“Cordon” in real life setting?

After 3 weeks of being too tired to play tennis in the weekend I forced myself this morning and cycled over to Bo Club to meet the coach for another session on the court. On my way over there, I heard a woman shouting something at me in Kreo. I could pick up ‘ebola’ in her sentence so I stopped and asked someone to translate it for me: ‘you puwnis are well protected against ebola, but you will infect us and we will die’. As I continued my way I thought about what the women said. Maybe she has a point; we are protected in some way, because the last days a lot has been done to prepare ourselves for an outbreak in Bo. In the houses, chlorine buckets have been installed to wash our food and our ‘bodies’ to kill any virus trying to invade our system. The fact that you smell like a swimming pool the whole day is just a minor inconvenience.

However, it is sad to notice that a lot of people believe that the ‘white men’ are injecting the ebola virus in patients in the hospital. It shows again how important it is to really understand the cultural believes and ways of reasoning in the population, otherwise there is no way this outbreak will be contained soon. These believes and rumours result in people infected with ebola hiding and running away from the hospital, because they are scared. Soon all hospitals in Bo will be empty and all the children suffering from severe malaria will die at home, because their parents are too scared to come to the hospital. Off course they are scared! Everyone is very worried at the moment, puwni or not. 

Pharmaceutical companies don’t invest in finding treatment as it will not pay off the investment. Previous outbreaks have always been contained rather quickly and the number of people infected remained low compared to other diseases. Although there is a lack of treatment, the last months showed that people do fight the virus by themselves and walk out of the isolation ward in good health. Providing supportive treatment like fluids, malaria treatment and vitamins can help to make the body strong enough to fight the virus. That is why it is so important to come to the hospital and get this treatment, and above all, to prevent infecting other people. Too many have died already, this really needs to stop.

I didn’t manage to keep my eyes on the ball today…

Man climbing the waterfalls in Kenema, Sierra Leone, 2014

Love in the time of ebola

You hear people whispering it in the streets,…ebola….like saying it out loud would make it appear right in front of you. MSF plays an important role in the history of ebola, being one of the only organizations with hands-on experience in outbreaks. I wish I could be more of use, but besides explaining the role of primates in transmission of the virus, there is not a lot of expertise I can offer. I am still learning the basics of epidemiology and it was not really planned to get in the middle of all sorts of outbreaks.

In the meantime business goes on as usual, working long hours and reflecting on the things that happened during the day with a nice glass of marula. Since 7 years, I always try to hide somewhere on the 7th of June, not an easy thing to do in this setting. Some days I love it, when you learn new interesting things and you feel you get a very good bond with colleagues that become partners in crime. Other days I really wish to be back home in my nice comfort zone, so I could at least be with my family when my grandmother passed away last week or today with my friends, sharing memories about that special one we lost 7 years ago. I wish I could have told my grandmother that when working in Africa, I often take my second name ‘Clara’, her name, because no one can pronounce ‘Veerle’ (it becomes something like Veelie, Veurlie, Vierleu,...). She would have liked that.

Fortunately in crazy outbreak times like these, we got some good news! The gynaecology and obstetric ward of the hospital will stay functional until the new hospital closer to Bo is up and running and the expertise of handling complicated pregnancies and deliveries can safely be handed over to another hospital. The original plan was to close down the ward in June and continue the paediatric care, but as women often come from far away to safely deliver in the hospital and the maternal mortality is still high in the country it was decided to stay open. On moments like these it is great to be here: if the good news that no one would lose their job would be announced in a Belgian company, everyone would politely smile and quietly think, "yes, I still can redecorate my kitchen this summer", and then go back to work. But when the news was announced here, the midwifes got together, and danced in the rain around the hospital, laughing and singing. 

Midwifes dancing in the hospital after the good news, GRC, Sierra Leone.

A tree is the limit

On the road to Kenema, the 3th largest city in Sierra Leone: It’s nice to escape Bo for a day, certainly if you are in the good company of two beautiful women from DRC and Malawi, another Belgian and my good friend from Ivory Coast. Seeing the Gola forest passing by, I immediately think of the chimpanzees that (just like the people) are trying to survive in harsh circumstances. It must be nice to be able to go look for them and see how the populations are doing in Sierra Leone.

Being a ‘first missioner’ I have to get used to all the aspects of living the MSF life. Before coming to Sierra Leone I was working in complete different circumstances, i.e. tracking chimpanzees and gorillas in the forest of Eastern Cameroon. It has been the most interesting, but also most disturbing working experience so far. It is amazing to live in the forest, never knowing what to expect the next day. But there is one thing you need to be able to do your job, regardless of where you are. You need the support of the organization in all its aspects. There will always be unforeseen circumstances, but if you are abandoned in the forest by your drunken field guides and you are planning to climb a tree to spend the night to avoid the risk of being trampled by elephants, you realize that as flexible you want to be, everyone has a limit. It is not always easy now to deal with all the security rules and protocols that we have to respect in our professional and personal life with MSF, but I understand more than ever that you need this to be actual able to do your job without being distracted and always switching to survival mode to make it through the day.

I miss the forest, the pollution in the city is difficult for me, but I love the fact that I can be much more productive and actually contribute to the well-functioning of the hospital. They warned us during our training before departure that working for MSF is like a marriage: some days you just want to run away from it as fast as you can, but most of the days you feel how much you love this lifestyle and would do anything to make it work.

An average working day in Dja Faunal Reserve, Cameroon [2013]

Small Small

A paediatric mortality rate of 6% for the first quarter of 2014 was one of the results we presented this week in the hospital. The target of staying under an 8% mortality rate was achieved. Just looking at the numbers you want to clap in your hands and congratulate each other on the good work. 

But when I was walking back to the office, I saw a young father carrying his deceased child out of the hospital. For a second I thought he was holding a small gift, trying to show it to the people around him. Wrapped in a beautiful blue-yellow lappa, he was holding the child in front of him and with a certain grace he walked out of the hospital. 

At the exit, the paper put on the small bundle said that it was indeed his child and that he would appear in my statistics as ‘exit outcome: death diagnosed as severe malaria’.

All of a sudden you feel that this 6% is nothing to congratulate each other on.

Attempt to play tennis in Bo Club, Sierra Leone [2014]

New York Kisses

She was supposed to celebrate her 30^th birthday today. It would have been our perfect excuse to organize a crazy party, to dress up as we did when we were 16 and drink (a bit) too much of that home-made cocktail.

So I promised her to get out of this life as much as I can for the both of us.

a birthday kiss [New York, 2006]

Welcome to Sweet Salone!

So, this is going to be my home for the next 12 months! Arriving in James Bond-style by speedboat, with an amazing sunset in the back makes me feel very welcome in this small unknown country.

When you think of Sierra Leone you think of a country somewhere hidden in Africa that was terrorized by a horrific war for almost a decade (and of Leonardo Dicaprio in Blood Diamond). But I see a whole different sight of Sierra Leone now: people are very welcoming, friendly, have a great sense of humour, party until the morning comes, dance in front of mirrors, drink ‘Star’ beer (which I as a good Belgian refuse to call ‘beer’) and the children shout ‘hellow hellow Puwni, I love you!’.

MSF started working here to provide medical care for refugees during the war. When the war ended it was decided to continue providing free health care for children and pregnant women and a hospital was built on the spot where there used to be a refugee camp. Plans are made to move the hospital more closely to the city center to make it more accessible.

It almost feels like I have a normal life now: getting up at 6am to go jogging, walking over to the office at 8am, meeting the team in the hospital at 11am, lunch at 1pm, analysing hospital data and getting intrigued by interesting epidemiological cases in the afternoon and going for a drink after work in the ‘under the palm tree’ bar.

Let’s not mention the fact that the heat is killing me and that it feels like I inhaled half of the Sahara which makes me cough like I have been smoking since I was 5…

It is hard to believe that not so long ago Freetown was under attack by an operation ‘no living thing’ and the sand on the now beautiful beaches was coloured blood red for days. Keep in mind that people forgive, but not easily forget.

On the road from Freetown to Bo, Sierra Leone

Last Night in Belgium

Tomorrow by this time I will get out of that aeroplane and embrace the steady ground of Sierra Leone under my feet. The days before leaving for 12 months to go work as an epidemiologist for Médecins Sans Frontières have been wonderful and painful at the same time. Cycling my last 20 km back home after drinks last night, watching the stars (without crashing into traffic signs this time), I reminisced about the exciting things that are going to happen and that have happened so far.

Having lousy friends would make leaving a lot easier...now I feel lost having to go, knowing that this time a lot of things will change in everyone's' life. Being in our late 20's - early 30's asks for a certain evaluation of how life has been and how you will fill up the next decade. But where the hell is the right answer?

I sometimes hear people saying 'it's so courageous of you, going to Africa and work for this wonderful organization, I would never be able to do that!' Than I always smile and think, you have no idea how courageous your are yourself, I probably would never be able to do what you do either. Mutual respect creates a nice atmosphere.

In conclusion: I am nervous, scared, worried, but excited and curious at the same time. Lets get over this fear of flying (or take that Xanax) and fight that Ebola! I have the most wonderful friends and family in de world, it was great hanging around with them again for the last 6 months and I just want everyone to be safe, healthy and content. Finding your way is never easy, but you are all doing a great job, keep that in mind.

Last Night in our Roaring 20's - Farewell Belgium