Farewell to Liberia; itinerary planning

Angola, December 7, 2003


This is my eighth last day in Liberia. Here's my probable itinerary for the next eight weeks. Details subject to change.

• Friday November 30: Last day in Buchanan


• Saturday December 1: Fly Monrovia via Dakar overnight to Brussels


• Sunday December 2: Arrive Brussels, fly to London; Consume litres and litres of fresh milk


• Monday December 4 to Friday December 8: Work at Merlin London HQ, completing a hospital patient satisfaction survey analysis and report, debriefing for Liberia and briefing for Sri Lanka; Watch the new James Bond film.


• Tuesday December 12: EuroStar London to Brussels - then Amsterdam


• Sunday December 17: EuroStar Brussels to London


• Monday December 18: Dad arrives in London; to Aunt Jill's in Nottingham


• Wednesday December 20: Fly East Midlands Airport to Cyprus with Dad


• Wednesday December 27: Return Cyprus to East Midlands Airport; To York


• Thursday December 28: National Rail Museum and Humber Bridge with Dad


• Saturday December 30: Dad to Canada; To Belfast


• Tuesday January 2: Belfast to London


• Wednesday January 3: London to Ottawa


• Friday January 5: Ottawa via Chicago to Washington DC


• Sunday January 7: Pick up, load U-Haul truck with personal effects; Drive U-Haul to Harrisburg, Pennsylvania


• Monday January 8: Drive U-Haul to Syracuse, New York


• Tuesday January 9: Drive U-Haul to Ottawa


• Wednesday January 10: Unload U-Haul in Osgoode


• Saturday January 13: Fly Ottawa to London


• Sunday January 14: Fly London to Sri Lanka????

My first birth

Sydney Opera House, Sydney, Australia.
March 28, 2004

On Thursday I witnessed a birth for my first time. Our visiting medical student, soon-to-be Doctor Charlie has done Caesarian Sections (emergency and scheduled) and assisted with natural births but had yet to deliver a baby naturally herself. (Charlie is specializing in obstetrics and gynecology.) When her chance suddenly arose I rushed along with her to the Liberian Government Hospital to witness the miracle of birth for myself.

When we arrived the 17-year-old prima gravida* mother was 8cm dilated and incredibly noisy. Whenever she wasn't emitting a pure piercing yell she was demanding an operation (she meant a Caesarian) and for someone called 'Jasmine' to 'come to my rescue'.

Charlie quickly took charge but was expecting to learn from the midwives. They were marvelous - guiding but respecting Charlie as she learned the routine procedures. From time to time Charlie or the midwives would refer to the clock or to hand-drawn circles of different diameters on the wall. (It was all too technical for me.) Their style with the Mom was a bit rougher than I expect we have in the west - slapping her when she didn't hold her ankles properly or for any other infringement.

(The Liberian Government Hospital's obstetrics ward has about 12 beds which often have to hold two women and one or two babies each, a nursery with five cots and two incubators - awaiting proper wiring - and a room with two delivery beds. We deliver an average of about twenty babies a month. A large proportion of those are complicated cases because ordinary births can be done at our nearby 'Well Baby' clinic - or, very frequently - at home.)

The midwives tickled the woman's (huge) belly to provoke contractions - which in turn provoked the intense screams, which made me wonder whether Merlin should install sound absorption materials. I tried to pretend to be useful by stroking the mother's head - she didn't pay me the slightest bit of attention. Finally the baby's tiny head emerged. Charlie seemed to yank it around terribly roughly but she knows what she's doing. The head took about a minute of manipulation and then Charlie pulled the rest out easily. It was a baby girl - incredibly tiny but way way more beautiful than I'd ever imagined. (I thought babies were just slimy little animals until this. Maybe that stage starts after a day or two.)

She was a kind of grey-blue colour. I've learned that African babies turn black only a bit later on. The first thing Charlie did once the baby was out was to suction goop out of it's mouth and nose. I was incredibly nervous until it started crying. Then she clamped the cord in two places and snipped it off - leaving about 10cm on the baby. Then I think they washed it and weighed it and stuff like that - I was watching the mom who'd gone catatonic and therefore thankfully quiet.

They wrapped up the baby and showed it to the Mom who just stared without expression. (Later my sister Ruphine told me that when that happens you refer to the history and form certain suspicions. but maybe the Mom was just in shock.) Anyway when we went out into the main OB ward and told the family they started to dance with joy and then I realized that I'd really seen the growth of a family.

I think I'd like to see another birth but I'll never forget this one. I was honoured that I witnessed Doctor Charlie's first complete personal delivery. And I was pleased that the Mom finally stopped her ghastly screaming. It is truly the miracle of birth but I'm so glad I had a vasectomy.

More on the execution

Indian Pacific Railway, New South Wales, Australia.
March 27, 2004


We have learned the following about the troublesome death penalty case from a valuable source at the United Nations:

1. The guilty man is one Emmanuel Kpah, found guilty of murder. He has been in pretrial detention since January 2005.

2. On September 7, 2006 Mr. Kpah was sentenced to the death penalty, by public hanging, scheduled for September 29, 2006.

3. Liberia DOES still have the death sentence in the Constitution. However, on September 16, 2005 Liberia signed an "International Covenant of Civil and political Rights aiming at the Abolition of the death penalty."

4. An appeal is in progress and the supreme court will most likely be changing the ruling to life in prison.

5. A death warrant would have to be signed by the president to be carried out.

6. 1978 was the last time the death sentence was carried out in liberia.



Thanks very much to the friends who have written in with advice and encouragement.

Liberian execution?

Child at Well Baby Clinic, Buchanan, Liberia.
September 13, 2006

There's great confusion about this possible public execution penalty issue - Liberia supposedly abolished the death penalty in August 2005 but then, in December, passed a rape law that prescribed the death penalty. This was then altered to life imprisonment but the lack of commitment to the abolition is very disconcerting.

Various sources are giving various 'facts' so first of all we have to find out if there really is a plan to execute.

We (MSF-Holland) and I have contacted our HQ with varying levels of success. We've communicated with Amnesty International but have had no response yet.

Thanks to those readers who have sent in advice.

I hope to post good news here soon.

Capital punishment

Danielle, Richland WA, 2002


A little while ago I began an atomically small bit of activism when I complained to the Mayor of London about a street performer I thought could be dangerously influencing children. Not much became of that but now I have a much bigger thing to worry about: we learned yesterday that the Liberian Government intends to perform a public execution of a convicted murderer here in Buchanan on September 29. Here's a brief media reference about it.

Capital punishment is more objectionable to me than the crimes of the murderers being executed. I'm not as eloquent about it as many more important and heroic people but I think I might be about to get vocal. I won't be quiet on this but I don't know what I can do while representing Merlin. Or will working for Merlin give me a useful voice?

We're also wondering security issues - will there be any social unrest that could mean 'business' for the hospital? - or conversely, might there be risks that would require us to get out of Grand Bassa County? Part of me wants to be far away when it happens and another part wants to fight it.

I'm seeking advice and direction from Merlin but I'd also like to hear from anyone reading this.

Access to health care

Srinagar, Indian-Administered Kashmir,
October 2005

I'm back from three nice nights in Monrovia, where we can stay in very nice apartments with HOT WATER! On the way there we stopped at one of our clinics where a woman was in labor distress and needed to be transported to the Liberian Government Hospital in Buchanan. The clinic had stopped a few cars but the drivers had demanded 400 Liberian Dollars (US$8.16) and the woman's family couldn't afford it.

We radioed for a Merlin vehicle heading back to Monrovia to take the woman but by incredible luck a Medecins sans frontieres car came by with Dr. Jochan. He delivered the baby but it had died.

This could almost certainly have been prevented. It was her second pregnancy and second loss. Better health education and the option for family planning would probably have helped. Better access from rural areas to the clinics (she had had to walk to the clinic) would also have helped. An ambulance system that could be dispatched to the clinic could or her home would probably have saved the baby's life. Actually we expect to be able to put an ambulance in place, thanks to an anonymous donor, but the attitude of Liberians who wouldn't even take her to the hospital is always going to be a stumbling block.

Cheerful construction worker adhering to Liberian safety rules and regulations. August 3, 2006.

My running speed is slowly improving, but not because of any great dedication. I'm a bit too ready to use the frequent rains as an excuse not to go. Actually recent improvement is probably due to walking up and running down the hills.

Camera in the Atlantic

Crab and Fateful wave, Buchanan, Liberia
April 14, 2006

I had a bit of an adventure last weekend - the wave shown in the picture above swept me off the rocks where I was crab-watching. (The picture below, shot previously, sets the scene. I was sitting on the rocks on the left but further back where both sides were sunny.) I went under water but held my camera as far up as I could. The surge was nice and strong and would have been pretty thrilling if I hadn't been worried about my camera and the fact that the park safety officer hadn't inspected this ride yet. I surfaced out beyond the rocks out of my depth where I treaded water and noticed that the lens was still dry! I had to time my kicks toward the rocks with the waves and brace myself the surf as I clambered onto a shelf - still holding the camera as high as I could. When I was stable I tried the camera - it seemed to work once I'd turned it off and on but I think it must have had a shock because it's been moody ever since - sometimes displaying nonsense on its status screen and sometimes refusing to auto-focus. Little does it know I'd been thinking of replacing it anyway.








'Surprise Notch', Buchanan, Liberia
April 14, 2006





I hope it will pull its socks up because we will have a special guest at the Liberian Government Hospital next Saturday - Her Excellency Ellen Johnson Sirleaf, President of the Republic of Liberia. She's coming to open our new Outpatient and Medical Imaging Departments and we have a lot of preparation to do. People are asking me if I'm excited but all I can think of to say is that I'll be excited when it's over. Luckily the photography won't fall to me and my camera - we've got an expert coming and although she doesn't have a Canon (this is one of my few big brand loyalties) I know she'll do a wonderful job.



I just did hospital rounds with the hospital matron. This job is teaching me so much - about development, myself, and a little bit about medicine. Tonight we saw a two-year old boy with severe malaria who is very unlikely to survive.



Everything else is the same - work personalities are testing my diplomacy and I'm really terribly busy, tired and lonely.

Kittens growing so fast

'Bravo Zero' with (left to right) 'Bravo Zero-One, Two or Three', 'Bravo Zero-Two, Three or One', 'Bravo Zero Four', and 'Bravo Zero Three, One or Two'.


'Bravo Zero Four'

I'm sure I seem like one of those people who are besotted with their cats at the expense of a good grip on reality. Well - I am. Our kitties are now three weeks old (where did the time go?) and totally adorable. My colleagues have come to grasp that when they kick and fling them I will scream. They (the kitties, not the colleagues) are shown above on their first day of scrambling outside the box. Their box has been placed in the dining room cupboard where 'Bravo Zero' took three of the kittens after about a week of putting up with their roommate's (that's me) snoring. She had left the spotty one - 'Bravo Zero Four', known from photographic monitoring to have been born last - squeeling in my room. Thus it's the one I've become most attached to. I'm glad our friend Kathleen has chosen one of the tabbies (I can't tell them apart) for her allocation instead of 'Four'.

I lost an argument with my boss Sophia the other day. Sorry - this is still about cats. Her cat 'Tarzane' just delivered four completely different-looking (but all adorable) kitties. (Her delivery room was inside their Sofa Bed - Tarzane ripped an entrance hatch and made a nest right in the underframe.) Sophia claimed that cats can have kitties in one litter that have differnt sires. Rediculous, I claimed, and went straight the net to prove my point. Well, it was me who was wrong. I learned that cats, dogs and rabbits can exhibit this superfecundity - and then I learned from my colleage Dr. Simon (who is an obstetrician) that humans can too!! Furthermore, cats can also exhibit superfetation - overlapping separate pregnancies. That's it - Bravo Zero is never being allowed out of the house again. Even though she is supposed to be patrolling for rats and snakes. At least the appearances of her litter suggests that she's only half the shameless tramp that Tarzane is.

In other news - the last few weeks have been extremely busy and stressful but rather successful. We've got assurances of funding for our clinics (from the Irish government) and for our hospital (from the European Union) for 2006 and we're very relieved. My colleagues and I (both here in Buchanan and in Monrovia) worked very hard on final reports and new project proposals but it was all very well worth it.

So since my last entry I've become a bit of a cat litter matron and a bit more of a Project Coordinator. But I've still got a lot to learn about both.

I'm going to Sierra Leone for a short R&R on Thursday.

2005 wrap up

Kitchen department, Liberian Government Hospital, Buchanan, Liberia

December 31, 2005

Best wishes for a wonderful 2006 to any readers out there.

I'm writing this at 10:13pm on New Year's Eve and I think I'll be too tired to stay awake until midnight.

What an amazing year I've had. In these 12 seemingly brief months I took a mere 60 flights, visiting eight new countries (Brazil, Thailand, Malaysia, Cambodia, Ireland, India, Nepal and Liberia, bringing my official country total to 40), riding overnight trains in India, Canada and the US, and setting foot on five continents. I finished one job (working for the Survey Action Center in Afghanistan), started and finished another (with Oxfam in Afghanistan) and begun a third (with Merlin in Liberia).

Amongst my adventures were the following (not quite chronologically):

• Leaving Afghanistan on Business class, drinking Turkish coffee in Istanbul - and then finding myself back in Kabul six weeks later;


• Dancing until dawn in Itajuba, Brazil during Carnaval;


• Being spied on by monkeys with Jenny on the Pao De Acucar in Rio de Janeiro;


• Riding an elephant through the jungles of western Thailand after rafting through gorges, jumping off waterfalls, and enjoing welcome serenity in an eco lodge;


• Learning to Scuba diving at Koh Chang, Thailand;


• Taking my most comfortable (yet affordable) overnight train trips ever (Bangkok to Chang Mai) in Thailand;


• Climbing and pondering the incredible monastery at Angkor Wat, Cambodia;


• Swearing yet again that I'd attended my last Formula 1 Grand Prix (this time in Malaysia);


• Gazing up (from valley floors) and down (from tiny aircraft) at the most beautiful country (Afghanistan) I've ever seen;


• Being given an improbably large number of interpretations of whether or not the Holy Koran permits alcohol consumption;


• Being told (before takeoff from Yawkalang airfield above 8'000 feet in the Central Highlands of Afghanistan) that we would make an immediate right-turn because otherwise "if one of the engines fails we'll hit that hill...";


• Being the only person to follow Blue Rodeo around all twelve of their UK tour gigs - and in so doing drinking Guinness with some of them until long after their Bambridge show, being played 'Lost Together' for my personal loyalty in Leeds, and bar hopping with some of them and their most wonderful fans in Dublin;


• Continuing the process of falling in love with Scotland;


• Realizing that the Kings Cross bomb exploded 48 hours to the minute after I'd been there;


• Visiting the incredible Taj Mahal but also the arguably more wonderful nearby Agra Fort;


• Being required by kidnapping threats to ride cars from within and between walled compounds in Kabul;


• Emerging from an ultra-modern cinema in Delhi into a darkened shopping precinct and bumping into a very dark and sacred cow;


• Feeling a gentle swaying of the ground in Kabul - then flying to Delhi before learning that it had been a devastating earthquake in Kashmir;


• Reaching out to hold hands with friends - riding in a separate speeding auto rickshaw weaving in and out of Delhi traffic;


• Discovering truly wonderful restaurants in Delhi that would star even if I hadn't just emerged from Afghanistan;


• Relaxing on a houseboat in Srinagar - then while at 10,050' in Indian-administered Kashmir being hailed by my tour guide from western Thailand;


• Wallowing in the friendliness and extreme comfort of Kathmandu;


• Feasting at American Thanksgiving (with great friends old and new);


• Confirming once and for all that I'm too old to sleep on transcontinental railways without a bed;


• Not sleeping in one bed for more than five consecutive nights between October 8 and December 25 (as I've already moaned);


• Requiring the services of an English <> English translator in Liberia;


• Beginning my potentially most rewarding and meaningful job ever.
  

Above all meeting lots of people in lots of countries, almost all of whom are immeasurably more gentle than their governments, and meeting and revisiting many wonderful and very very special friends (in one or two cases, quite unexpectedly). Almost my only regret in 2005 was that I couldn't go to see all the rest of my friends. You're all welcome to come and visit me in Liberia!!

Happy New Year.

Christmas in Monrovia

Merlin residence, Liberia, Monrovia

December 24, 2005

Merry Christmas from Monrovia, capital of Liberia!

This is going to be a rather lonely Christmas for me - symbolized quite well by the tree where I'm staying. On the other hand I'm looking forward to two days of peace and quiet. I've had a very good two weeks working on mapping and data collection with three colleagues from England and I'll miss them but I'm also glad to be able to turn my attention to my upcoming responsibilities. And what a contrast they are to those of my previous job where very little I suggested was accepted and implemented. There I could not procure paperclips - now (and this is after being transferred from Harper, where I've never even been, to Buchanan) I'm responsible for two projects employing about 38 actual staff and over 200 more subsidized by Merlin, and having a combined annual budget of over 1.4 million US dollars.

I'm looking forward very much to actually moving to Buchanan, which I'll do on Tuesday. I've already been there twice (and when I went the first time I didn't know that that was where I would be stationed) but Tuesday will be my first chance since OCTOBER 8 to completely unpack my bags and settle somewhere where I'll remain longer than five days.

Next few days in Liberia

Beach at Monrovia

December 10, 2005

Sitting on a veranda at 'London' - the main Merlin residence in Monrovia - reflecting on a very good but very surreal week since my last entry. OK, since typing that sentence I've fled to a different veranda because colleagues Andrew and Deston are having a meeting up there (it's SUNDAY for goodness sakes - and Sundays are our only days off) and because it was too bright to see my screen. Now I'm only disturbed by noisy Colin the cockerel, who doesn't know how close he is to a filling out a nice casserole. Maybe I can scare him away with Bizet's Carmen?

Surreal enough for you yet?

On Tuesday afternoon seven of us squeezed into a LandCruiser and set off on the 'two and a half' hour drive to Buchanan (further east along the coast). We got there six and a half hours later. I rode on the floor at the back and I think I was the most comfortable amongst us. Four staff sat across the back seat - I couldn't have coped with that. Amongst my failings as an aid worker are claustrophobia and the related abhorrence of personal-space invasions. (Other failings include my resistance to various staple vegetables and to tea.)

The first halt was called at the Firestone rubber plantation's grocery store. Firestone operated in Liberia continuously throughout the war - as did the breweries. (I have yet to get any satisfactory pictures of their plant or plantation but it's on my to-do list.) We also had very fruitful stops at a couple of Merlin's Public Health Clinics en route. This was my first exposure to what we actually do here - health care provision. The staff were extremely helpful and dedicated and I took it as a very good sign of things to come in my job.

Bokey Town Clinic staff, Grand Bassa County, Liberia

December 13, 2005

These things meant we weren't going to get to Buchanan before dusk, which is a contravention of security rules. But then the primary fuel pump of our LandCruiser failed and we were stuck - fortunately just within radio range of Buchanan. The Buchanan staff sent out a rescue vehicle but we jury-rigged a fix and set off, watching out for the rescuers. Then our vehicle failed again and we had to be wait to be towed the rest of the way. We got to Buchanan long after dusk with a water-tight excuse.

On Wednesday our Geographic Information System (GIS) people concentrated on their training and development and while I was given a life-changing tour of the Liberian Government Hospital in Buchanan by my friend Dr. Simon (from Tanzania).

Liberian Government Hospital, Buchanan, Liberia. (Construction of new Outpatient Department in the foreground.)

December 14, 2005

The hospital does such good work and I was very happy to learn from the tour so I could do a better job in my posting to Harper - and then on Thursday night I learned that I am going to be transferred 'from' Harper (I've not yet been there) to Buchanan. This means I'll be working with, for and at this hospital! I'm delighted and I'm looking forward very much to taking on the duties.

Liberian Government Hospital ward
December 14, 2005

The world's largest contributor to UN peacekeeping forces is Bangladesh, and they seem to be the largest contingent in the UN Mission in Liberia too (although in total 49 countries contribute). Friday was Bangladeshi 'Victory' Day and Buchanan Merlin staff were invited to their party. Um - it was a tiny bit stiff and bland. First we were treated to a video from the Bangladeshi Tourist Authority (or some such) during which stiff soldiers served tea and snacks. Then we were served delicious food but the atmosphere remained a bit rigid as a very old Bollywood-type film (I was told the next day that it was Indian rather than Bangla) was projected - without sound. Needless to say the event was dry. I'm afraid we preceded to the 'EK' bar in Buchanan before the film ended. I hope the lead character got the girl.

Yesterday some of us drove back to Monrovia while the rest of the GIS team explore the beach in Buchanan. (I'll have a lot of opportunities to explore it in due course.) I'll be here in Monrovia for a few more days.