni last week, one of the most outgoing and friendly national staff members, Aminata, traveled back with me. While we were in the car, we stopped at a bunch of different points along the way to buy fruit and whatever else Aminata needed. At one particular stop, everyone was calling her “Aunty” (the term of respect people use here) and trying to get her to buy from them and when we pulled away she was just laughing and asking me if I’d ever seen anything like this. We soon drove by a group of school kids who were walking home and they all started waving and saying hi and I mentioned how much I love when they do that because that’s not typical in the US. Aminata told me that she had taken her son to NYC last year and when they were there she had to tell him, “Don’t do what you’ve been doing in Sierra Leone. Don’t say hi to everyone. Don’t open the door for everyone.” How sad is that? It would be so nice if we could say hi to everyone on the street with being looked at as if we had four heads or if children could open the door for every person who knocked and invite them in without having any reason to be afraid. Sierra Leone has us beat there. On a different note, every time I travel with Aminata we seem to be transporting something outrageous. Note to self: don’t look at what we’re transporting when we drive back from Makeni. Last time I came face to face with a live chicken and this time I ended up sticking my face in a box of cows feet which is really a misnomer because the feet were still attached to what appeared to be a recently severed cows leg. Lesson learned.

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