Clarke Read, a current member of the EWB-Sierra Leone team sent the following email:

“Fatu Conteh has a particularly amazing story, in which she mentioned how a patient came in that needed oxygen from an accident nearby.  And it was only because of oxygen tanks that could only be installed due to the expanded power grid that this patient could be given the care he needed.  Because of the cells, he lived; without them, Fatu said he surely would have died.

And from Allan Mayfield, who is working with Dan on many WA-related things:
‘And many thanks to EWB for what they have already done. In the two years since their first visit, the Wellbody clinic has increased its patient census from 400 to over 1,000 patients per month and added several pieces of equipment that required secure, reliable electric power, including a specialized refrigerator for pediatric vaccines and an ultrasound machine for maternal care.’
“

Great follow up news like this warms my heart and it’s great to see that the change we had envisioned is in fact happening on the ground. It’s an especially refreshing grounding in reality, especially since I’m currently working at the WHO this summer in Geneva, where the formation of policy guidelines often feels so distant from their intended impacts.

-Neal

Kristof published this blog post right before we left, in which he discusses some criticisms of his writings as portraying Westerners in a sort of “knights on white horses” role to Africans who are helpless in their dire needs. Check it out here:

http://kristof.blogs.nytimes.com/2010/07/14/westerners-on-white-horses/

In the short post, he explores a few issues that I think are very relevant to our project. One is the extraordinary work being done by Sierra Leoneans – like Dr. Barrie and everyone who works at NOW. Or the rising stars of EFO, like Jalloh, Suma, and Idrissa, students who have the technical expertise to bring electricity to all parts of Sierra Leone. Or even entrepreneurial Uncle Ben and his guest house, which is undergoing construction for expansion and providing pretty much the only secure, clean, and safe lodging for visitors to Kono. Another issue is the portrayal of Africa – I think sometimes we were frustrated with the pace of progress, or the corruption that was accepted as the norm, or the vast number of needs we witnessed. Yet I hope that we also portrayed a picture of Sierra Leone that highlighted the rich culture and incredible people and signs of hope for the future. A third issue is the Westerners – we did show up with solar panels and funding, and although I would have been sad to not have been able to visit Sierra Leone again, the project could have happened without our physical presence in the country. However, sending the four of us was not only a great learning experience for ourselves, but we were in a sense the “bridge characters” that Kristof talks about. Would we have reached as many people as we did with the story of GAF/NOW’s great healthcare work and EFO’s steps to light the country if the Beacon Solar Energy Project for Sierra Leone (that’s us) didn’t keep a blog?

Hopefully the benefits of this project extend far beyond the community of Koidu. Maybe someone out there was looking for a worthy cause and has since contacted or become involved with GAF/NOW or EFO. Or maybe everyone is just a little more knowledgeable about Sierra Leone or solar panels or international development (a topic that I sometimes think is harder than thermodynamics). I hope through our blogging, we joined people like Nick Kristof in raising awareness of both the needs and the success stories in places like Sierra Leone.

-Meghan

-Zoe

During the last couple of days, I have spent 38 hours traveling from Freetown to San Francisco. During that time, every single one of my three airline flights has been late. I am also 0/2 for checked luggage retrieval during this trip. Yep…. Royal Air Maroc lost my luggage not only to Freetown, but now also back from Freetown. Due to these delays, I have also been the last passenger to board a connecting flight twice during this trip, sprinting through terminals in order to barely catch transfers from JFK to CMN and JFK to SFO. Well… I guess at least I can say that the process of traveling for me is never boring.

Anyways, it’s good to be home, and I’m not too worried about the luggage. I’m assuming it’ll show up one of these days, and now that I’m home, I’ll have more than enough spare clothing to wear. Perhaps all of this travel misfortune is just to offset the relative smoothness of our project implementation in Sierra Leone. If that’s the case, then there’s no doubt that some close-calls on transfers and lost baggage are more than worth the inconvenience.

I second Meghan’s post from yesterday. I am so grateful to have had the opportunity to have seen this whole project through. It was really touching to be able to have created, designed, and shaped our own project from start to finish. I think we are all so lucky to have had the support that we’ve received from Princeton, without which none of this would have been possible.

But I also hope that this project is not seen as a fully satisfactory endpoint. In a country like Sierra Leone, which still has some of the worst health and economic statistics, there is always so much more to be done. A solar panel system provides power, but only with the proper management and usage of this resource will it have the most impact. The NOW clinic will be using the electricity to power their new medical equipment, and we are also hoping that the lights might now be able to help enable the clinic to extend their hours of operation. We hope to monitor how the solar system is functioning in the upcoming months as well as the impacts it has on the clinic. The range of issues concerning the impact of our system resonate deeper still and are interlaced with the effectiveness of NOW’s efforts to reform the healthcare system in Sierra Leone. There are many layers of complex relationships that exist between the NOW clinic and the government, and it is our hope that the success of the clinic will help provide an example that will inspire change in the Sierra Leone healthcare system.

Meghan and I would like the Princeton relationship with Sierra Leone to continue after this project. I’m sure that Henry and Zoe are doing their best to assess for other potential ways in which Princeton students may be able to contribute in the future. Meghan and I have agreed that in our post-Princeton lives (yes, although hard to fathom right now, I’ve been told that there is life beyond Princeton) we plan on returning to the clinic again. Maybe we’ll have learned something useful from grad/medical school.

Until then, we wish everyone who is or may be involved in the future with the NOW/GAF clinic’s efforts the best of luck.

Below are some pictures from all of our cameras.

-Neal

The installation of the Open Medical Record System has been, in short, a frustrating nuisance. The clinic has four donated laptops that are eventually to be used for an electronic medical system that is linked by a local network. The program, Open MRS, is supposedly designed for use in developing countries but it has proved to be the exact opposite. Henry has been working on this while I have been painting, and the four programs that must be downloaded in order to make the system run cannot seem to find each other on the computer. Henry has been playing around with the code but our lack of computer science/engineering backgrounds aren’t helping us. The program recommends that an IT tech be on hand for the first three months of usage for troubleshooting, a requirement that is rather preposterous given that it is supposed to be for developing areas. Luckily, Dr. Barrie has an IT person coming in November to help out around the clinic so if we can get the basic software and local network set up the IT tech can then help the staff through transitioning to electronic medical records. With their growing number of patients, an electronic system would be greatly beneficial but hopefully the complexity of the software and technology won’t be an impediment.

Lastly, we went to see the new Kono Public Library with Kulani, one of the GAF interns, today. It took two years to build but it is an absolutely beautiful and incredibly spacious building. It is still completely empty, although books will be arriving this coming week. They have planned for a children’s department, a reference center, lending department, and two computer labs to be used as internet cafes to both library members as well as the general public. They will need much assistance getting an internet cafe up and running since it will be the first of its kind in this area and will not be financially supported by the Sierra Leone Library Board as the rest of the library is. We are considering helping them with this for our next project since this will allow the library to have a constant source of revenue and use that profit to hire staff who can lead reading sessions and classes for both children and adults. The schools here in Kono do not have libraries and very few people have access to books. The hope is that the internet cafe will attract community members and encourage them to explore the educational opportunities offered by the library as well. We will return to the library later this week with more questions and also check out the Central Library in Freetown to see how they are run. The current plan is to return to Freetown on Sunday so that we will have time to explore the library and how the US Embassy sets up their wireless network.

Tonight we’ll be having a small feast at Uncle Ben’s! Another Princetonian, Matthias, is coming to Uncle Ben’s so we will splurge a little and enjoy the luxury of eating some chicken, a meat that is much more expensive than beef here. Time for a motorbike ride in the pouring rain to get back to Uncle Ben’s…nothing like the pleasures of the rainy season here.

-Zoe

Today, we also met with Simon from EFO, the head guy and our initial contact. We had a good meeting, just to debrief how the project went. Aside from some people-skill issues with Jalloh, on the whole, we felt the project was a great success. In my earlier post, I lamented that progress here was slow. But there is still progress, and projects like ours and the many others that EFO has planned (solar panel installations are growing, slowly but surely – Simon mentioned a new system available for about US$100 that uses LED lights and a single panel, scaled for an individual home that seems to be a promising option) at other clinics, schools, orphanages, and other non-profit-type installations throughout the country. He’s pretty dedicated to the growth of renewable energy in Sierra Leone, also teaching at GTI, where some of the instructors for the next school year were recently students themselves, so the knowledge is going local.

Neal and I are really excited/happy/relieved that we saw this project to the end. Last year, Dr. Barrie mentioned that plenty of white people come to Sierra Leone, take pictures, make promises, and never come back. That’s always been in the back of our minds through the year as we applied for grants and made plans for this year’s trip. Especially since NOW/GAF is, in our eyes, such an outstanding example of an effective and transparent organization that makes a real difference on the ground (if anyone out there is looking for a worthy cause for monetary donations, definitely consider these guys: www.go-act.org). It’s easy to see all the needs and poverty and feel like there’s not really much that can be done. But it’s been a great reminder to see such tangible effects and know that health care for the people of Koidu has just improved – ultrasound machine, forthcoming x-ray machine, liver function tests, kidney function tests, bloodwork, refrigeration, even a simple fan in the observation room to provide just a little more relief to a sick patient.

We’ve both been wondering if/when we’ll be back. We sure hope so. I don’t know when, but maybe there will be some way to have our respective med/grad schools send us back in a few years. In any event, we look forward to following the progress of the clinic in Kono and the EWB team back at Princeton as they continue this great partnership.

In the words of Neal’s interestingly-translated extemporaneous speech at the lab’s opening ceremony: “plenti plenti tenki tenki tenki tenki” (or something like that). Basically, thanks to everyone – the EWB team at Princeton (and Eric and Chris) for their work on this project, our sponsors for making this entire thing possible (Davis Family Projects for Peace, PEI/Grand Challenges, Fred Fox Fund, and the Class of 1978 Fund), Elsie and the Pace Center for their encouragement during the year, NOW/GAF (Bailor, Dan, and Kathy) for presenting us with this opportunity (which was a great learning experience for us as well), our friends and blog followers and anyone has e-mailed us while we were here, our families for “letting” us jet off to Sierra Leone and for their love and support, and of course, the people of Sierra Leone who welcomed us and let us into their lives and taught us so much more than we could have ever imagined about life and their culture and international development and who knows what else.

See you all back in the US,
Meghan and Neal

After briefly sitting in a central meeting hut and talking to a few of the villagers (the chief was out), one offered to take us to the next village over where there were some goats. This is when our trek through the wilderness began as we followed an about 8 inch wide trail through rolling hills with elephant grass towering above us at all times and beautifully green and vast vistas occasionally emerging in front of us. One of the more notable moments involved our being carried across a narrow, shallow, and slow flowing river on our translator or the villager’s back so as to avoid getting any parasites that may be in the water. Both men are smaller than I am and I found myself both worried and impressed as I help my perch. After finally reaching the next village which grew rice and raised many cattle, we found a few goats but these were at first not for sale since the man of the house had gone out into town. By sharing a little poyo (palm wine) with the locals though, they reconsidered but only to settle for the most outrageous prices (i.e. $50 per goat when we were looking for $25 per goat and the expected to be more expensive goats sold in town were going for about $30 last time they had checked…also had a higher risk of carrying a disease called PPR though). We thus decided to continue our trek into the wilderness to the next village where we sent our translator ahead to bargain down prices (so as to avoid the “white man price”). The attempt was unsuccessful however and, after a long trek back to the village, we decided to try our many-times-again-unsuccessful luck by visiting villages along the walk back to the clinic. At least the views were still gorgeous and we also happened upon some diamond miners at work in a riverbed.

Finally back in more familiar territory, we found some more poyo, better than the morning’s poyo which was already better than the one Meghan had found in town. To those who think we were, at this point, no longer drinking responsibly…palm wine is both relatively low alcohol content and pretty rehydrating so let’s just say it was a necessity! About an hour from sunset at this point, we chose to rush off once again on bikes to the sheep and goat yard in town Rafi and BJ had first visited. After arguing, pleading, saying “crazy craz” a lot, turning away in disgust, and walking away in fake disinterest, we finally got our first two goats for 200 000 total, one male and one female, both relatively young but healthy and thus enough for our purposes. A little more haggling and we hooked a mother and her two kids for another 300 000, all approved by some impromptu (and honestly not sure how legitimate) veterinarian who hangs around there. To get to Wordu faster, we loaded once again onto bikes with one goat each. Not sure how everyone’s else’s ride went but I was holding the male (by the legs as per instructions) who, after the first 5 minutes during which he seemed to be enjoying himself while wide-eyed and looking at everything rushing by, started bleating regularly and struggling to get his front paws free (not a good idea on a moving bike but he didn’t grasp the concept). Still we (the goat and I) made it safely to Wordu where we were greeted by a mass of villagers and a few amputees welcoming us and leading us to the now constructed goat pen. We also had a chance there to listen to Tboi’s rap (which Meghan had told us so much about). He sang “Money in the Bank” to us with his brother and they then showed us some break dancing (a version of break dancing full with contortions apparently). Some more poyo (sweetest yet) and we rode back into town for an overdue meal, accidentally meeting up with Kulani and Nicky there.

Sunday was a good full day of adventures but is also got me to consider why I was so glad I’d come out here to help. When I think about the condition of Salonians and how we’re hopefully contributing to improving their lives, for all the impact the clinic has (and thus presumably helping the clinic have a good source of electricity will have), it’s sometimes disheartening how small a drop in the bucket our project is. And our project is not a small drop. In other words, I do think we’re having a considerable and measurable impact on a fairly vast part of the communities in and around Koidu thanks to the clinic’s still building popularity. So I’m certainly glad about our adventure here and our project’s design but, when realizing the pervasiveness of the country’s infrastructural inadequacies and how these affect the population, it’s sometimes tough to fathom how one of us can “change the world”. But it’s exactly this thought that leads me to my usual optimistic streak. Though installing this solar panel system may be only one more inch towards the sort of life we want all Salonians to enjoy, with guaranteed access to healthcare, sustenance, and education at the very least, the project itself had undeniably marked each one of us and, perhaps, will inspire us all to seek to help further in the future or inspire the luckiest Salonians to choose to stay and help rebuild their country, much like Dr. Barrie has. So rather than seeing how $29 000 contributes presently in helping Salone, I imagine the domino effect such a project will hopefully lead to. Time will tell but I’ve never been one for pessimism. After all, we did get those goats in the end.

M and I are a bit tired from the journey but might come up with some new insights tomorrow.

-Neal

The Wardu camp is pretty far from the center of town, about equidistant from it as the clinic, but in the opposite direction – so any amputee in need of medical care has a long way to walk if they can’t afford the Le 2000 or so to take a motorbike. The goat enclosure was under construction when we got there, but BJ is getting increasingly frustrated with the slow rate of progress – they are behind schedule and the project seems to require some babysitting to get done. We took a look at the water pump, which now has a wall built around it. One of the villagers who speaks English (most people speak Kono, and some speak Krio as well, but very few speak English out here), James, pointed out the two issues with the well: 1) there is no way to secure the well cover, so someone could come and poison the well or steal water; and 2) during the dry season, the well runs out of water. Issue 1 could easily be solved with a little rebar, extra cement, and a padlock, although for some reason everyone really wants the cement cover replaced with a steel one, even though nothing is wrong with the cement one. Issue 2, we perhaps need some help – anyone out there with faster internet and/or knowledge of hydrology/water pumps??? I’ll put some more details about the issue at the bottom of this post. The well is supposed to be chlorinated every few weeks, and chlorine should be available at the government hospital, but apparently the hospital refuses to let people in without a bribe unless they are white (this is the reality, not the policy that the hospital says they have). The villagers don’t have the cash to pay weekly bribes, so without the interns, they won’t be able to get chlorine.

I met a “rising rap star” of Koidu, who wrote me a song on the spot that included “Legan you are the only girl for me” before calling me Meghan (Mom, Dad, why did you give me a name that is so difficult to pronounce in foreign countries?). Then we went to the Joe Canal’s of Koidu – just another house. Palm wine was Le 500 for a half-liter. It was rather underwhelming, and doesn’t really have a taste. In fact, it doesn’t smell or taste like alcohol at all. A poll of our team yielded the following descriptions:
Me: diluted baking soda and vinegar
Zoe: sour rice
Neal: vegetables, “intense romaine lettuce” ??
Henry: alcohol that has gone bad
You can also buy gin in plastic packets (similar to ketchup packets) for Le 400. Only gin. I guess a remnant of British colonialism?

Before leaving, I met Kumba again. Kumba is one of the camp’s amputees, an elderly woman who lost both her hands during the war. It’s quite a different experience to shake someone’s forearm. She only speaks Kono, but she is very friendly and active (she was weeding her front yard with a hoe fitted with straps for her arm) and says that Dr. Barrie is her man, because he found her when she was very sick and performed life-saving surgery. BJ and I discussed the impacts of these projects and other development projects on the walk back. So many of the NGOs seem ineffective, but this goat initiative should make a substantial difference in the lives of the people in Wardu. But progress is slow. And frustrating. And there are just so many areas in which progress needs to be made – basic infrastructure projects like roads and sanitation; secondary level education; economic progress, medium-sized businesses, credit, and effective investment; malnutrition, malaria, infant mortality… the list goes on and on.

On a lighter note – on our walk home, we pass a basketball court where guys our age are usually playing pickup games. We were stopped yesterday by Desmond, who invited us to come play any time. So today we joined in for some Sierra Leone street ball. Neal and I first joined their 3-on-3 half court game, but as more guys showed up, we switched to 5-on-5 full court (and Henry and Zoe subbed in). Which was exhausting. Especially because their style of play is almost entirely fast breaks, so we were constantly running. Lots of 3-pointers, some fancy dribbling, and long passes that were often intercepted – I felt like we were playing NBA Jam. These guys were pretty good, and really fast. And jumped really high, so I wasn’t blocking too many shots. It was a lot of fun, and we have an open invitation to stop by whenever!

Well issue: The well runs dry during the dry season, although a well less than 50 meters away is fine. I don’t really know much about relative use of the wells between the two. My only thought so far is that more conservative use of water during the rainy season would leave more water remaining for longer during the dry season, but I don’t know if that’s entirely true. The villagers wanted me to put in a longer pipe (even though the pipe is currently at the bottom of the well) or dig the well deeper (I definitely do not have the knowhow or machinery for that). It’s a Grundfos pump, I believe, standard hand pump, if you want to get an idea of the mechanics. If you have any suggestions, comment or e-mail!

This is long enough and we’re tired from the million games we played, and tomorrow is the opening ceremony for the clinic’s new lab!

Meghan

For Meghan and me, it’s been especially interesting to consider how these past few days have been so different from our first trip to Sierra Leone, which happened last summer. Of course the contrasting natures of the two projects explains many of these differences. As newcomers attempting to place ourselves in a foreign country, we came last time mainly as observers, taking in the surrounding environment and culture, trying to orient ourselves and a future project. This time we come having had that experience already behind us, ready to wade in a little deeper. One simple yet significant point of difference that continually comes to mind is our mode of transportation. Last year Ali drove us every day from Uncle Ben’s to the clinic. Everything in between these two points was just the scenery outside the window, and the world with which we familiarized ourselves was in a sense very incomplete. This time, however, there is no car. The 7 mile walks between Uncle Ben’s and the clinic have really allowed us to take the time to walk among the town stores, interact with the locals, and sample the many different snacks that are sold along the path of our daily walk. Although the long journey can grow tiresome, it has been very satisfying. For the first time, we’ve really been able to get to know this area, which has resulted in some very crucial discoveries. For example, whereas last time, Meghan, Chris, Eric and I ate rice and stew every meal, during this trip, we’ve discovered a whole new set of dishes involving beef, beans, potatoes, and spaghetti. The diversity in diet has really helped improve our quality of life.

Our rigorous schedule over the past few days has also come as somewhat of a surprise. The Sierra Leone I remember from last year was a bit more relaxed, and I definitely got in a bit more quality reading time during the long periods of waiting that we frequently had. This year, however, ever since we’ve arrived, we’ve been working nearly nonstop, continually resulting in early mornings and late nights. Of course much of this has to do with having hired a business (EFO) as our project partner. Whereas Jalloh’s management of the project may have not been as “friendly” as some of us were expecting, he did manage to keep a fairly tight schedule. That steadfast commitment to meeting deadlines helped push this project along with speed. The success that we’ve had in accomplishing this much in such a short period I think speaks to a much broader idea: the potential of private enterprise in promoting development. I find it hard to imagine our PV system being installed anywhere nearly as quickly had it been done purely through nonprofit volunteer work. It’s amazing what the right incentive structures can do in terms of inspiring efficiency and expediency.

Some things, though, remain the same from last year. Royal Air Maroc is still fantastically horrible. My luggage is still out in the void somewhere, whereabouts unknown. We’re all still losing weight. I realized yesterday at one point that we were counting calories, not because we were concerned about consuming too much, but rather because we wanted to know if we had eaten enough to get us through the day. We will all probably lose around 10 lbs during this trip, but I think this year it will have a lot more to do with the 8-10 miles of walking we do everyday than with food poisoning (no one’s gotten sick so far!).

What we did today:

Today was a busy day, even after EFO had left. There’s still a lot of work to be done in terms of integrating the PV system into the clinic. To begin with, we worked on securing the system. A room was built to hold the batteries, inverter, and charge controller. We also purchased and installed security lights on the outside walls of the clinic. The installation process was somewhat slow and we did have some difficulties now that EFO has gone along with their tools. We would have benefitted nicely from a drill and small screwdriver. Among some of today’s highlights include my brief electrocution from installing one of the lights and Henry’s soon-to-be-ex-fingernail after he accidently pounded it with a hammer. We’re alright though and ready for another day.

We still need to finish with the security lights, talk with the clinic about energy saving habits, among several other things. More details hopefully coming tonight! This post is already long enough.

-Neal