V-E's Sierra Leone Arrival

```Inwali-O!
The V-E’s landed safely in Sierra Leone, West Africa on December 7th, 2011. Internet access remains an ongoing challenge thus the delay in posting our first blog entry for this adventure. We encountered the usual busyness of extracting ourselves from farm, family, friends and work. We enjoyed Thanksgiving with extended family in Illinois and assisted Ma Varnes in recuperating from her knee replacement surgery - she did, and is doing, great!

Finally, departure day came and we boarded our flight at O’Hare bound for West Africa via Heathrow in England; a mere 20 hr journey. Our connecting flight from Heathrow to Freetown was predominantly Sierra Leonean nationals returning from or for holiday and the whole 7 hr flight was quite festive. We began our descent into Lungi airport after dusk. The lack of electric power was immediately evident. The shadow of houses and forest and soft glow of kerosene met us as we touched down. We disembarked the plane by walking down the airplane steps onto the still steaming tarmac, then veritably whisked from there to the airport entrance into the thick, warm, unmoving airport air and general chaos of customs and luggage retrieval. Ahmae described the air as a mixture of water and natural human scent.  Fortunately, all of our checked luggage appeared and our driver had prearranged our passage through customs. So into the crowded, dark parking lot we walked keeping bags and kids close and politely refusing the many taxi drivers crowding us and vying for our business. The scented air now included wood smoke and kerosene enhanced by the tropical humidity.

Abu Conteh, our driver, hurried us into the awaiting van and drove the 5 miles to the ferry deftly using both sides of the narrow road and passing slower vehicles with hardly a glance in their direction. The vehicle was loaded onto the ferry and we went to the upper deck to have our first Star Beer, Sierra Leone born and brewed, ahhhhhhh. About an hour later we were off loaded en masse to the Government Ferry Port and driven the short distance to St Edward’s Retreat Center where we would spent a rather hot, humid night with simple accommodations which included intermittent electricity. Freetown, Sierra Leone's capital of 3 million has yet to acquire 24 hr power.
We left for Kabala the next morning anticipating a full day to make the 250 mile journey into the far northern region of Salone where we would spend the next 2 ½ months. But first, one must negotiate the Freetown traffic. It took the better part of 2 hrs bumper to bumper to exit the city. Abu thought it was a timely departure and quite a stroke of good luck! So, off we sped into the Salone countryside giving me ample time to reminisce about my time spent here as a Peace corps Volunteer from ‘87 - ‘89. How I enjoyed my time here; the tropical climate, friendly people, roadside food, foothills, plains and mountains, palm wine, fellow PCV’s, and “Africa Time” - gentle, unhurried and always time for proper greetings. That isn’t to say that I had forgotten the occasional running belly, malaria and a particularly nasty meeting with staph pneumonia. I guess I prefer to view things through the poetic expression that “distance lends enchantment”.
Late afternoon found us entering the outskirts of the Koinadugu district town of Kabala. There had been a tripling of the population after the brutal civil war in the 90’s and only a few identifiable features were evident. The town of 18,000 is still unpaved and the main form of transportation outside of walking is by “Okada” or motorcycle taxi. The taxis run fast and furious over uneven dusty roads kicking up lots of particulate matter which mixes with the ever present cooking fire smoke which mixes with the slash and burn ash so common at this time of year in the surrounding hills making for a bit of an assault on ones lungs. Fortunately, the Harmattan winds coming in from the North African desert tend to keep the air moving as well as cooling the place down a bit for a few months. Electric power is limited to those NGO’s and wealthier individuals who can afford a generator or solar power.

We enjoyed a fine greeting by Peacemaker Kargbo and his wife, Merah. My krio was quite rusty but I managed to get through greetings and understand how the guesthouse was set up. It was immediately obvious that we would be treated as family!
Adjusting to such a radically different culture, climate and fare is not always easy so we set up a daily structure that made sense and allowed for plenty of down time. We also had the fortune of catching the festivities at the tail end of a ten day visit by a surgical team that had offered specialized care at the government hospital to about 70 patients. This group from ISHI International was organized by an energetic, charismatic former Kabala PCV now NP, Marina Goldman.

Ah, the people in our neighborhood…. SEED, INC in conjunction with CITA International runs Nar Sarah clinic, a private sector clinic serving the people of Kabala and surrounding villages. We are staying in the clinic guesthouse next to Peacemaker’s house and a stone’s throw from the clinic. Peacemaker is the head clinician, greatly respected in the community and all around patriarch of family and clinic business. He is credited with saving many many people when the rebels entered Kabala in 1999 to continue their killing and maiming spree. In so doing, he was separated from his own family at a most desperate time. Fortunately, they all were reunited. But the scars of the war continue to permeate the community in many different ways, from visual evidence of burned out buildings that have been abandoned and amputees begging on the street to internal scars from dealing with months of shear terror, loss of family members through violent acts, kidnapping of ones children to serve as sex slaves or child soldiers committing monstrous atrocities while gorked on cocaine. Despite all this, Sierra Leoneans should be held aloft and hailed by all of us for their ability to forgive and courage to rebuild a broken country.
Hawa, our new best friend, participates in the Women Against Poverty Program and helps us stay fed and watered and wearing clean clothes. Each day she prepares a traditional meal of rice and sauce. She washes our clothes by “brooking” them against a rock or wash board. I tried to brook our clothes on my own and wanted to teach the kids how it’s done, but Hawa became thoroughly disgusted with the results and kept taking them down form the line where they were drying to brook them “properly”. It took a few weeks but I finally gave in and am glad to have her help.

The neighborhood kids are a lot of fun and very engaging. Card games, soccer, volleyball, story telling, sharing music are daily activities. These new friends are pretty much part and parcel of our day and have been helpful in introducing the culture and Krio language to our kids. Krio is the common language in a small country that has 18 different tribal languages. It’s a mixture of the King’s English and Portugese. Greetings are very important and learning to greet people properly is first and foremost in language acquisition here. Greeting the elderly involves respectful gestures such as holding your right forearm in your left hand as you shake hands to indicate that it takes two of your arms to hold their single arm.
The country fare is a bit restricted comparatively but no one is going hungry! It’s all “seasonal” and, I must admit, makes me chuckle a bit at our general locavore attitude back home. Locavore is a term reserved for people with options. Here, it is the only option. So what are these options?…tasty ones! Groundnut stew, country rice (rice sewn by hand, harvested by hand, threshed by foot, dried on mats or the road, beaten in a mortar, winnowed with the breeze, germ intact resulting in a fat, full, slightly brown speckled grain of rice that leaves your belly satisfied all day!), cassava or potato leaf, pumpkin stew, bean stew, peanuts, papaya, banana, orange, bread, benniseed cakes, cabbage, tomatoes, pepper. We’ve been frequenting a local establishment where we can get cold drinks as well. So, if money is in your pocket, there’s no reason to hungry at this time of year!

Nar Sarah clinic, in short, offers primary care, limited laboratory services and has a delivery room. As yet, there is no inpatient or surgical capability but these will, hopefully, be offered sometime in the next year as the clinic expands its services. It is very close to becoming a self supporting entity and is run entirely by Sierra Leoneans. A typical patient visit will cost between $1.00 and $3.00. Delivery is $7.00 and the mom stays about 12 hrs. Keep in mind that unskilled laborers tend to make less than $2.00/day. Power remains a constant challenge and the solar system can only provide power for a few hours a day. I have conducted 2 deliveries by flashlight and we were fortunate to not run into any complications. There is a bit of a one size fits all approach to patients as diagnostic adjuncts are limited and timely follow up is unpredictable (some patients walk ten miles or more to get to town and can‘t afford to stay long). Practitioners tend to think it’s simply better to cover for bacterial infection, malaria, typhoid and parasites and throw some oral               re hydration and vitamins in for good measure then to risk under treating a patient. There doesn’t seem to be much concern about creating resistant organisms. I’m reasonably sure there hasn’t been any investigation of such given the current infrastructure of medical care in this region and in the country. All in all, the staff is motivated, dedicated , and a pleasure to work with each day.

Lisa returns to Kondeya: Kondeya, a small village outside of Kabala of about 150 people and Lisa’s Peace Corps site from ‘87 - ‘89. The village knew I was returning and, unbeknownst to me, had made some special preparations for the day of my arrival with my family. We rode in the clinic ambulance for the 5 mile drive. It took at least 45 minutes to navigate the rough road! It’s hard to imagine the beauty of the steep hills and sub-Saharan terrain bordering on tropical forest. Plots of swamp rice in layered green and yellow hues were fully planted and almost harvest ready dotted the valley floor. Palms of all kinds rising up in 2 and 3’s with mango, avocado, guava trees scattered about and bordered by tall elephant grass. Upland (hillside) crops which were, during my time as an Ag volunteer, grown in tandem with swamp rice were noticeably absent with decidedly more bush encroachment extending to the road. Occasionally, farm families could be seen from the road tending their crops, burning refuse, driving birds, or cooking the mid day meal. At last the final hill came into view and, at long last, I was to see my friends of my youth who have endured so much pain and loss in the interim. As we entered the village, the villagers raced to the vehicle en masse. I jumped out and was immediately embraced by what seemed like hundreds of brown arms with singing and drumming and hollered greetings and cheers and jostling all punctuated by shouts of Sanfon Sesay - my Africa name. I was swept up and placed in a canopied hammock and was not allowed to walk into town but was to be carried the 100 yards by four strong men to the chief’s house. Michael and th kids were carried to the house in this way as well. Overwhelming…words can not describe how I felt other than that I’m sure it was consistent with what anyone might feel when returning home to friends and family after a Very Long Absence. It’s hard to describe what happened next - there were speeches and gift exchanging and memories shared and groundnut stew and country rice and palm wine and cola nuts to be chewed on and lots of “Do you remember me?”, “Do you remember this child you played with so often?” , etc, and, inevitably, who was shot and killed in the war. Michael was gifted a traditional Kuranko tunic which, I have no doubt, was imbued with various potions and incantations to provide him with protection from any harm as is the custom when making such clothing. Michael and the kids were also made honorary Sesay’s; Michael/Balansuma, Kai/Hassan, Haven/Finah and Ahmae/Yehri. All in all, it was beyond any welcome I could have imagined and we celebrated our good fortune to be alive and enjoying the time together. We departed reluctantly but full of gratitude for having had such an uplifting and filling experience.