June 30. The Palm Oil Stain

The Palm Oil Stain written by Nadia Maddy is a great love story of Shalimar, who suffered from Rebel War in Sierra Leone. Shalimar escaped from Rebel attacks and had to separate from her family. She was protected by mercenary, whose name was Chameleon in Freetown, but she always wanted to return to her home, Blama, to reunite with her family. She was always desperate to leave Chameleon, but he did not want to let her go. The RUF Rebel was still there, and he needed protect her. What fates are waiting for them?

I began to question myself that what is the most important thing for me.

My family? My future? My love?

If I were Shalimar, would I take risk of going back to see my family, or settle for the present?

Sometimes, I think that studying seems to be really extravagant because it needs a lot of necessary conditions. Tuition, textbook, stationery, perfect satiety, and good place with the right temperature… all those are directly with money. Selling cassava leaves and potato leaves in the market just like Shalimar was not uncommon after war. I wish all youths in Sierra Leone will be filled with hopes and dreams so that they will not suffer the pain of war again.

June 29. II. Laundry

Before I came here, I did not think too much what kinds of technology are available here. It would have been funny if I had asked, “Is there air conditioner? Is there laundry machine? Is there supermarket?” Those things could be easily known at one time once I get here. The answer is everything is available in Freetown, Sierra Leone.

The last laundry machine did not work.

In my home area, there was a public laundry machine room. I had no doubt that it should be working. It took one week to find out where it was, because whenever I asked, security guard said, “It is closed now.” My last solution was to ask Amadu. He showed me a laundry room and said that only one laundry machine works. But that machine looked also strange. There were filthy water inside the machine, and Amadu bled all that water by scooping up one by one.

I wished that laundry machine worked well, and I waited for three hours until it finished. Oh no… It did not work! It never refreshed in clean water, and all my laundries were submerged in the same type of dirty water. I could not even open the machine door. One housekeeper helped me to take them out and said, none of the laundry machines worked for a long time. So then, how residents here do the laundry? To my surprise, all residents have hired housekeeper, and they did not even know whether laundry machine works. The housekeeper asked me, “Can I work for you?”

I asked myself. Do I need housekeeper or person who cook for me? My neighbor Nephas suggested that his maid could also do my laundry and clean my room, because he pays her well. I felt awkward about this situation that it is common to have housekeeper in Sierra Leone. My life will be easy if someone cook, clean, hand wash, and iron for me. But I am fine, I can manage on my own. I would rather live in a little dirty(?) place and skip breakfast, as I always do. Also, there is a beauty of 손빨래, hand-washing; you can exercise by scrubbing and squeezing out water of the wet clothes.

However, for the second time, I brought my laundry to the Family Kingdom hotel and asked, “I don’t stay here any more, but can I use the laundry machine here?” Thank you so much, Magnus! He made it possible. I am happy with the machine that works for cleaning my clothes.

June 29. I. Where is Saint John?

Today, I decided to go to church by myself. I was still not familiar with roads, but I remembered the big point: go to the Aberdeen road (1,000 Leone), and then taking another taxi to go to the Saint (St) John (1,000 Leone). Finding taxi or motorbike on the road normally takes less than 10 seconds. I chose the taxi, safer transportation, and it was the first moment that I took a taxi alone.

“Ah-Bah-Dee road!” (Aberdeen road!)

“Ah-Bah-Dee road weh-ah?” (Aberdeen road where?)

“Well… Aberdeen road intersection?”

All I knew was just “Aberdeen road.” I did not know where this road starts and ends. Taxi should go to a certain spot if I just say “Aberdeen road” from the place where I was standing. Anyway, taxi departed. There were no traffic lights anywhere, but it was amazing that all motor vehicles went here and there smoothly, and motorbikes passed well between cars. The roads were not that complicated; even though there was a winding path, it was an actually one main road. Expectably, the taxi driver drove me there, and I got off because the driver demanded 20,000 Leone to go directly to St John. Motorbike drivers lined up through Aberdeen road intersection, and everyone called me,

“China!” “Let’s go?” “We going?”

But at this time, I wanted to catch another taxi, safer transportation again. I needed some bargaining because 1,000 Leone was enough to get to St John. I got in a taxi. I was not familiar with the roads from here, so I began to feel worried. A taxi entered a crossroad, the different way where I did not expect to be.

“Is here Saint John?”

“Yeah.”

“Can I get off here?”

“No problem.”

Well, it was not Saint John, and I searched for Saint John everywhere. There were many people wearing nice suits (I assume they were also going to their churches), so I asked people over and over,

“Hello, where is Saint John?”

The nice man who I asked last saw my church’s address, and kindly caught the motorbike and explained the driver where I was going. I did not ask his name, but I thanked him! I had no choice but to ride a motorbike, less safe transportation, paying 1,000 Leone. But, it was fun! Although I could not find Saint John for myself, God guided me onto the right path to the church by allowing me to meet good people on the street.

“Cha-ss!” (Charles!)

Little girls from the church called my name when I got an alleyway of the church. Haha, I arrived. We went into the church together.

June 28. Mango

Mango is a tropical/subtropical juicy stone fruit that easily can see in Sierra Leone. Somehow, it was the first time for me to see the actual size of intact mango, and I took a bite of mango. Mango peel was not delicious, so I peeled a mango with my front teeth.

Mangoes have mostly been cultivated in Asia – India, China, Thailand, Philippines, Pakistan – but some African countries – Nigeria, Egypt, Ivory Coast, Sierra Leone – have growers and marketers of mango. Global demand for mangoes has been rising because people in the richest countries seek organic, super fruit, and natural fruit juices without any sweeteners, instead of consuming soda, such as Coke or Fanta. There is a much more positive outlook on the Sierra Leone economy that harvesting mangoes will create a labor intensive industry that solves thousands of Sierra Leone’s unemployed youth. However, there will be a fierce global competition because India already takes up 50% of the world’s mango production, and other mango producing countries would not easily allow Sierra Leone to go into the mango industry.

Anyway, Sierra Leone mango was sweet! Mango trees are prevalent in all across the tropical landscape, and it could be a good solution to improve maternal health in Sierra Leone.


Reference: 
http://www.bread.org/what-we-do/resources/newsletter/may-june-2013/field-focus-improving.html
http://www.sierraexpressmedia.com/archives/63484

Unripe mangoes on a street mango tree

June 27. Communication

I know that communication is one of the most important factors for any organization or group. However, the theory and practice is not the same. Student and intern have a different aspect to communicate with people. When I was at school, all I needed was to talk with instructors, teaching assistants, and students. There was no limitation to ask something, and school also permits my mistake by giving me worse than grade A. On the contrary to this, intern confronts the real-life situation. Intern only breaks the half of school shield, but it is the first-step to move forward to the jungle of competition in a free market.

There are various World Vision/school staffs who make Global Health Fellow possible: World Vision International/ Ireland/ Sierra Leone, school staff and my two readers for this practicum essay. In the World Vision Sierra Leone, there are many staffs from different department who work for Access to Infant and Mother (AIM)-Health. As an intern, I cannot simply do whatever I want; I have a given part of job, and it is done with my supervisors. I mostly communicate with my immediate superior, and try to follow his direction as much as possible. A certain schedule could have been delayed due to Ebola outbreak; I received the instruction that I may not spend consecutive time in the field because of the movement restriction. I also have many superiors to talk to, and it is not that easy to ask demands in a vertical relationship. In addition, World Vision is a large international non-governmental organization, and it is, necessarily, bureaucracy. Chance would be find things if all people related to AIM-Health gather at the one place at the same time to achieve consensus on Fellow’s action plan. However, the reality is it does not; some people went business trip, messages are transformed into different meaning, and all we have is a signed document.

As far as that goes, there is not travel ban in Sierra Leone. Even though Ebola outbreak is out of control, “WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend any travel or trade restrictions.” As of WHO’s Global Alert and Response (GAR) on June 24, the geographical distribution of these cases and deaths is as follows: Kailahun, 135 cases and 32 deaths; Kambia, 1 case and 0 deaths; Port Loko, 2 cases and 0 deaths; Kenema, 19 cases and 2 deaths; and Western, 1 case and 0 deaths. Currently, 52 patients are in EVD Treatment Centres in Kenema (12) and Kailahun (40). It does not bode well for Sierra Leone. Will Ebola spread to entire region in Sierra Leone? 

We can say that there is no Ebola case in Bonthe District, the place where I should go for completing AIM-Health mid-term evaluation, so it is ok to go. Of course, none of staffs would not be deployed the Ebola-affected regions. I am going if there is no restriction to go. I believe that getting hands-on experience in Bonthe District far outweigh the benefit of spending time in National Office.

Besides my work in World Vision, I am learning a lot when it comes to communicating with people. This week, I was in an awkward situation because every staff had a different expectation about Fellowship timeline, and I was in a double bind in Freetown. I realized that I should act wisely and get the point when I should take initiative, and when I should listen to superiors’ direction. Finding my duty for myself is not easy because all of tasks are interrelated, and that is why communication is the most important to succeed in doing my role. After a long discussion to clarity everyone’s expectation, I will be able to go to the field next week. I already wonder what I will learn and have the benefit of fieldwork.

Reference: http://www.who.int/csr/don/2014_06_24_ebola/en/

June 26. FBI

Today, we gave a farewell party for Agnes Oti-Mensah, who was a finance director for three years in World Vision Sierra Leone. Across the ages and in all countries of the world, letting someone go is sad. But nobody was crying, rather, each department told several amusing anecdote about her, and everyone laughed loudly. I liked this relaxed and vibrant atmosphere and Sierra Leoneans’ sense of propriety. I am hesitant to say that this is a farewell party, more of well-done party.

The Best FF that I've ever met in
Sierra Leone

But the best part was undoubtedly Free Food (FF)! I feel like I am a really simple creature who is excited about FF. I have been waiting for this very moment for so long, and I was so happy to eat all this kind of African foods. I enjoyed nutrition self-intervention. Suddenly, my hungry coursework year occurred to my mind. I lost my sense of taste and could not find the reason why I eat. I overeat one-time for a day, just like a bulimic patient. However, I did not keel over from hunger because my dear friend frequently conducted Free Banana Intervention (FBI) to me. Nutrition Facts for 1 large banana is 121 Calories, 0.45g Fat, 31.06g Carbs, and 1.48g Protein. It was not a mere Baltimore Banana (BB); FBI was the best Lives Saved Tool (LiST) for me. Estimating the impact of FBI was beyond the range of nutrition; I got over the hump, and I appreciate that I have a valued colleague who motivate me to keep up the pace.

June 25. III. Un-ended War: Tragedy of National Division

Korean War Veterans Memorial in Washington D.C.

Today is June 25, the date when the Korean War broke out in 1950. The War called a truce on July 27 1953, and it has been more than 60 years since North and South Korea pointed their gun at each other. Armistice. That means the second war can break out at anytime. Recently, I heard sad news from South Korea military. There was a fugitive South Korean solider in front-line troops – northeastern Gangwon province – who threw a hand grenade and fired a gun at random, and ran away. Five colleagues were killed, and seven colleagues were seriously injured. Before being captured alive, he shot himself, but he was survived by prompt surgery.

Unfortunately, it happens often. Some soldiers lose their reasons and escape their military force when their girlfriends say good-bye to them. The result for escaping is to be locked up in the guardhouse and dishonorable discharge in the end. So to speak, we say 빨간줄, the permanent red line for the rest of their life that they can never erase the history of breaking military discipline. I know that breaking up with girlfriend during military service is heart wrenching, miserable and sorrowful. How do I know? Because I also experienced. The more pitiable moment for me was that I did not even have any good reason to grasp her hand and say, “Don’t leave me.” I was a solider, and she was a civilian. Times flies like an arrow; it was already six years ago. No matter how many days have passed, it is still a poignant pain to me, not because I still love her, but because I was an incompetent man who could nothing to change her mind.

Skirmishes in the western sea occur frequently between North and South Korea, and many South Korean marines have died on the battlefield. To be honest, some South Koreans may be insensible to this news because they take it for granted. “Oh, it happens again?” And then, they forget about it. However, I feel as if it could happen to me. Truly, it could have happen to me during my 2.2-year compulsory military service in the air force. I am still not done yet. I am a reserve forces sergeant for seven years, and I have to go if my Republic is calling me.

War messes everything up. Young man’s promising future and love, and family’s harmony can be knocked over in a moment. The Sierra Leone Civil War has just ended 12 years ago. The country may still bears the scars of being at that war, and I do not want to reopen their old war wounds. The Lumley beach is always calm and quite. Sometimes, I am suddenly afraid of my haze of illusion that this placid ocean turns into raging waves and all people are swept away. Don’t know what the day will bring. The world is so noisy. There was a deadly blast attack in a crowded shopping centre in Abuja, Nigeria, and at least 21 people were killed and several dozens of others are wounded. Wait, is Matt OK? I am really worrying my colleague, who is working for the Clinton Foundation in Abuja. I sent a Facebook message to ask if he is OK. Yes, he is alive. :)

Wherever we go, there is no safe zone. What we can do is to be thankful to have today, at this moment, and put the best energy into everything.

June 25. II. Health Status in Sierra Leone

I want to be careful to use the word, “worst” or “poorest.” These words sound really bad. Surprisingly, it is hard to explain the health status in Sierra Leone without using these adjectives. According to UNICEF, child mortality rate (deaths of children under 5-year-old per 1,000 live births) is 182 in Sierra Leone, which is the highest in the world. Almost 20% of Sierra Leone children cannot see their 6^th birthday in their lives. Even Somalia has lower child mortality rate – 147/1,000 live births – than Sierra Leone. WHO estimates that under-five mortality rate in Sierra Leone is 267/1000 live births, more than one-fourth children die before 60 months.

Under-5 age child mortality rates (deaths per 1,000 live births)

The number one cause of deaths in Sierra Leone is malaria. Malaria burden were more than 500 per 1,000 populations in 2003, and it decreased to 330 per 1,000 in 2007. That means half of people suffered from malaria, and still, one-third of people are not free from malaria these days.

Maternal mortality ratio is 495/100,000 births (2004) in Sierra Leone, which is one of the highest maternal mortality rates in the world. The contraceptive prevalence rates are 5% and exclusive breastfeeding rate is 8%. However, HIV/AIDS prevalence is only 1.50% (CIA, 2012), even though it has becoming threat to Sierra Leone. The highest HIV/AIDS prevalence rate is 26.50% in Swaziland, and South Africa is 4^th ranked, 17.90%.

Marriage before age 15 is 27% and before age 18 is 62%. Teenage pregnancy is a serious health problem in Sierra Leone; 40% of maternal deaths are a result of teenage pregnancies, and 70% of teenage girls are married and most of them drop out of school. Total fertility rate, which is the number of children that a woman give birth to, is 5. Life expectancy is 49.4 years. Adult literacy rate is 25%. Net primary school attendance rate is 48%, and net secondary school attendance rate is 19%. About two-third of population live in rural areas, but more than half of the 23 secondary care institutions are in capital city, Freetown.

According to 2007 Human Development Report, Sierra Leone is the least developed country in the world; its Human Development Index ranks as 177 out of 177 countries. GDP per capita (PPP) is $700, which is 102^nd out of 108 countries, and Human Poverty Index (HPI) is 51.7.

I looked around in Freetown. People are going somewhere, taxies are always honking horns, and motorbike drivers are standing in a line and waiting for passengers. Christians in churches are enthusiastic in their praises of, and security men at hotels and apartments are standing guard for 24/7. On the surface, everything seems to be fine. Where is Ebola virus? Where are starving children? Where are single teenage mothers? Inconvenient truth is that there is nothing that I can do right away. I am here to plan. I am here to estimate the impact of childhood/maternal health intervention. So then, when do we implement those interventions? Time is passing by, but I am slow in progress.

Reference: 

http://www.who.int/countries/sle/en/

http://www.wvi.org/child-health-now/publication/uncounted-and-unreached

June 25. I. 만사

I am not good at talking about myself to somebody else. Even if there is something that I feel uncomfortable, I try to handle with it by myself. I am careful in talking whenever I have something to ask for, even though it is a reasonable demand. I am from the country of courteous people in the East, South Korea, and I still keep the Korean’s characteristic. However, I needed to change because it was not a good attitude in the U.S. Everyone during the discussion engage in free debate without any constraint or formality.

Out of sight, but it becomes more vivid mind. 

When I heard about 만나며 사랑하며 (만사), the four-month church program that mentor and I meet every week for one-on-one talks, I had a personal antipathy because I did not want to share my personal life with anyone. Also, I did not want to show my weakness, and I always pretend not to be vulnerable. However, as always, church is the magnetic attraction; I got very powerful and intense feeling of joining 만사 program all of sudden. It was in the middle of 1^st year coursework at school, and I was almost losing my mind, so there was no way for me to contribute to it. Nonetheless, putting any difficulties aside, I began 만사 with my mentor, June.

When we were about to begin 만사, I asked him that we would have met via Skype or e-mail from June, and it is still possible to do it. The meaning of 만나며 사랑하며 – Meeting and Loving – did not have to be physically meeting. That was how it all started. I have to see everything to finish. There are several chapters left, so it should be done every week through any method: letter, e-mail, or Skype. I talk everything about me to him; if I do not do it, 만사 will be meaningless. Sharing even trivial daily event makes me feel relaxed and relieved. I think writing my blog is an extension of happiness of sharing my life in Africa. I want to tell people that Africa is not a mysterious continent anymore, but it is another place where people live. The way of living is the same, no matter where human being is. I do not know how many friends read my blog, but I would be very happy if there is at least one regular reader who sympathizes with my blog.

Chapter 7. explains how man and woman came into the world, and how human relationship is formed. For this chapter, June and I should have discussed in person because it is really important to me! But I emailed him, and I am waiting for his reply. Genesis 2:18 says, “It is not good for the man to be alone. I will make a helper suitable for him.” Well… I am a super-single for a long time. However, I feel that many things are beyond my power, and I cannot rely upon my single life forever. I got one-way ticket to come here, and I do not still know when I go back. Someone spoke half in jest, half in earnest(?) that I may fall in love with African lady and live in Africa during my entire life. Where on earth am I going? I cannot know my future. However, if I interact with people in an unaffected way, and then only will be able to realize who is the person that I want to share everything about me for the rest of my life.

June 24. II. Sierra Leoneans Cuisine 3: Street Food 1

I thought Jollof rice was only available in Ghana, but I saw Jollof rice here in Sierra Leone! I just realized that Jollof rice is a popular dish in West Africa. This rice has some taste because it contains red pepper. Street Jollof rice had no ingredients, but it is commonly with tomatoes, onion, salt, vegetable, meat, and spice.

The side dish was meat soup(?) and it was spicy. I liked it! Another good thing was I could have it with cheap price: 5,000 Leone ($1.15) whereas the shrimp food in the hotel café was 80,000 Leone ($18.44). It is really ironic that hotels in Sierra Leone are for foreigners or travellers who can afford to stay, not for local inhabitants.

I ate this meal for three-day in a row at night. I should cook at this point, but I do not want to be bothered by cooking… Taking a taxi to go to supermarket, buy stuff, come back home, cook, and wash dishes… I just wanted to eat something cheap food to satisfy only my hunger.

Freetown Supermarket sells everything. Last Saturday, I came across my neighbor, Nephas, and we went to Freetown Supermarket. Foods in that place were almost exactly the same what I saw in the U.S., and I even saw Korean noodle, 신라면, which I can probably find any supermarket across the world. The prices were even higher than in the U.S., and I was hesitant to buy anything. I thought, “What is this supermarket for? For rich travellers? Can local inhabitants afford to buy food here?” I am curious where and how residents find food. I just wanted to understand Sierra Leoneans food life, not just finding noodles or U.S. food. However, I know that I cannot eat street food every day because I do not know how much my immune system endures brand new unfamiliar street food. When I was about to drink street water, Amadu stopped me and said, “This is not good for you!” Then, he bought a bottle of water for me. Maybe, trying to do the same thing that Sierra Leoneans do might be my greed. However, I do not want to be afraid of experiencing something that might have some risk because I am here in Africa, and I do still remember the idiom that “Do in Rome as the Romans do.”

June 24. I. Ever-present Danger of Diseases

Even though the medical charity Doctors without Borders said that Ebola outbreak is out of control in Guinea, Liberia, and Sierra Leone, Jay Keystone from University of Toronto said that there are far worse diseases out there, such as malaria and cholera.

Ebola kills hundreds of people in West Africa this year, but WHO says that malaria kills 1.2 million people, and cholera kills 100,000-120,000 people annually. Nonetheless, malaria and cholera can be cured, so mortality rate is really low, while Ebola is death sentence disease showing up to 90% fatality rate, no known cures or vaccines.

Although Ebola is little threat to travellers, I have to be really careful to limit my movement in Sierra Leone and wash hands thoroughly. I have only worried about Ebola so far, but preventing malaria and cholera is also important for me to practice health maintenance. Should I say good-bye to street food…?

The ways of transmission of disease are various, through food and water (E-coli traveller’s diarrhea, hepatitis A), insect (malaria, dengue fever), air (measles, Tuberculosis), and bodily fluid/blood (Ebola, Lassa, HIV).

Blessedly, Ebola is not an air-borne disease. Like HIV, Ebola virus is transmitted by bodily fluids or blood. Another blood-transmitted diseases, Lassa hemorrhagic fever, is way more serous disease that kills 10,000 people every year.

The result? Of course, Ebola is a fearsome disease, but there are so many diseases that we have to be cautious. Mass media attracts people in the world by sending breaking news about Ebola, and I may also be terror-stricken, but I can surely prevent Ebola. There are so many diseases that I have not even heard, and those diseases kills people. Ebola is emerging but temporary disease that we can develop treatment and vaccine in the near future. 

Reference: http://www.cbc.ca/news/health/guinea-s-ebola-outbreak-there-are-far-worse-diseases-out-there-1.2585797