Magic

     Magic is an interesting concept here.  That which is unexplained is often explained by magic.  Several times, there have been multiple deaths occurring in a village and the explanation from the inhabitants is magic.  We initially think Ebola or at least that we need to rule out ebola.  Often in resistant villages, they don't need any additional explanation.  It is magic and they don't even want to test for Ebola for fear of the repercussions.  This obviously is a potential problem.

     The belief in magic doesn't have to be due to ignorance.  It is part of the belief system here.  It doesn't matter that one is a Christian or if they are Muslim, they can still believe in magic.  In Senegal, I was offered a 'gigli' stick by a Muslim Senegalese physician.  He told me that it would make bullets veer away from me and make knives break when they were used to try and cut my skin.  While it would have been handy to have had, I declined.  It is also common in Haiti where it is said the the country is 90% Catholic, 10% Protestant and 100% voodoo.  Another physician was treating a native coworker for malaria.  He prescribed the medication but later in the day he say the coworker entering the hut of a native healer.  When the physician asked the coworker why he went to the native healer, the coworker replied:  'I went to you to be treated for malaria, I went to the healer to find out why I got malaria.  It is not always so straight forward.  I have seen gashes on the arms of children with fractured arms to release the evil spirits from the injury.  While many traditional healers do recognize their limits, many do not.

      One of our security guards was injured in an off the job moto accident suffering multiple fractures to his left leg and a basilar skull fracture.  We had offered his family some help to get him to Monrovia for treatment but instead his family was wanted to see how he would do with a native healer's potions.  One of our Liberian nursing assistants was helping the family.  When we asked the nursing assistant whether she tried to dissuade the family from taking their son to the healer, she wouldn't answer.  We suspect it is because she, at least at some level, supported that decision.  We all pray that it turns out well.  

More Animals

     I haven't written much about animals so I thought that today it would be appropriate to write on the most common type of animal that we find here, bugs.  It is flying ant (termite) season.  After a certain amount of rain, something triggers the migration of the termites and out they come.  They look like large ants but they sprout wings and emerge all together in large swarms.  They will head to the lights like many flying insects and you can see them swarming in the halo of the overhead lights.  You can see them collect in the .5% chlorine step buckets that we use to disinfect our boots.  There were so many there this morning that you had to depress the mass of them to get your boot soles wet.  Then they shed there wings which also litter the walking paths. In some areas, there are so many that you can't avoid stepping on a few as you walk.  Then, in another day or two they are gone, back underground.

     There are a lot of other notable insects as well.  Certainly there are a lot of mosquitos but not as many as I had feared.  This may change when during rainy season when water starts pooling everywhere.  Another insect that is prominent is the rhinoceros beetle.  This critter can be almost 2 inches long and an inch thick.  It does have a  large horn similar to a rhinosorus.  It doesn't bother anyone, but it does occasionally freak out one of the expat nurses.  Then there is the Nairobi bug.  It is a brightly colored half inch long bug that doesn't seem particularly impressive.  However, you do need to be careful of insects that don't need to camouflage themselves.   This one secretes, basically oozes, a toxin that causes a nice burn on the skin.  You don't even need to hit it, even brushing it off can get enough of the toxin on you to cause a nasty burn.  There have been several of the expat staff who have had a bad encounter with the Nairobi bug.

     Of course there are many other insects, spiders etc located here.  Some are familiar like ants, house flys etc.  Some are big and juicy but don't cause any problem except cleaning your boots when you accidentally step on them.  Also, these insect support a great many insectivores, but there always seems to be many more insects than there are of whatever might catch them.  I guess I could do with a few less of the bugs.  I'm rooting for the insectivores, except when they are in my room.

What we eat

     Liberian food is just different from ours.  I am not saying that it is worse, literally a matter of taste.  But it is different.  Our first cook in Tappita was a little more in tune with US tastes.  We certainly had a lot of Liberian food, but she would mix in meals with fried eggs and a type of chipate pancake, there was some degree of familiarity.  And once she learned to add sugar to the cinnamon rolls, you had something to look forward to.  Our new head cook hasn't learned these peculiarities yet.  Now breakfast is almost always a cream of wheat type porridge, occasionally with hard boiled eggs.  Cold cereal is usually available.  Once or twice a week we get a donut looking piece of fried bread dough which is a nice break.

     The staples of Liberian diet are chicken, fish, beans and rice.  We would have multiple variations on these possible combinations, usually with a lot of hot spices.  In the US, I will normally eat my meals a good bit more quickly than the others with whom I share the meal.  Here, I can't eat too quickly because my mouth would burn up.  It does help with conversation around the table, but even then it can take 15 minutes for my mouth to feel normal after a meal.  

     Spaghetti noodles have become popular and in Haiti were even a regular part of the breakfast meal.  Here they usually come with lunch or dinner.  You will notice that I didn't mention anything about vegetables.  The main one is a dark green leafy vegetable, often called Lagos spinach which is mixed with the stewed chicken or fish.  There is one type of food that both the Expat and Liberian staff enjoy;  french fries and barbecue chicken (not KC BBQ, but the chicken does taste better than it is prepared at other times (still really spicy)).  Sometimes, I think to satisfy the expats, there will be sliced cucumbers and in half the meals we do get fruit.  Usually it is pineapple and you hear no complaints from anyone about this.  The pineapple here is fresh off the tree and amazingly sweet.  I usually save it for dessert (which is a tradition that seems to be absent in this part of Liberia).  

     So, enough of my first world (barely concealed) complaints.  When we drive through the villages, there are still a lot of children with the pale brown hair and boney arms of chronic malnutrition.  You can also see the stunted adults and the drawn faces of the chronically hungry.  I am indeed thankful for the food I receive, but I do look forward to a nice piece of prime rib with a twice baked potato at Hereford House.  

Ceremonies

Sorry for the delay in posting.  We have started our sixth day without internet.  I am borrowing a sim card to let my iPad connect.

     Our daughter Sarah just announced her engagement to Joe.  It was difficult to perform some of the traditional engagement rituals with me over here.  However, it got me thinking about how engagement is done elsewhere.  I have observed a wedding ceremony in Uganda that included the giving away of the bride, exchange of gifts etc and it was really interesting. Our ETU is a pretty multinational group here and I started asking about how engagement is done in the different countries.  

     In a Liberian engagement, there is a ceremony where the groom to be approaches the parents (usually the father) of the bride with his father or someone else in authority (often a tribal chief).  The groom to be then asks the father for permission to marry the daughter and a dowry is exchanged.  It is a token dowry here, usually cola nuts or a ten cent piece.  That exchange of dowry also constitutes a legal obligation.  If the groom dies after the dowry is exchanged, then the care of the bride to be is the obligation of the groom to be's family.  After acceptance of the dowry, there is an exchange of gifts between the parents, usually involving a good wine that is consumed in the following celebration.  In the Congo, the minister has a huge role.  One of our physicians is from the Congo and was married just before coming to Liberia.  It is traditional in the Congo for the groom to be to approach his minister who questions him on his preparation for marriage.  If the minister is satisfied, he (almost always a he) goes with the groom to be to the bride to be's parents with the groom to be and there the groom to be asks the father of the bride for permission to marry.  A dowry is exchanged, usually symbolic but occasionally more substantive and then a large party ensues.  In the Congo, the minister will accompany the couple to the courthouse so that they can be legally married (usually to make sure that they are both at least 18 years old) before the ceremony of marriage.  In Nepal, there isn't as much ceremony, just the families getting together for a large party after the groom on his own, asks the parents (both) for permission to marry their daughter.  In the Philippines, it is much more westernized and the couples will announce their intent to marry to both sets of parents and a large joint party ensues.  Elopement is common.

     It looks like we won't get to observe an exchange of dowry with Sarah and Joe.  However, a good bottle of wine and a party sounds like a part of the tradition that we can do.  Congratulations Sarah and Joe!

Our fishbowl

    Sometimes it is hard to write the blog when nothing happens.  Sometimes it is hard when there is a lot happening.  I am afraid that both have applied over the last week.  Personnel issues are never fun and I have jokingly said that my job position title should be changed from Chief Medical Officer to Chief Personnel Issues Officer.  

     There was a good article in the New York Times recently on aid worker stress.  Thankfully, our stress here has revolved more around being ready and not having enough to do.  But that is also quite significant in it's own way.

     The expats here live in a strange social environment.  We are cut off from most of the social supports that we have at home.  Yes we have email, yes we have the US news, at least by internet.  But we don't have the interpersonal contacts from which we draw our comfort and reassurance.  Not in the same way that we have them at home.  We can develop some of those over here, but it usually is not the same.  Some people just don't do as well when isolated, especially when they aren't busy all the time.  These limited social interactions can also reduce the social inhibitions on behavior.  People can do things that they normally wouldn't.  That can make things interesting from a management point of view.  

     Once it is over, you look back and say, 'wow, that was crazy'.  But if I think that things get weird inside our fishbowl, it is important for me to remember that I am in that same fishbowl like everyone else.  You just have to be careful.

Working together

One of the things that you notice in Liberia is the wide variety of organizations and nationalities that are represented.  There is a literal alphabet soup of acronyms on people's ID badges and shirts.  Many are the usual culprits like WHO (World Health Organization), UNMIL (UN Military Liaison), USAID (United States Agency for International Development) etc and, of course, the many NGO (Non Governmental Organizations) such as Direct Relief, MSF (Medisin San Frontier -  Doctors without Borders), and IMC (International Medical Corps).  Heart to Heart is also an abbreviation, usually listed on rosters as HHI.  However, many people still have their national uniforms even when they are working for other organizations.  There is a UN police presence in Tappita that includes police from Jordan, Nigeria and Zimbabwe, all wearing their national uniforms.  Many Other African countries are represented with people from Zambia, Congo, Kenya and Uganda.  Conversations between the different nationalities is usually conducted in accented English.  Some countries are over represented on the military side such as Bangladesh and Sri Lanka, the governments of which earn significant money renting out their soldiers to the UN.  There are some combinations that make you wonder.  While waiting on a UN flight back to Tappita, one organization loaded ahead of us onto a different aircraft.  Two of the members wore their countries military uniforms, Russia and the Ukraine.  I wonder how that works with them having to work together.  Although, maybe that is what is what they have needed, working  together to help someone else in need.   Hopefully a little good can come, one way or another, from this epidemic.