Daily sights

Finding Normal

I apologize to everyone that I took a little hiatus from writing.  My routine was disrupted by a few different things and my Sunday night blogging session took a bit of a hit.  Now that I’ve been here for nearly two months, I’m realizing that I’m starting to find my normal here.  Although my life here borders on the bizarre… taking UN helicopters and having my temperature checked 6 times a day or so, I suppose you really can get used to anything.  And, of course, not everything is so different.

In case anyone was wondering, Netflix actually does work here so Law and Order have been part of my weekly routine.  The workload here is heavy, but at least once or twice a week a make conscious decision to leave my work laptop closed when I get home and try to cook dinner and watch my Netflix.

Last weekend I was able to have a ‘treat yo’self’ weekend with a friend from work.  She’s lived here off and on for seven years so she knows where to find a good mani/pedi.  I usually work on Saturday, but I slept in and then met my friend for a mani/pedi followed by cappuccinos and pizza.  Then I went home and ate a really nice Valentine’s Day dinner that my roommate (who is French, mind you) made.  Then on Sunday, it was a beach day as per usual.  All in all, not a bad normal to have.

Some things, of course, are still harder to get used to.  Since the city is still on lockdown, we can only get groceries until 6 pm.  Since we all work a lot, it’s really hard to get to the grocery store before it closes, so that is a constant stressor.  And then when you do get to a grocery store, it’s basically a guarantee that you won’t find everything that you need.  They are all quite small and often lack basic things that we would consider a necessity.  I’ve started kind of picking up random things here and there that I know I would use for a recipe and then hoping that something will come together at some point.  I haven’t really found my cooking stride yet because it’s so hard to get ingredients, which is frustrating for me.

I’ve also been dealing with a lot of uncertainty around my job.  As I’ve talked about before, I’m the OICC (observational interim care centre) Manager, where children can complete their quarantine period if they don’t have an appropriate caregiver.  However, the number of cases is dropping quickly and as such, the need for OICCs is dropping as well.  For the past 3 or 4 weeks, there have been a lot of conversations about what to do with the OICC Training Team that I supervise as well as what to do with me.  For those who know me well, you’ll understand how hard it is for me to deal with uncertainty.  Finally this week, my role was decided and I’m quite happy with it.  I’m currently in a period of transition now to become the Freetown Health Manager.  I’ll be essentially supervising all of the health projects that are going on in the capital, which is great for me.  I will still have my OICC duties, but we expect those to start reducing quickly.

In the meantime, I’ve also been having a lot of things happening on the PhD/DrPH front.  I submitted applications for PhD/DrPH programs before I knew that I was going to have this job, so things have been moving forward with that since I’ve been here.  I applied to Washington University, Tulane, Johns Hopkins, and Boston University.  At this point, I’ve gotten interviews at all of the schools and already been accepted to Tulane.  I’m waiting now to see what happens with the other three schools as well as what the financial package will be at each.  Stay tuned!

Unsung Heroes

This week I was finally able to make it to Port Loko where we have our Ebola Treatment Center, which currently employs over 300 people.  This center has been the biggest piece of our Ebola response and has definitely gotten a lot of press.  However, I didn't even see the treatment center while I was there.  I was there to observe the OICC Training Unit that I supervise do a training at an OICC in the area.

I think in my earlier blog posts I talked about how OICCs started popping up all over the country with extremely varied levels of expertise and experience.  Not to mention the fact that everyone was figuring things out as they went along since no one had ever built and OICC before.  That situation was the catalyst for the creation of our training unit.  They travel around the country (often on a moment's notice due to the unpredictable nature of the ebola response) and do training and mentoring with OICC staff.

I arrived at the Lunsar OICC around one pm from Freetown and met two of my training staff at the OICC.  The staff were on lunch so we had a chance to chat a little bit about a training we are trying to schedule in a place called Kumala.  Unfortunately, this training has become a logistical nightmare due to the isolation of the town and a lot of inaccurate information passing back and forth.  I was at my wits end as I spoke with my team and said we may not even be able to do the training when one of them said, "Listen, this training needs to be done and we will find a way to do it.  If we have to go down there and sleep in the car, we will get it done.  Don't worry about it, boss."

After that little conversation, they gave me a tour of the OICC.  This is a follow up training, so they were telling me about the things they had addressed in the previous training like implementing a cohort system and handwashing stations.  I was feeling pretty pleased with the progress until I saw three caregivers working with the children without any gloves or PPE (personal protective equipment).  And then I watched as one of the caregivers walked out of the red zone where she had been working with the kids and into the green zone where I was standing and watching without watching her hands.  My heart dropped in my chest as I realized that I was at higher risk in that moment than I had been at any point during my three weeks in Sierra Leone.  The caregiver didn't come anywhere close to touching me and none of the kids were symptomatic (Ebola is only contagious during the symptomatic stage), so in reality it wasn't that much of a risk.

Anyway, my internal freak out isn't the point of this post.  What I realized from that experience is that the training unit that I work with is much braver than I had ever realized before.  They walk into these OICCs with no fear because they know that this training is essential to keep the kids there safe as well as prevent the spread of Ebola back into the communities.  You'll never hear about an OICC training team for a variety of reasons from politics here to the fact that it's just not as striking as an Ebola Treatment Center doctor in full PPE.  However after spending some time with this team and seeing their dedication and fearlessness, I wanted to share their story.

On the personal front, things are going pretty well.  I've realized that it's very important for me to define my own social life rather than just going along with what other people are doing, which is really easy to do when you live in a house full of people.  I've also realized that when you work with a pack of workaholics (and have some workaholic tendencies yourself), it's pretty easy to get into unhealthy habits like skipping dinner a lot and eating shawarma every day for lunch.  I'm trying to get a handle on what things I can actually cook here so that I can eat better and also trying to set boundaries like limiting work talk at home.  I know that this is an emergency situation and my life here won't ever be quite normal, but I need to make it as normal as a I can or I won't be able to cope.  This weekend I was able to take up my favorite sport again: boxing!!!  I had no hope that I would be able to do that here, but someone had a number for a boxing coach in her phone from the last person who had owned it so she gave it to me and I set up a lesson for today.  It just takes place on the beach, which is kind of cool... except that people kind of gather around to watch you, which is mortifying.  I realized two things during my lesson: I'm in awful shape, but the team at South Shore Sportfighting taught me well because my fundamentals were spot on :)  Watch out for my left hook, y'all, it's a knock out punch.

Afternoon view

UN Helicopter, it's how we do

Mind the Gap

I'm sure many of you have seen the signs in the London Tube (subway) that say "Mind the Gap."  As Americans, we love this little turn of phrase that is so different from how we would say it.  The signs are there to warn passengers to be careful of the small gap between the subway cars and the platform.  However, once in a movie or something I saw someone apply it to the gap between expectations and reality.  I think that perhaps the thing I will come away from this experience is a more skill in that particular area.

Anyone who has lived in a developing country can tell you that there is always a gap between what you expect and what happens.  You expect a bus to arrive around a certain time and it never comes... you expect a scheduled meeting to occur and no one shows up... you expect to watch a little tv and the power goes out.  The combination of an extremely poor country, a raging epidemic, and staff that are stretched to their limits means that expectations are further from reality than I think they have ever been for me.  As some of you may know, I like to plan just a little bit.. and I don't much like not being in control so this week I found myself testing the limits of my patience.

As I mentioned in my previous post, I was supposed to go to my site visit in Kenema on the UN helicopter.  The tickets come the day before the flight, so although nothing was confirmed I wasn't worried.  I went to a meeting at UNICEF that I expected to last for 2 hours... but the reality was that it lasted for three.  I got back to the office after 5 and found no ticket... I called our Administrative person who just said she wasn't in the office, so that wasn't much help.  Turns out no ticket had been bought, but it was ok because someone was going to set up a car for me.  Expectations: 0, Reality: 2

I was told I would be leaving at 11, so I was in my office just trying to get a few things done when I get a call from my boss who tells me I need to be leaving right now.  The drivers didn't know this, so although I got in the car to leave at 10:15, we ended up running around to get gas and whatever else to prepare for the trip and I still left Freetown at 11.  Expectations: 0, Reality: 3

By this point, I was close to tears and so frustrated I could barely talk.  All along the way to Kenema, the police set up checkpoints where they make you wash your hands and they take your temperature.  About 3 hours and who knows how many checkpoints later, I met up with the colleague who was coming with me to Kenema.  This colleague had been slow on emails and I didn't expect to really get along with her, but she was great.  Expectations: 0, Reality: 4 (see, they aren't always bad)

In any case, I think get the idea.  Despite my difficulty in getting to Kenema, my visit there went really well.  The OICC that GOAL is running there is very impressive and it was really nice to get out of the office.  I did a good job strengthening my relationship with one of the nurses on my team as well as getting to know my colleague who will be in charge of another OICC that we a planning on opening soon.  I left Kenema feeling really happy with the visit.  And I left on the helicopter :)

So, the first 10 or 15 minutes of the trip you feel like perhaps one of the coolest people in the world.  Then you realize that the noise is nearly deafening and you can't really do much and it does get old kind of fast.  But still, it was pretty cool to ride on a UN helicopter!!  I'm going to post photos in another post :)

One week down... or is it one month?

So, I feel that I must correct some misperceptions about my Sierra Leonean life and my participation in the fight against Ebola.  The media has shown all kinds of pictures in people in full body suits with respirators and the whole bit working with patients.  That is not my life. At all.

On a daily basis, I wake up in the morning and head into my office.  I generally either stay there the whole day or run around to various meetings.  When I do have to go to the OICCs (quarantine units for kiddos), I won't be allowed to go into any "red zones," which are areas where there is a risk of infection.  So all in all, my risk of catching Ebola is very, very small and my life is very different from those people who are working on the front lines.

In some ways, my life here is easier than my life was in Boston.  We have someone who drives us around (although making the arrangements for drivers can be a pain), someone who cleans our apartment, and someone who does our laundry.  So in that sense, it's much easier than home.  However, this is still an emergency situation and there are some things that are definitely hard.  Everyone here is working full stop, so although it's not explicitly stated, that's kind of the expectation.  I've been here for a week and I'm already attending meetings with major partners (like UNICEF) on my own.  There is no time to get oriented, you really just have to jump in with both feet and hope that you don't sink entirely.

As I'm sitting here reflecting on the past week, the thing that I can't get over is how quickly I found my place in the office and started taking on responsibilities.  That's why it feels like I've been here for a month rather than a week.  My biggest fear here actually isn't Ebola, but rather it's making a big mistake or just not meeting the expectations of my colleagues.

One thing that I can say for sure is that this will be an experience unlike any other I've ever had.  I'm surrounded by really incredible colleagues that I've already developed a great deal of respect for and I look forward to learning from them.  I have no doubt that coming here was the right decision and I just hope that I can rise to the challenge

So, here are some highlights from the week:
-We have a giant TV that didn't work, so I made it my mission to figure out how to hook up a computer to it so we could make movies.  And I was successful :)
-My roommate made chocolate cake and it was lovely
-I went to one of the beautiful beaches near Freetown and fell in love with Sierra Leone a little bit
-I found out that one of my colleagues, who is Serbian, lived briefly in Topeka, Kansas
-I realized that wine here is cheaper than at home, although everything else in the supermarket is more expensive
-I put up pictures in my room so now I have the smiling faces of the folks I love to keep me cheerful

Next week so far on the docket I have a trip in the UN helicopter to see our OICC in Kenema, a meeting with UNICEF, and a meeting with the Minister of Health.  So ya know, I'm of course not at all intimidated.