The gift of dignity

A song and dance ceremony

A woman thanks the staff at the clinic

The drum music was electrifying, the women breathtaking in their Africana and the air thick with optimism. I was fortunate to be invited to a very special ceremony last Friday. It happens every week but no one really knows about it. At a medical clinic in Aberdeen, the west end of Freetown, five women were about to go home after a simple surgery that’s pretty much given them back their lives and dignity.

All suffered from a condition called Vesico-Vaginal Fistula.

What is a fistula?

• an abnormal opening between the bladder and the vaginal wall
• most often caused by obstructed labor which occurs when the baby’s head is unable to pass through the birth canal and is jammed in the maternal pelvis
• pressure from the obstruction causes a loss of blood to the surrounding tissues, leading to necrosis
• a hole develops in place of the dead tissue resulting in constant leakage of urine
  

The women lose control over their bladder and bowel movement resulting in social ostracism and stigma. Many are abandoned by their families and branded as witches. Some older women have lived segregated lives for 25 or 30 years just because they didn’t know where to get help. The Mercy Ships Fistula Clinic where I was, repairs these vaginal tears absolutely free of cost, giving the women control back over their bodies. There’s also another organisation called the West Africa Fistula Foundation that operates out of the smaller city of Bo.

Fistulas often result from early pregnancies and in a country where conditions of childbirth are appalling, it’s not surprising that the problem goes largely unattended. I was thoroughly inspired by the work the doctors and nurses at the clinic do. As a woman I firmly believe that no one should have to live a life of shame.

I face many challenges in this country every day. Sometimes I wonder if things will ever get better. Will there ever be stable power; will sanitation continue to be a pipe dream? Will the victims of the war ever be compensated?

And then something miraculous happens. You meet one small group of people who are genuinely making a difference and that gives you hope. Yes we can!

Million Dollar Boys

My last post on Freetown's dollar store prompted me to repost a column from my blog at The New Internationalist. It's about black market money changers who are an indispensable part of society here.

http://blog.newint.org/majority/2009/09/03/million-dollar-boys/

Also check out my other posts by clicking on 'Related Posts' on the right.

Freetown’s dollar store

On the densely crowded Kissy Road in the eastern part of Freetown, there’s a shop where the service is terrible and the prices never change. It’s the city’s very own dollar store where everything is sold at 4,000 leones (one US dollar is about 3,900 leones by the current conversion rate).

I am a self confessed supermarket addict but not the classy stuff. No, leave me unattended for 10 minutes and I’ll return with a cart full of random crap I’ll never use. The most useless thing I can remember buying at the 99 Pence store in London was a veiled hat with a giant bumble bee stuck on it (I later donated it to my flat mate for her Halloween costume). Oh yeah, there was also that singing donkey.

So when I drove by Saad M. Raslan Co. and saw the 4,000 leones sign, I almost floated in. Inside the racks of colourful paper cups, hideous umbrellas and all things plasticky were protected by grills. Steal from a dollar store? Really? I think thieves have better taste.

This one, I have to admit, didn’t do it for me. Maybe it didn’t have enough ‘Made in China’ junk to hold my attention. Also, the manager was rude and wouldn’t let me shoot in the store. Guess who’s not getting my dollar…

Ode to Okadas

I’m usually slow to warm up to two wheel travel. I remember my early days in Amsterdam when wild horses couldn’t chase me onto a bicycle. I was told it was the only way to get around but I resisted. Today, I can say that I am the proud owner of a ‘I love my bike’ bell and dream of the day I will be able to afford that gorgeous hybrid Claude Butler.

I grew to love bicycles, not just for the speed but also the sheer abandon of the wind in my hair and the immense high of a good tail wind.

When I first came to Freetown, I was warned that under no circumstance was I to get on an okada. A Nigerian word, okadas are motorcycle taxis that zip between cars, speed headfirst into traffic and have caused more than more serious accident. I was intrigued though, it must be cool getting around at the speed of crazy. Many of the okada drivers are former combatants from the war who because of a lack of employment opportunities have turned their bikes into people movers. Everyone loves to hate them, they speed, they’re rude, they rip people off and are disrespectful of traffic police.

About a month back, I finally boarded one with great apprehension. Should I hold on to the driver? Would that give him the wrong idea? How do I contract my body into a shape small enough to slide between two closely parked cars? Zipping down a hill while a mild drizzle came on, I was sure that this was it. I was going to die in Freetown in the most inglorious way, a motor cycle accident. By the grace of god (a popular local exclamation) I arrived at my destination in one piece. I was quivering as I reached for my wallet to pay the man, my knees wobbled as I crossed the road, I was petrified. But I was also hooked.

I’ve slowly picked up bits of okada etiquette, how to get on while wearing a skirt, how to get the driver to slow down by saying “go small, go small” and how to close my eyes tight during those careening moments of terror. I recently promised a friend that I would introduce her to okada travel in Freetown and I can’t believe I ever lived without them. I may not have a bicycle anymore but I can still feel the wind in my hair and watch the city whiz by.

So that’s how I came to love okadas. It’s part of the romance of Freetown and I’m most upset that the traffic authorities are trying to get rid of them. Are they a menace to society? Sure, but what’s life if you can’t live a little dangerously?

The wisdom of scholarships for virgins

I would like to revisit a post from a couple of months ago. I wrote about a local ‘scholarships-for-virgins’ scheme that was aimed at keeping teenage girls chaste and free from HIV.

A brief refresher from my earlier post before I continue:

“In the Biriwa Disrict in northern Sierra Leone, the Biriwa Youth Association for Development (BYAD) claims it has a hundred university scholarships to offer teenage girls who can prove to a community nurse that they are virgins.

The group feels it is a way of curbing teenage pregnancies which is alarmingly high in the region. According to the National Aids Secretariat the district also clocks the highest number of HIV infections in the country.”

I bring this up again because I recently read UNICEF’s 2009 Out-of-school report for Sierra Leone and was disturbed by one of their findings. It says that in the Kailahun and Makeni districts of the country young women were being forcefully impregnated by their male peers as a punishment for receiving opportunities to further their education. I quote from the report:

NGOs working in Kailahun communities have apparently recorded cases, where girls were raped by their male classmates (resulting to pregnancies) because of the “unfair” benefits the girls received from the scholarship programmes.

Are the local authorities getting it wrong? I’ve been reading reports of similar initiatives in other African countries like Uganda and Nigeria but nothing that evaluates their success in either controlling teenage pregnancies or empowering young women.

According to UNICEF, rather than keep girls in school, these scholarship programmes are offering them up for sexual intimidation. Very often these offenses go unreported because of poor understanding of the law.

Do these financial chastity belts work or are they keeping more children out of school? By offering scholarships for chastity are local do-gooders perpetuating the victimization of young women in this country? Unfortunately I don’t know the answers to these questions. I hope someone does.

Of capacity building, sensitisation and stakeholders

Recently a friend asked me what my pet peeves in Sierra Leone were. Without hesitating I rattled off these three words. Let me explain why they make me cringe. My job in Sierra Leone is to train journalists how to report human rights issues more effectively. However I see it more as an exercise in brainwashing or unbrainwashing if you like.

Anything you do in Sierra Leone is capacity building or sensitisation. If an NGO trains nurses, they’re not just training them. No that’s too trite, they’re building capacity. If the United Nations High Commissioner holds a two-day workshop in refugee issues, it is absolutely nothing less than sensitisation. Oh, and everyone that attended is a stakeholder. Development speak and has crept into journalistic writing, simply because of the number of events that they attend every week and the heavy doses of NGO jargon that are laid on them. So reporters have adopted these words as part of their daily vocabulary and pepper their articles rather liberally with them. Which drives me quite potty to be honest. Who on earth wants to read about stakeholders whose capacity was built in a two-day workshop?

I place the blame squarely on the shoulders of every single NGO that operates in this city. By offering small amounts of ‘transport’ and ‘breakfast’ money to reporters to attend their events they’ve turned them into zombies who parrot whatever is thrown at them. Expunging these words from print is probably the most challenging quest I will ever undertake. I’m up against an institution that’s pretty much pillared on these three words. Yes, no wonder journalism in Sierra Leone is a bit wobbly.

Last week, I was invited to the local UNDP office to consult on a training programme for journalists. They started by telling me that they wanted to build capacity. I knew I had to act fast. So I said, “I’m sorry but journalists in this country have been sensitized to death. Teach them something they can use.” Hmmm, not sure if I’ll be asked back there, but I felt compelled to open my mouth.

I bring to my job my journalistic biases. When I hear these words I’m overcome by the same feeling of nausea that’s triggered by pompous academic writing. Breathe, breathe, breathe.

Witches amongst us muggles?

A curious paranoia has gripped the residents of Freetown over the past couple of weeks; that we are being controlled by dark and evil forces. Now, this post is not inspired by the fact that I’ve just finished watching Harry Potter and the Half Blood Prince; the obsession with witchcraft in Sierra Leone has intrigued me ever since I first got here.

Let me recount the latest events. About two weeks ago, the city’s main water supply was choked off by a severed pipe which took that long to fix. The government released a statement saying that that damage was too severe and they were doing all they could to plug the problem. A different group of commentators however forwarded a more sinister conspiracy theory: that there were witches and wizards in the president’s closest circle. It was apparently these ill meaning sorcerers that had a spell over our water supply in an effort to embarrass the ruling party.

The more recent incident involves the performance of a cleaning ritual at the president’s official residence, the State House. A local paper reported that the head of security at the State House had been passing around a hat to collect money to hire an ‘ariogbo’ (witch doctor), to come and rid the premises of bad karma.

This seems to have unleashed widespread pandemonium with everyone speculating that the president, Ernest Bai Koroma was indeed possessed. Joe Minah, a local journalist who investigated the story assured me that he had seen the exorcism pyre with his own eyes an vouched for some of the president’s aides being wicked.

I must pause here to mention that I’m not one to ridicule traditional beliefs. I’m merely a rational person trying to understand things on the periphery of our consciousness. I have had conversations with a number of people about witchcraft in Sierra Leone. A young media researcher narrated a first person account to me. Her father was suspected to be under the influence of wizards so an ariogbo was called in to expunge the spirits from his body. This involves the smearing of an ash-like powder on the arm, following which the area is branded with a hot iron. I’m told if the person is clean he or she will escape unscarred.

To me as an outsider who admittedly doesn’t understand the local culture that well, witchcraft seems like a convenient scapegoat. It’s what causes mental illness, polio, typhoid and malaria. The cure is some variation of the above mentioned ceremony.

Another fear that grips locals is that of being shot by a witch gun. I have often wondered what this offending weapon actually looks like. Some tell me it’s invisible, others say it’s small enough to fit in your pocket. A third group say it’s the evil eye.

I wonder why I find witch craft so hard to digest even while I’m glued to the screen waiting for Voldermort to make an appearance. As a muggle who’s spent many fantasy trips wandering around the dark halls of Hogwarts, I of all people should be able to embrace this real life ‘Abacadabra’. Is fantasy easier to believe in than reality? For Sierra Leoneans, not seeing is believing; this is their Pottermania.

Used syringes lying about at The Arab Clinic

A crumbling ward at The Arab Clinic

Medical drama

I grew up watching TV shows like CSI, Law and Order and Numbers where the bad guys were always the ones hiding behind a locked door and the men and women in blue had to kick their way in to bust up some nefarious activity.

The other day I got to live out that police dream. I accompanied the Ministry of Health and Sanitation on a crackdown on illegal hospitals and clinics in the city. We all piled into ministry cars and accompanied by armed policemen we set out to rid Freetown of quacks.

I have to say it was not the most subtle of raids. Our convoy was far too conspicuous and every where we went, a couple of public relations officers got out to clear the traffic for us. In the car with me was Dr Edward Nahim, the chief of medical services in Sierra Leone and the man in charge of the whole operation. Incidentally he is also the country’s only trained psychiatrist.

The first couple of stops were less than exciting; we checked papers and let them off with warnings. However it was an eye opener about the quality of healthcare in this country. Flickering lights, dingy wards, dirty sheets and filthy mosquito nets. If there had been a couple of drills lying around it could have been a scene from Eli Roth’s Hostel. These are not places where anyone can recover from anything.

The third place was where things not exciting. This was the Arab Clinic, part of a chain of Egyptian-owned private medical centres. Same ambience, even discarded needles lying lazily on a table near the reception. The man in charge seemed confused by our presence. Dr Nahim began interrogating the doctor in charge, a Guinean man who couldn’t produce any paperwork to prove that he was a certified medical practitioner. So amidst great pomp and protest we threw them into the police car and bolted the clinic.

Now comes the sad part, the patients who were admitted there. The ministry had obviously not thought this through very well and had no idea what to do with these people. They were simply told to “go to the nearest government hospital.” No one helped them remove their IVs or fetch them their crutches. “They’re better off without these fake doctors. This is dangerous,” Dr Nahim said to me. Surely there’s a reason they’re here. I winced as a young woman bled all over dress trying to pluck out the needle from her fore arm.

Same story at the next place. I was stunned by the fact that all the patients complied and agreed to be thrown out even though they had paid to be looked after. There was also no talk about whether they would get any money back.

By late afternoon everyone was pretty exhausted. Word seemed to have spread and every successive hospital we went to was shuttered already. Not sure what the point of this exercise was really, beyond publicity. It’s not going to stop illegal medical practitioners from treating desperate patients or mothers from dragging their daughters to unlicensed abortion clinics. The owners of these hospitals will bribe someone in the ministry and be back in business within a day.

That’s the cynic in me. The optimist however would like to believe that we stopped crime, saved lives and were heroes for the day.