Nigeria brings back Liberian memories

It has been a hectic past few months, and I realize I have not posted anything since last August, spare for the one entry last week about Ebola in Liberia. Since August 2013 I have been traveling like a mad man. I may have spent 6 weeks at my home base (Nairobi) between August and end of 2013. No wonder I haven't posted anything. Since my last trip to Myanmar, I have been to Washington DC, Cambodia, Myanmar (again), South Africa, Nigeria, Boston, DC again, Chicago, and NYC. All except NYC were work travel. Good times!

I was in Abuja, Nigeria for two weeks back in October. This blog post has been lingering in my drafts since then. What made me go back to my drafts and finish the post is my latest visit to Abuja few weeks ago. If you have ever been to Nigeria you know that it plays a major influence in African affairs, particularly West African affairs. Nigerian music, food, and style is emulated all over Africa. Nigerians are friendly people who are proud to showcase their culture, heritage, and they love welcoming foreigners to their country. The hospitality I encounter every time I am in Abuja is warm and welcoming.

As my friends know, my travels revolve around work and food. I was glad to be back in the land of spicy goat pepper soup, jollof rice, egusi soup, and eba. I was in heaven when I tasted goat pepper soup after a gap of almost one year. I haven't had goat soup since leaving Liberia. Since I pray at the temples of street food, I had to venture out and try Suya, which is meat marinated in a lot of spice and grilled on coal. Let's just say my mouth and insides were on fire after eating a few skewers of beef suya. Delicious!

Suya

The typical West African escargot is a must try if you are adventurous. I used to eat a lot of escargot in Liberia and Coté d'Ivoire, but I haven't found the same ever since I moved to Kenya. East Africans do not appreciate giant snails like the West Africans do. Imagine my joy when I took my first bite of Nigerian escargot after a gap of almost one year.

Escargot

Spicy yam cakes

Egusi soup

Besides eating my way through half of Abuja, work was productive. I trained a lot of people on conducting research in malaria so we can use the information to strengthen access to antimalarial medicines in Nigeria. But enough of that...who wants to read about boring work anyway!

Some of the trainees

In between the training sessions I took a short break to walk around the hotel where we were delivering the training. I went to inspect the pool area and heard some familiar sounds. I turned around and noticed a bird cage with two African Grey Parrots. The sight released a flood of memories. Some of my friends remember Isaiah, the African Grey we had in our Liberian home. He was our child and he lived a good life until the day he passed away. I used to take Isaiah on a walk in our garden....that's right folks, I walked a bird! Watching these two African Greys reminded me of Isaiah and his shenanigans. A teary eyed moment....

Isaiah's family

I also visited the Arts and Crafts Village in Abuja. Wonderful gift ideas and some interesting items. While the beads, leather items, and jewelry were beautiful, there are some items at the market that left me feeling uneasy, sad, and angry. I saw merchants openly selling ivory items, whole elephant tusks, lion teeth, and a variety of endangered animal skins. I almost cried when I saw a group of Chinese tourists bargaining for ivory chopsticks. I wanted to bring an elephant to the market and let it trample all the merchants and buyers. It was quite disturbing! I bought some beads, two pairs of leather sandals, and left the arts and crafts village in anger.

Arts and Crafts Village

I am not sure when I will be back in Nigeria again, but I look forward to eating some good food and experiencing the wonderful Nigerian hospitality.

Ebola in my beloved Liberia

The past few weeks have been very nerve-racking due the Ebola outbreak in Guinea that has now spread to Liberia. As many of you know, there is an outbreak of Ebola in Guinea at the moment that has reached crisis levels with over 60 deaths attributed to the disease. You can read more about the outbreak here and here.

Like most countries with porous borders, Ebola outbreak in Guinea means Liberia and Sierra Leone are next in line. Senegal has already shut its border with Guinea to prevent spread of Ebola. Reports have emerged about deaths in northern Liberia from Ebola, particularly in the Foya and Zorzor districts of Lofa County. I fondly remember the time I spent working in the Foya and Zorzor hospitals when I was working in Liberia. Lofa County was my favorite to visit because I could stay at the United Nations battalion stationed in Voinjama. The battalion was Pakistani and it had the best chicken curry and nan I had in West Africa.

Needless to say I was worried about my ex-team members who work in Lofa county. I called/ emailed them and they are all safe as of today. They are disappointed by the response from international community towards containing the disease. Being health care workers, they are worried about the fact that they still do not have adequate personal protective equipment. However, that does not stop them from providing health care for the needy. No matter where I've been in the world I always encounter health care workers who spring in to action regardless of their safety. It is what makes the clinicians a unique class of people. I am proud to be one of them.

I would like to share one of my favorite pictures from Liberia, which was taken in a clinic in Lofa County...which is now the seat of Ebola scare. I am showing one of the nurses how to enter antenatal care data in to the ledger. I miss my staff...

This Ebola scare has brought back so many fond memories of Liberia and concern towards my staff. I will be closely monitoring the developments and pray that the disease is contained and the Guineans/ Liberians/ Sierra Leoneans do not suffer any further.

Mere piya gaye Rangoon...

Anyone who knows their classic Bollywood music will know the song "Mere piya gaye Rangoon". It is from the film Patanga released in 1949. The song has been remixed in recent years because it seems to be the trend in India to remix oldies.

I remember listening to it as a child when my mother used to play classics in the house, so we could learn our native culture while living in a foreign country. For my non-Hindi speaking friends, it is a song about a man that leaves his wife to go work in Rangoon and she sings this song when he calls her all the way from Rangoon. You will notice the traditional Myanmar outfits in the video. I am wearing the same traditional longyi in one of the pictures.

Mere piya gaye Rangoon, kiya hai wahaan se telephone = my lover went to Rangoon, he is calling from there. 

That song always stuck with me because it kinda resonates with my life. I have been traveling across continents since I was 11 months old and I wish I could take my family and friends to the places I visit. When I was young I wished that I could take my friends, now that I am an adult and happily married I wish I could take my partner with me.

But why am I talking about a Bollywood song that majority of my non-Indian readers do not know? Because I was in Rangoon for the past two weeks. Now known as Yangon, it is quite the interesting city. I was in Yangon for work purposes, to learn more about Artemisinin resistance containment efforts, and meet with USAID to discuss how my project can help with malaria control in Burma...oops, Myanmar. I wish my piya/ partner came with me to Rangoon...oops, Yangon! 

So, Myanmar! It seems to have become the latest destination for tourists. I saw plenty of young American and European tourists on the streets of Yangon. They all seem to want the Myanma experience (people of Myanmar are called Myanma). I was there for work and luckily there happened to be a long weekend in the middle of my trip, which enabled me to get out and explore Yangon, Bagan, and Inle Lake. Yes, I am an efficient traveler when pressed with time. I covered Bagan and Inle Lake in three days/ two nights.

View of the Shwedagon pagoda from my office

There have been numerous travel articles written about Myanmar and some silly food network tv shows as well. I am not here to write about where to do and what to see, because that has been covered in various books and guides. However, I will say this... Bagan is a must visit. The moment when you climb upon one of the temples and see the panoramic view of thousands of ancient temples scattered across the plain will take your breath away. It is stunning, humbling, and enchanting at the same time. Words cannot express how I felt after watching the view... I just sat on top of the temple and stared. I have always been a sucker for ancient history and Bagan was paradise to me. Inle Lake, on the other hand, is the complete opposite of Bagan where there is not much to see or do. You rent a cottage on the lake and enjoy the views of the lake and mountains while recharging your batteries. You are pretty much dependent on the boats to travel anywhere outside your cottage, so your movement is limited. It is a good place for people who want to unwind and relax.

Shwedagon pagoda just before the rain

While Bagan and Inle were beautiful, the best part of Myanmar is the Myanma. The people are in a league of their own. I have not seen such levels of honesty and integrity among the general population in a long time. It gave me hope for humanity. I could leave my iPhone, wallet, cash, anything on the dining table at a restaurant and return after 15 minutes only to find everything untouched. The people are friendly and polite. They have a work ethic that is unseen in many countries. The Maynma are what makes Myanmar an interesting place to visit, more than the historic sights.

A monk enjoying his beer after a long hot and humid day

In addition to visiting Bagan and Inle, I went to Bilin in the Mon State for a work visit. I visited a few clinics and pharmacies that provide malaria treatments and other health care services. It was a wonderful visit where I got to see the health care delivery systems and countryside of Myanmar. I had to seek prior permission from the government to visit the clinics and I had to be escorted by an official through my site visit. The few clinics I visited seemed to be well-run with the limited resources they have. I spoke to doctors, pharmacists, and community health workers about febrile case management, malaria in pregnancy, and overall treatment guidelines. I was very impressed with their knowledge and adherence to internationally recommended guidelines. I also had the rare privilege to meet a "quack", someone who has no training in western medicine but dispenses treatments and advise. I was horrified to know the quack's practices and discussed them with the responsible people upon my return.

A villager is intrigued by my presence in his village

Besides the work stuff - which most of my friends find boring - I was able to witness the countryside of Myanmar. It is breathtakingly beautiful and seems like a land where the clock stopped moving 40 years ago. You have to experience to believe it.

At work, wearing the traditional Myanmar longyi 

In many ways, Myanmar and Myanma reminded me of the India I knew as a child. Myanmar now is what rural India used to be in the 80s. I remember when we traveled to India as children to visit our grandparents' in the village. I remember having to take an ox cart from the bus station to my grandparents' house and everyone in the village would stare at the newcomers who obviously looked like they are visiting. I also remember how friendly everyone was when they saw outsiders come in to the village. People just came up to the ox cart, stopped the oxen, and welcomed us to the village. Some even offered fresh coconuts to quench our thirst. I fondly remember those memories when it felt like the whole village was one big happy family, despite the clearly marked caste system. You do not see that anymore. As I grow older and somewhat wiser, I notice how the same bonds are not there anymore. I recently went back to my grandparents' village (they have passed away many years ago) to visit extended family and nobody bothered to even stop and say hello. My smiles were met with stares and indifference. Long gone are the days where people just came up and talked to you, regardless of your caste or creed. As India becomes more commercial and capitalistic, I feel like the poverty has reduced by a lot but it also took away the friendliness and niceties.

Myanmar reminds me of the friendliness of Indian villages when I was a child. I am now in my 30s and I have seen India change drastically over 30 years...from a poor but friendly country to a middle class but indifferent nation where people are more concerned about chasing the next Rupee. I hope Myanmar does not lose its charm because of the political and economic reforms and the Myanma continue to hold on to their values, integrity, and friendly attitude to outsiders. It would be a shame to lose the wonderful characteristics of the Myanma to commercial development.

I will write about Bagan and Inle in a separate post because they deserve a separate entry.

Resistance Park - the seat of many protests during the military regime

The biggest freak show I have witnessed

...happens to be at  a North Korean restaurant in Phnom Penh. I almost do not want to write about it because I want to keep this gem hidden for my own pleasure, but it is too good to not share with my friends and readers.

I have traveled a substantial amount in my life and I have seen some freaky stuff. But nothing comes close to this spectacle. I was in Phnom Penh for work... to kick start our malaria control study and other activities. One day after a long hard day of working, I decided I am tired of eating at the hotel every day and I should venture out in the neighborhood. Asian food is my favorite - from Indian to Japanese and every country in between - and it is a crime to not taste the glorious Khmer food. So, I went on a little walk around the hotel in search of a place to eat.

There are numerous restaurants in Phnon Penh...in fact, too many! It is difficult to pick because they all look good. However, one place caught my eye. I saw at least a dozen massive SUVs parked outside, spilling on to the sidewalk of this restaurant. It baffled me because you don't see that many mega gas-guzzling SUVs in one place in Phnom Penh...this is not America. I look up and I see a huge brightly lit neon sign saying "Pyongyang restaurant". I couldn't believe my eyes for a second...is it really a NORTH Korean restaurant? I have eaten at numerous Korean restaurants (I can live on Bibimbap, Dol Sot, and Jap Chae for the rest of my life) but they all seem to be South Korean. I have never seen a blatantly North Korean restaurant. Needless to say, I rushed in.

From the moment I entered to the the time I left, it felt like I was in a different world. I cannot do justice to the experience by writing about it, it is something you have to sit there and experience. From the dolled up wait staff who all look like barbie dolls and run around in high heels to the dog meat stew on the menu, it was all quite entertaining. However, the freaky part starts when you notice the North Korean government propaganda videos on the flat screen tvs. The videos show North Korea as a beautiful country with stunning beaches, luxurious homes, and happy smiling people. Of course, we all know that is far from the truth! I have heard of these propaganda videos before, but it was my first time watching them. I started experiencing disbelief, then I started laughing, but then I became angry realizing how the innocent civilians are suffering while their government is advertising N.Korea as a rich country.

There were the regular Korean staples on the menu...beef, pork, chicken, sea food, and dog meat. Nothing extraordinary from what I have eaten before. The only thing I noticed, which I haven't seen before, is a hot pot with various cuts of dog meat. That was new. I did not order it. The wait staff are all young women. They wear heavy makeup, faint pink dresses with high heels, high and long ponytails (all seem to be the same length), and have a smile plastered to their face. None of the smiles look genuine, but you probably guessed that. They run around like robots and tend to the numerous patrons. Speaking of patrons, the place was packed on a weekday evening. Most of the patrons looked Chinese and Korean, I was the only non-SE Asian in the room. Needless to say, my appearance and presence drew stares from some patrons. Also, everybody seemed to smoke in the restaurant, which was annoying to me. I was able to snag the only table available, which was near the kitchen door. I had a good view of all the wait staff running in and out of the kitchen in their high heels and swinging ponytails...it looked like some kind of a cartoon show to me. My waitress spoke minimal English, but we were able to communicate the basics. She understood beer, water, and food...which is all that matters when you are in a restaurant.

Just when I thought the freak show ended with the propaganda videos, cartoonish wait staff, and smoky patrons, the real attraction began in the form of live performances. Now THIS is something that I was not prepared for!

All of a sudden, some of the waitresses came out of the kitchen in costumes and started dancing on a stage at one end of the restaurant. Two waitresses started playing the keyboard and guitar (I think they were pretending to play). The first "show" was three waitresses dancing to traditional Korean music and singing in - what I assumed to be - Korean. It was actually nice. I was about to take pictures when three waitresses descended on me as soon as I pulled out my iPhone...their smiles disappeared and in their place was a stern look and they all repeated at once "NO PICTURES". The look on their faces told me they aren't joking. Then one of them says "Our leader do not like foreigners taking pictures". Word to word!

Did she just say LEADER?? This experience just got richer!!

That is the reason I cannot share any pictures of the performances with you. I was not going to risk abduction and being sent to a North Korean prison for taking pictures of some freak show in Phnom Penh. I have work to do and meetings to attend!

So, I started eating my food, drinking my Angkor beer, and enjoying the live performances. My waitress brings me extra rice and another beer and while she is serving them, stops abruptly, drops the tray with my food on my table, and rushes to perform on the stage. I guess she forgot it is her turn to perform. For the next 3 minutes she swayed, gyrated, and lip synced to Celine Dion's "My heart will go on" with a boat prop on the stage. They tried real hard to recreate the scene from the Titanic...and failed! She finished her performance, came to my table, and took away my dishes as I finished eating by then. As if nothing happened in the previous 3 minutes. Now that's what you call a professional!

This, my friends, is something you will not experience at many restaurants worldwide. The whole experience felt very staged, very robotic, and forced. I left a $3 tip on my $18 dinner bill and tried to leave silently. However, the waitress seems to have noticed when I was leaving my tip because she ran to the door in her high heels, held the door open for me, and thanked me profusely for the tip. I was very uncomfortable as it was quite the scene. I thanked her for the excellent rendition of the Titanic song and walked away.

You know where I am eating next time I am in Phnom Penh.

The best reward

Allow me to paraphrase an old Taoist saying: " The best leaders are those the people hardly know exist. The mark of a successful leader is when the team says WE DID IT!"

I have always believed a leader is only as strong as his/ her team. My work has consistently given the opportunity to build the capacity of my team and others involved in my work. The effort you put in to building a team's capacity is directly proportional to the quality output. Now, what is all this talk about leadership, you may ask? Strengthening health systems has a lot to do with leadership. Building the capacity of workforce and the system requires leadership qualities. That is why I sought a doctorate in public health leadership after my medical degree. I am firm believer that leadership is essential to build and strengthen health systems.

So, what is the exact relationship between leadership and health systems strengthening (HSS)? Allow me to give an example. HSS requires a commitment and buy-in from various stake holders, government and non-government players included. Anyone heard of "From silos to systems"? Strong leadership qualities are an absolute necessity in securing these commitments and buy-in. A successful leader will engage all the players and bring them together to build a strong health system. That is what I have always done in my line of work...engage, secure commitments, and obtain buy-in. It is the first and crucial step towards building/ strengthening a health system.

My work in Liberia is a testament to successful leadership. I can proudly say I was responsible for conceptualizing, operationalizing, and initiating the first and only comprehensive HSS/ capacity building framework for a post-conflict country. It would not be possible without the commitment and support from various stakeholders and my staff. Starting from the Liberian Ministry of Health to international donors like USAID and various NGOs, everyone played a role. I am proud to have created and implemented a framework that facilitated the stakeholders to come together and rebuild Liberia.

Besides stakeholder buy-in, a successful leader is also appreciated by his/ her team. It has been almost six months since I left Liberia and I continue to receive messages from my staff and colleagues about the impact I made in their career. The best message is one I received from an ex-staffer which read "Thank you for all that you have done. WE are now able to work towards rebuilding and strengthening our health system". I capitalized the word "we" to emphasize the mark of a successful leader. The message brought a tear to my eye. I am glad the ex-staffer said "we". I never want things to fall apart after I leave, and I am glad my ex-team is following up and making things happen after my departure. I take pride in them and I am blessed to have had the opportunity to build their capacity, which enables them to continue with the work I started.

A latest message from an ex-colleague in Liberia made me think about leadership today. She wrote "good to know that you are working in Kenya. I know you will help people in Kenya like you helped my career". Am I a successful leader? I may not fit the stereotype of a traditional leader, but I possess some leadership qualities. I will, however, say with certainty that I will continue to build the capacity of people and health systems in order to prove myself as a successful leader in my line of work.

While I appreciate every opportunity I have been given, I am particularly appreciative of the fact that my teams always say "WE DID IT!". The sense of camaraderie among the team members and the stakeholder buy-in will continue to be the best reward of my career.

Onwards and upwards!