July 25. Are You Married?

The most FAQ from Sierra Leoneans is “Are you married?” When I say “No,” then, they ask me “Do you have a kid?” I am embarrassed to hear the question because the order of question is so awkward. I said I am not married, but they ask me whether I have children. Do I look like a single dad? I answered “No,” with a curious frame of mind. Then they ask me again, “Do you have a fiancé?” Oh… I have to say the same answer, “No.” The last FAQ is “How old are you?” I said, “29 years old.”

When I pass these unfamiliar orders of questions for my marital status, a look of surprise comes over their faces, and they say, “What’s wrong with you?”

Am I strange here? Yes, I might be a complete stranger to them who is from the opposite side of the earth. I may have been habituated to hear “Are you seeing anyone?” outside of Africa. Actually, nobody have asked that to me when I was in the U.S. I had a sudden think-tank time why I am single, belatedly here in Africa. Have I done something wrong? I start worrying myself.

The average age of marriage in Sierra Leone is early 20s. And they love to make a big family, having about 5 or 6 children. Some large family, like Joseph Musa’s, also lives with extended family, so they all live in a little cluster of houses. That is amazing to me because today in many countries is the age of nuclear family. I wonder how the creepy word, nuclear, combines with worm word, family, which defines small family. Anyway, I have only one younger sister, and she also live separated from my parents. My family comprises of the father, mother, younger sister, and I, but this small family disintegrate into three: parents, younger sister, and I live in different places. I do not even remember when is the last time my family gathered and ate dinner all together.  Moreover, our recent family picture may be taken several years ago, but I have no idea know what/where it is. Is there any issue with my family? No, not at all. Just because it is becoming common where I was from.

Quite the contrary, Sierra Leoneans have a big big family. What surprised me was that I often hear somebody’s relatives have passed away.

A friend of mine texted me through WhatsApp all of a sudden, “Hi how are u’ I los my uncel.” [I lost my uncle.] Another friend told me that her boyfriend was dead last year. All I could say that I was so sorry for bereaved friends’ loss, and I did not ask the name of a disease. But the point is that people here die of some reasons at their young age.

I know that remaining unmarried is not that pleasant, especially here in Sierra Leone. Should I tell them a white lie that I have a really really pretty lady in the U.S. who is always counting the date I come back? If I do, they will be no longer looking at me so strangely, I also feel relaxed, avoiding interrogation about what’s wrong with me. 

No, I just want to be honest, like this:

“I have a fiancé. But I don’t know yet where she is. She may have been doing so well somewhere, and time will tell who she is.”

In the home balcony: How much am I enjoying my single life?

July 24. AIM Health Mid-term Evaluation

When I heard the words qualitative data and AIM Health Mid-term Evaluation for the first time, I was puzzled. Qualitative? What data? What is AIM? Mid-term? Do I need to take some kind of mid-term exam? What I had known about AIM was AIDS Impact Model – a program that projects the consequences of the AIDS epidemic – from LiST. But I realized that AIM-Health was Access to Infant and Maternal Health, in this case. Oh, my acronym!

Spectrum Policy Modeling System is to analyze evidence-based information to estimate the impact of development programs and policies. Several project models system – Demography (DemProj), Family Planning (FamPlan), AIM, RAPID (Socioeconomic Impacts of High Fertility and Population Growth), PMTCT (Prevention of Mother-to-Child Transmission of HIV) and LiST (Lives Saved Tool) – are integrated into this Spectrum. So to speak, it is computer software to estimate the future! Especially, I am going to analyze LiST to estimate the impact of health intervention for maternal, neonatal and childhood health. By using LiST, I need to figure out how World Vision 7-11 Strategy has been and will have been implemented well during AIM-Health project period.

<7-11 Strategy> http://www.wvi.org/health/7-11-health-strategy

For qualitative data, I have been conducting in depth interviews (IDIs) for various areas of AIM-Health stakeholders. I have about 20 interviewees, and I finally begin to see daylight. I have interviewed PHU in-charge, District M&E officer, District hospital senior clinical person, point person in DHMT, development facilitators, project manager, base manager, national technical coordinator, WV M&E officer, grant finance managers. Additionally, I asked other staff who are involved in AIM-Health at some point, so I interviewed National Director and Finance Acquisition Manager. But I am not still done yet. I need to make an appointment with local council/district chairman and ADP manager. It seems a little early to give self-general critique, but I have to move on to LiST analysis from now!

The hardest thing about having an interview was that the almost all interviews kept being postponed for many reasons. People have broken or changed the appointed time, or they were busy with doing other things. Especially, Ebola outbreak suddenly restricted me to reach the rural area, so it became impossible for me to see them in-person. I am still trying to meet people through Skype, but poor Internet connection and long-distance communication keeps me from succeeding in interview. All IDIs were supposed to be done by the 2^nd week of July, but I am already late for almost 3 weeks.

The second hard thing was that I was totally ignorant of AIM-Health project. What is timed and targeted counseling (ttC)? What is positive deviance-hearth? What is community health committees (COMMs)? What is citizen voice and action (CVA)? Every time I interviewed, I was confused what I am doing: Am I actually interviewer? Or am I learning or evaluating? Am I listening to lecture from interviewees? I think the answer is all YES. But until recently, I had been wondering about my role because I am not WV staff but mere ignorant intern; I knew nothing about this project, so how do I evaluate mid-term AIM-Health project? So I asked my school colleague, Allyson in Ghana, “Why the position Intern exist? For my good? Or organization’s good?” Her answer was “Both.” This simple and clear answer explained everything. It was totally up to me how to balance my daily life to learn, work, make a good relationship with staff, explore new environment, enjoy new food, make friends, find hobbies, understand local people’s life and so on. In the same vein, I can not only learn but also work during interviews. If there is something to hear again or want to know, I have to ask that without any constraint. However, if I had knew more about the project in advance, I would not have spent time to ask the basic questions to interviewees during the given short time, and the quality of IDI would have been much better because I would have asked better questions.

The third hard thing was language. I heard my fellow colleague, Denice in Tanzania, had interviews accompanied by translator because people speak Swahili. And I saw Nicole’s picture that she was with other data collectors.

<Fellow Denice in Tanzania’s Blog> 
http://denicemarie.wordpress.com/

<World Vision Global Health Fellows Programme’s Blog> https://worldvisionghfp.wordpress.com/

Let's transcribe IDIs! 

Here in Sierra Leone, people speak English very well. I am so impressed that people in West Africa take the unified exam written in English for graduating high school, and they freely go to another country to enter university. By comparison, my English is dumb. I endure so hard with my rough English and rough writing in my blog. African’s unique pronunciation and accent was hard for me to understand for the first time. As time goes by, I have been accustoming myself to their English. My cell phone is hero; it functions as wonderful recorder. After interview, I listened to interview recordings again and again until I get perfectly what they said. Staff in the office had meetings and something to talk, so I barely heard the recording. My guesthouse in rural area was quite enough to hear recording, but I lost passion to do extra work at home in somber darkness. Actually, No light had nothing to do with transcribing because my laptop still had half-charged battery; but the shadows of night made me stop doing anything.

The fourth hard thing was respondents' order of priority toward interview. This IDI is my top priority as a fellow, so I need to get all IDIs done. On the other hand, some interviewees may consider IDI as the least concerned task; I called a respondent every day to make an appointment, but I could not meet him and instead, I sent interview questionnaire to him. I felt like I was interrupting busy staff; they have urgent emails, and somebody stepped in and do some work with a respondent even during interview.

When I drank bear with Momoh yesterday night, I asked him what makes challenging to him during the work. He said that he had a proposal to submit by noon today, so he was really busy, and continued as follows:

“Normally, we may feel unsatisfied the slow Internet connection, no electricity, no clean water. However, if I don’t finish my project on time, that means I did nothing. Those circumstances are just excuses. The most important thing is the result.”

He is right. No matter where I am, getting things done is the most important. I may have sweet excuses that might have been hindering my given roles; ‘Oh, everyone here is in chaos because of Ebola, and I can’t concentrate anything,’ ‘Oh, relocating to the new place is so stressful, so I need more time,’ ‘Oh, I have no electricity and no Internet at home, so it affects my work badly.’ I will allow no excuses. It is my responsibility to stay physically/mentally fit under those circumstances. Rather, I believe those circumstance will make me much stronger.

After those twists and turns, now I have most of transcribed qualitative data. The next step is how to analyze the data. Well… I do not know how to do it yet. There are always hindrances in every step! However, It is fine because I am also going to learn and work at the same time, just like I did for IDIs. AIM-Health mid-term evaluation is slowly going on, but it is on a cruise. Remember, Slow and steady wins the race.
                                                                                                

July 23. Slowly but Surely

I can hear the Ebola news here and there in real time in World Vision National Office. This news is way faster than BBC or the Washington Post. During the devotion time in the morning, National Director Leslie Scott said that Dr. Khan, who is the only one Ebola expert in Sierra Leone, has contracted Ebola virus. This news hit the headline on the local newspaper, Sad News… Dr. Khan was diagnosed with Ebola positive. I feel excessive distress that medical doctors, nurses, public health officials who had been taking the initiative in treating Ebola patients also have got infected and passed away. This is really serious. They may know how to protect themselves very well, but this virus has also claimed their lives as well. Nonetheless, he is a real fighter against Ebola, so I believe he will be a survivor from this deadly disease. 


<Sierra Leon's top Ebola doctor infected as the worst outbreak in history continues, with no end in sight>

http://www.washingtonpost.com/blogs/worldviews/wp/2014/07/23/sierra-leones-top-ebola-doctor-infected-as-the-worst-outbreak-in-history-continues-with-no-end-in-sight/

"Even with the full protective clothing you put on, you are at risk."

I am really wondering what kinds of disease on God’s earth lead human beings death almost immediately just because of touching somebody’s hands. I do not know how 17 neglected tropical diseases have been selected, but this Ebola virus is a real neglected virus that is ignorant to everyone, including health professional. It first appeared in Congo and Sudan in 1976, but the vaccine or cure for that has been no progress. I presume that is why the infection route is too broad; WHO states that the infection is transmitted by direct contact with the blood, body fluids and tissues of infected animals or people. It makes us in chaos because we do not know who the patient is on the street. Contacting with people who is in incubation period is ok? Touching money is ok? Touching taxi door is ok? Even if some expert says it is ok, but I cannot believe that fully. At this point, this is just horrified disease that all information seems to be unclear.

Toward the end of working hours, I asked Grant Acquisition Manager, Momoh Juanah, “Momoh, do you have good plan in this evening?” without any thought. But he assumed that I would want to walk around the beach and have some bears. “No, no, I didn’t mean anything. I just asked.” Until the end of closing time, he asked me for three times, “I thought you need some fresh air and bear.” I was so moved that my boss was warm-hearted who felt sympathize with my tedious life cycle: office and home, and office and home. I cannot deny that my daily life is so simple. After work, I am so frustrated by this Ebola situation and sleep early, and I cannot even go jogging because it rains everyday. I hesitant to go anywhere, and even hesitant to meet church friends.

“is anythg goin on u don’t wnt me 2 knw?”

“is it because of the breakout you are avoiding me 4?”

Those texts were from my friends. What a terrible situation for me is! I love them but I am reluctant to meet them because I have no idea who they have contacted with. Ebola is not a good opportunity to know anymore. It is just survival or death. It severs relationship between people and me, and isolates me in office and home. Human being is endlessly weak creature against all kinds of diseases. Besides Ebola, I do not enjoy going out during the night for security reason. Besides security reason, there is nowhere to go anyway.

Momoh and I went to Lumley beach area, the place where I stay, and he parked his car on the street. It was raining incessantly, and we sat on the chair under the awning. The name of the bar was VI Bar. (Is it pronounced vi bar or 6 bar?) While listening to sound of rain, I had one Heineken and two Savanna. Those alcohols were kicking me slowly but surely, just like Ebola virus has been spreading all across the country slowly but surely. When I get up in the next morning, I expect to become sober up, or start the day with a dull headache. But I regret to say that Ebola news become more serious next day. Bad feeling took possession of my whole mood that I will leave good people in Sierra Leone behind. And I will meet new people in a new place. Please, I did not mean it. Let me sleep again. This is the best thing I can do right now.