Thursday, July 16, 2015

Tastes Like Freedom

      As many of you probably know by now, I was very sick recently. I know I was pretty sick here once before, but that doesn’t even come close to how sick I was in the week leading up to the Fourth of July. On the Sunday night prior to the Fourth, I told Meredith that I wished we could just have one extra day of the weekend so I could lay around being my typical lazy self. The next day, as I lay on the couch feeling ill, I really regretted saying that. While I felt pretty sick that Monday, it was definitely a sickness that seemed like a passing bug. On Tuesday morning I still felt a little queasy, but I felt well enough to go to work. I had more to do that week than I’d had to do in a while and was supposed to be doing something specifically for our Country Rep (CR) so I wanted to get back to work right away. Within an hour of getting to the office I started feeling really warm so I pulled out my thermometer and my temperature was 99.1 F. That doesn’t seem like too much to worry about, but the safety policies for Ebola require you to leave the office immediately if your temperature rises above 98.6 F at all. So I ran to Sasha’s office and told him I had a fever which he was not pleased to hear. He asked me a bunch of questions about other symptoms and then told me to get a driver to take me home. Obviously we hit a ton of traffic on the way home so it took us almost an hour to get home and by the time we did, I felt like I was going to die. I literally almost collapsed as I was walking into the house. I made a beeline for the couch and collapsed onto it. I knew I should get up and change out of my work clothes and get medicine and something to drink, but I couldn’t bring myself to get up so instead of doing that I did what every adult does when they’re sick – I called my parents. I felt too weak to even hold the phone so I just alternated between calling my dad and my mom and kept them on speaker phone as I proceeded to writhe around in pain and misery on the couch. Thankfully Meredith was coming home for lunch that day for a Skype interview so I texted her to ask her to bring me home some Gatorade and/or Coke. My fever was probably up to about 101 F by the time she got home and I was so out of it. She was kind enough to get me drinks and a cold, wet cloth for my face and anything else I needed. Then Sasha called and when he found out my temperature had gone up more he told me he was coming home right away to give me a rapid test for malaria. Soon after Sasha arrived at home he gave me the malaria test. Waiting for the results was the longest 15 minutes of my life. Before he gave me the test, Sasha had said, “If it’s negative then I would be concerned.” Having had malaria is something of a badge of honor in the public health world, but that's definitely an honor I can live without. But when Sasha told me that we should be worried if it’s negative, I was seriously praying that it was malaria. Obviously there are a lot of other things that can cause a fever, but my symptoms and their progression coupled with the fact that I had been in the field the previous week and we’re in Sierra Leone and we’ve been seeing a spike in cases, put Ebola at the forefront of our minds. Quite frankly, in hindsight, it was freaking terrifying. Thankfully, at the time, I was so out of it that I couldn’t quite comprehend just how terrifying things would become if I did in fact have Ebola. I was oddly calm. When the malaria test was negative, I basically thought, “Okay. I have Ebola. I could die. That’s okay.” I felt so horrendous that I didn’t even really care at that point. I remember Sasha standing over me at one point and saying, “You’re miserable, huh?” I just looked at him and nodded. Somewhere in that time frame I Skyped with Anna Marie and EJ so they could pray with me. I don’t really remember much of our conversation, but I’m grateful that they were willing to take time to talk to me. After the malaria test came back negative, I was about ready to call for a plane to medevac me back to the US, but obviously that wasn’t something that was really going to happen unless Ebola was actually confirmed and that wasn’t an option. In order to confirm Ebola, a team would have had to come to Sasha’s house in full PPE to collect a sample from me and given my symptoms, I would have ended up in quarantine in a holding unit in a Sierra Leonean hospital until it was determined I didn’t have Ebola. That is not a situation that you ever want to be in. So instead of jumping to the outlandish conclusions that were running rampant in my head, Sasha said that we would treat my symptoms and hope that they resolved. I took Paracetamol to reduce my fever, but my temperature just kept going up. As far as I know, my temperature peaked just shy of 103 F, but it could have gone higher while I was passed out on the couch. After sleeping for a few hours, I woke up to find Sasha and Annisha at the dining room table alternating between doing work and staring at me. My temperature was about 102 F then, but I didn’t feel hot anymore because I’d gotten used to it. I was able to get off the couch for the first time and Sasha forced me to drink ORS (although I didn’t actually drink very much of it because it was disgusting) and eat some soup. Eventually, after a couple of doses of Paracetemol, my fever slowly started to go down. It was still well over 98.6 F for a few more hours, but it went back to normal after about twelve hours or so. Over the next few days, my temperature remained normal, but I still had plenty of other symptoms and I was unbelievably tired so I ended up spending the entire week at home. I probably could’ve gone to the office on Friday, but Sasha was working from home so I just stayed home too. I think I probably had a bad case of food poisoning, but I don’t know how I got it. I’m so grateful that Sasha and Meredith chose to ignore the rules that tell us not to get near someone who has even the slightest chance of having Ebola in order to take care of me. Even though I didn’t have Ebola (thankfully), I got a brief glimpse into what it might be like for people who are suspected of having Ebola. I know that what I experienced was nothing compared to what Ebola patients endure so the whole thing motivated me to finish out my last few weeks here in Sierra Leone with renewed vigor and optimism so that we can end this outbreak once and for all.
I've never been happier to see 98.6 F on a thermometer

      After combating my illness, I decided to join Sasha and Meredith and go to Martin’s place  at Black Johnson Beach for the Fourth of July. I hadn’t been to Martin’s since my very first weekend in Sierra Leone back in February, but Martin has visited us in Freetown a few times. He’s weirded me out ever since I met him, but his creepiness factor has gotten significantly higher since I discovered that he’s recently taken on a Sierra Leonean wife who cannot possibly be more than 22 years old and she’s probably even younger than that. Martin is at least 45 years old. Don’t get me wrong – Martin is a nice guy and he’s got some incredible travel stories and we bonded over our shared love of astronomy, but this whole situation with his young bride makes me extremely uncomfortable. I was, however, comforted by the fact that Meredith and Annisha also find it to be really strange. His wife, Effie, is very quiet around us so it’s hard to know what she’s really like when it’s just the two of them. This type of situation is quite common in Sierra Leone, but it begs the question – what motivates a middle aged European man who’s traveled all around the world to come settle in Sierra Leone and take a “bush wife” (as Meredith puts it) and why does he make such awkward comments about the situation? But it’s really none of my business. There is one really interesting thing that was happening on the Monday after we left. They were going to have a traditional fertility ceremony. It involved slaughtering a chicken and Effie’s grandmother coming to perform a ceremony where she would rub oils of some sort on Effie and pray that she would get pregnant. Martin doesn’t really seem like the father type to me (considering the fact that he thinks he probably has multiple children around the world and has no desire to find any of them…), but again it’s none of my business. I can still think it’s very strange though. Anyway, apart from all that the Fourth was not very exciting. We did, however, have this delightful “Product of USA” to eat and I may or may not have opened the can, ate a few and declared, much to Meredith’s amusement, “Tastes like freedom.”

Sasha didn’t get us any fireworks (literally the one thing we wanted for the weekend) so we ended up going to bed by like 9pm and it was insanely hot and humid so it was really hard to sleep. We spent the next day just lounging around on the beach and hoping it would get a little sunny which it finally did. Then I had the joy of sitting under a thatched umbrella while it drizzled all around me and it was literally perfect. Overall, it wasn’t how I would prefer to spend my Fourth of July weekend (it’s amazing how patriotic you can become when doing anything patriotic isn’t really an option), but it was pretty nice...
View on the way out of Freetown...I'm really going to miss this :-(

The hangout at Martin's

This sky made up for the fact that we didn't have any fireworks
     Donal also arrived in Freetown recently. I’m not entirely sure what Donal’s job is, but he’s Irish and he’s hilarious and that’s all that really matters. He arrived on the day I was really sick and he came to Sasha’s for dinner the following evening. I was still feeling quite sick and he was very drunk by the time I managed to muster up enough energy to talk to him (whilst in my pajamas which wasn’t awkward at all…). I had been in my room, but I heard Meredith trying to explain the Electoral College system to Sasha and Donal so I felt the need to drag myself out of bed to complain about what a horrendous system it is (although I also feel that the alternative system of a straight popular vote is bad too so I can’t win) and that obviously incited a political discussion in which Donal incorrectly assumed I’d be voting for Hillary and was shocked to find a Republican working for CRS. I am literally dumbfounded by the lack of conservatives in this organization. It’s a faith based organization. You think there’d be a few conservatives. I have yet to find one though. It’s well known that public health is dominated by liberals so I guess I shouldn’t be that surprised. Anyway, the point is that Donal was so shocked that he asked where I was from and obviously when I said I was from Rhode Island he was even more shocked, but since he was super drunk things got off topic very quickly and he started talking about the delinquent Boston Irish who, according to him, are not real Irish people. It was pretty funny. Fast forward to last Wednesday night in which another, less friendly political conversation occurred. Sasha and Meredith volunteered to host Wednesday night dinner and we finally did pizza night!! It was fantastic. Domenic is such an awesome chef. He’s been in charge of cooking for two of the Wednesday night dinners that I’ve been to and he has done a great job both times. He apparently worked in a pizza shop in Sweden at one point so he knew exactly what he was doing. He made about 20 different pizzas, one of which had a fried egg on it which made me ecstatic. When I wasn’t hovering around the kitchen trying to grab a piece of pizza before it disappeared, I was sitting outside on the porch with a small group of people just relaxing and avoiding having to talk to a million people I don’t know. Towards the end of the night, I was sitting outside with Pat and his wife, Hawa, and an older gentleman named Roger. I was already annoyed with Pat because he had told me he hates the Queen. I can’t even comprehend that. While I’d not so secretly prefer that we have a monarchy and that we still live like the Crawley’s do in Downton Abbey, Pat is quite the socialist just like Tom on Downton. Anyway, he decided that he felt the need to tell me that I should be a democrat because I’m a woman from New England and that Bill Clinton was the best president we’ve had since Kennedy. His wife was trying to get him to calm down and stop being an idiot, but he wasn’t having it. Then Roger started telling a story about what English and Irish relations were like when he was growing up and how the Irish were always looked down on by the English. In the middle of the story he mentioned that they used to call the Irish “Paddies”. Well, Pat flipped out on Roger and started yelling at him and saying that he was being rude and he wasn’t going to sit there and let him call him that name. He told Roger not to be rude and poor Roger was saying how he didn’t mean anything by it. I refuse to let anyone insult the elderly so I told Pat that he was the one being rude and he got up and stormed away. Hawa chased after him and I sat with Roger who was clearly very unsettled and shaken up by the whole thing. Later after Pat and Hawa had left, I was talking with Roger and he said that Pat should have known better than to talk to him like that, but he said, “Then again, he’s Irish…” I guess that British/Irish relationship still isn’t great.
      Last Friday night I went to dinner at Lagoonda with Annisha and Meredith. It was delicious as usual. On the way home Meredith and I saw a guy completely ignore a “Road Closed” sign and just drive straight on up a hill that they’ve been doing construction on for ages. This is pretty typical in Sierra Leone, but Meredith was like, “Rule of law? Who needs it?!” I nearly died laughing. It’d probably be funnier to you if you lived here. Anyway, in other random funny quote news, Annisha was talking about questions that Meredith might get asked in her interview and as the questions got progressively more ridiculous and funny, Annisha says, “Tell us about a time when you tried to save the world with no resources.” This is also probably funnier if you’ve actually worked in a country like Sierra Leone or a situation like the Ebola response. The (not at all funny) point is that we never have enough resources. I was shocked when I first found out how much money we spend in a week for just one project. We are spending millions of dollars to help people in ONE district of ONE country. I certainly believe that ever person matters and that everyone deserves to live at a certain standard, but when you think about how much money must be spent all around the world on projects like this, it’s overwhelming. Sometimes it seems so futile, but when you think about the individual that you're helping, it makes it a little better knowing that your project is making a difference in their life.
     Last Saturday we had a delightfully American brunch. Sasha thought it was so disturbing that Meredith and I like syrup on our bacon and eggs. Clearly he doesn’t know what he’s talking about. The rest of last weekend was pretty uneventful. I met one of our new TDY-ers, Michelle. She’s from California and she’s pretty cool. Sasha and I watched tennis (after having worked from home on Friday just so we could watch the men’s semifinals) and were disappointed that Federer lost.

     Anyway, this week hasn’t been too bad. Eve left which is sad. Annisha has been coming over after work most days because her boyfriend, Ahmed, is in Kenema for a week or so at the school he runs there. We’ve had some tasty food including Annisha's naan. I was also asked if I wanted a contract with CRS and I’ve been avoiding giving them an answer because I’m going to be really awkward when I say no. While I’m so glad to have had this opportunity and I’ve enjoyed working for CRS, I think it’s time to move on. Anyway, Sasha wasn’t feeling well today so we worked from home. Actually, I worked and Sasha slept. I was more productive today than I’ve been all week at the office. Tomorrow is the end of Ramadan so it’s a public holiday which is fantastic. I don’t think there’s anything better than getting a day off for a holiday you don’t even celebrate. Typically Freetown is like one big party during this holiday (Eid al-Fitr), but it will be interesting to see what it’s like tomorrow given the Ebola situation. What exactly is the Ebola situation right now? It’s not good. In recent weeks we’ve seen a spike in cases in Port Loko, Kambia and Western Area Urban (aka Freetown). In Port Loko the cases are confined to two chiefdoms and Operation Northern Push is hopefully working to stop the spread there, but the sudden, fairly large increase in cases in Freetown was unexpected given that we had gone 18 days without a new case here. I attended the Ebola Frontline meeting at UNDP this week and, after getting over the shock of the facilitator opening this high level meeting by having us mediate (clearly Ebola has made people a little crazy), I learned that we should be expecting even more cases. That’s not exactly surprising, but it’s a bit depressing. In addition to the increase in cases here, Liberia reported new cases after having been declared Ebola free back in May. That was devastating, but it’s reassuring that they seem to have things under control and were able to catch things quickly using their surveillance system. Sasha and Annisha are absolutely convinced that Ebola will never end here. I have my moments where I start to agree with them, but those pass pretty quickly. Nothing’s impossible. Ebola will end here. After it ends, it will likely come back again eventually, but stopping the current outbreak will be a huge achievement and when the next cases develop people will know what to do. 


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