Professor Moominpappa

Last week was the most professionally fulfilling week since I've been here. Don't get me wrong, I love my job, despite the drama and frustrations. But work is all I was doing since landing in Monrovia more than 3 months ago. I have accomplished a lot (according to USAID), and still felt I am not doing enough for Liberia. Well, now I don't feel lacking anymore.

Some of my friends know I like teaching. I was guest lecturing and assisting my friend/ colleague Christina in teaching a Masters level public health course at UIC before coming to Liberia. I never imagined myself being a professor (even a assistant or associate professor), but I enjoy teaching. Two weeks ago I mentioned to our Chief of Party (COP) that I miss teaching. Our COP is an Americo-Liberian woman, she was a practicing pediatrician in Monrovia before leaving the country many years ago. Besides running the largest US government health project in Liberia, she also teaches at the local university. A day after I mentioned to her that I miss teaching, she asks if I would like to give a guest lecture in her class. Imagine my joy when I resoundingly said yes!

Last week was my guest lecture. I was taken to Cuttington University by our COP. You should see the looks I got when she introduced me as the guest lecturer. I guess the students were expecting someone around our COP's age, not a young(er) professional. However, they were all eager to listen to what I had to say. I was surprised to find one of my staff members in the class. Even though I am her supervisor, I haven't been able to connect much with her (outside of work) because of our schedules. She commented "you are my supervisor and now you are my instructor as well". I hope that's not a bad thing!

Students work in teams to identify risk factors for health problems

The course that our COP teaches is titled "Primary Health". A perfect conduit to teach about public health. Since I don't believe in lecturing for more than 30 minutes, I made a short power point presentation. I then gave an exercise to work that lasted for an hour. I split the class in to teams and each team worked on identifying risk factors for a different health problem. I admire the tenacity of the students. Imagine sitting in a room with no air/ fan in a 100F humid temperature for 2-3 hours for each course. Some of them do it all day when they have back to back classes. I was soaked in sweat within the first 15 minutes of my lecture, I can only imagine how these students do it every day. I took encouragement from the students and kept on with the lecture even though I was dripping buckets of sweat. These students are my inspiration.

The students thoroughly enjoyed the exercise. Each team had arguments and discussions, but they all came to consensus in the end. In fact, when I asked what's the most important lesson of this exercise, their answer was "team work". You have no idea how happy that made me. We all know how important it is to work in teams, but team work has an added significance in a country like Liberia that has been torn apart due to internal differences. They really need team work here, at all levels.

More student teams working on the exercise

I think the best sign of a successful lecture is when students ask you to come back. At the end of the class, when I asked if they have any questions, they all said "we hope you come back!". Yes students, I will be back. I will definitely be back now that I have found my favorite way to contribute to Liberia outside work. Just call me Professor Moominpappa and I will be at your service!

Trips to the "bush" and cow meat soup

You cannot rebuild a health system sitting at the central ministry in the capital (Monrovia), you gotta travel out and see what's going on in the interior. In my quest to explore the state of affairs in the counties and villages, I travel often. One such trip was to Lofa County. The capital of Lofa is Voinjama, a small town quite far from Monrovia. Located only a few minutes from the Liberia-Guinea border, Voinjama is a small but busy town in the middle of the jungle. It took us 8 hours to get there, mainly because of bad road conditions... and that's during the dry season. It takes longer once the rainy season starts. Sometimes we stop in one of the towns on the way, stay overnight, and continue the next day. The road is paved only till Gbarnga (3 hours north west of Monrovia), and then it is dirt road. The local slang for all villages is "bush". Locals say "bah! you gone to the bush?". "Bah" is a term of endearment, meaning friend. Liberian English is a language of its own, with varying dialects and pronunciation. I have to switch gears between the drivers, my staff, and the housekeeper. One of my staff even speaks a mixture of English and Mano (a local language), making it difficult for me to understand what he is saying. But, I have gotten better at it. I now understand 75% of what he says, it used to be 20%.

The paved road is nothing to talk about, just an old road that is ridden with pot holes. I wonder if some of the potholes are from the heavy rains or remnants of bombings during the civil war. I do not recommend anyone with back problems travel on these roads, you will need spinal surgery after a few trips. It is interesting to watch our drivers maneuver through these huge pot holes... most of the times we end up off-roading while I cling on to my dear life by holding on to the railing in our Land Cruiser. I pity all our vehicles, they take such beating when we go to the bush. The dirt road, on the other hand, is a beauty. The soil in Liberia is very fertile with a red hue, almost rust-like. Our white vehicles return looking rust-colored after every trip. It is quite beautiful driving on a red dirt road surrounded by thick green jungle interrupted by rivers and streams with the occasional goat or monkey jumping on to the road... it almost looks like a painting.

The red dirt road to Voinjama

The soil is so fertile that villagers have to burn the brush so it doesn't grow back within days. Cutting the brush won't do, you gotta burn in to the ground. Even then, new sprouts arise within days. A mixture of perfect tropical weather for vegetation, heavy rains, and fertile soil makes Liberia a heaven for plan growth. Unfortunately, this natural resource has not been  harvested to grow food for the population. Prior to the war, Liberia used to export rice, now 85% of food is imported. Various international organizations are helping rebuild the agriculture infrastructure.

Before going on one of my trips to the bush I was informed of a restaurant in Gbarnga by fellow expats. Even my drivers sung high praises of this restaurant. I wanted to check it out and we stopped for lunch. They had only one dish that day - cow meat soup. That's how it is in the bush, people serve what they get on that particular day. Some days it is nothing. I always carry Clif bars with me because you never know if you will get food in the bush. Shout out to my pal Lissner who taught me the wonders of Clif bars. Even though he tried to get me to like the white chocolate macadamia flavor, I prefer the dark chocolate flavor. Anyway, I digress.

My staff and I sit down and order the only option we have. By this time, after two months of living in Liberia, I have come to accept the fact that it is normal to find mystery meat in your food. Liberians do not understand the concept of cooking or cuisine, they dump everything they can lay their hands on in a pot and cook it. As I talked in my previous posts, expect to find anything from feet, fat, and organs to meat, skin, and other unidentifiable parts of an animal. When in Rome...

We sit down and wait for our cow meat soup. The waitress assured me it is cow meat. That doesn't mean anything in Liberia. You always get a melange of animals regardless of what they tell you. So, here comes this cow meat soup. What Liberians call soup is actually stew. Looks like chunks of meat+fat floating in an oily stew. Fine, it is not any different from other stuff I've eaten. Remember my post about Lowise's restaurant and palm butter? Well, that was one of the many instances.

Cow meat soup - meat and other stuff swimming in oil

I dig in to my oily stew, scoop out a spoonful on the plate of rice that comes with the stew (everything comes with rice or fufu). Halfway through my meal I notice strands of short thick hair. Eh, this is nothing. At least it is not a dead roach. I pick the hair out of my food and continue eating while pondering where the hair came from. Then I receive the answer to my pondering. In the second spoonful, I notice a chunk of cow hair sticking to the skin. Ah, so this is not just cow meat soup, it is cow hair soup as well. The culprit is a piece of cow skin with a tuft of hair still attached to it. I look at it and wonder which part of the cow it came from? Is it the hump, the tail, leg, which part? Should I call it leather instead of skin because it has been cooked to death? Looking at the length of the hair, it could be the skin from a cow's tail or back. I am posting a picture of a smaller chunk of hair, because even I couldn't stomach the idea of taking a picture of the larger tuft of hair (yes, there were more than one chunks of hair). Notice the lone strand of hair on the side and a small tuft of hair sticking to a piece of skin, next to the rice.

Hair sticking to cow skin, a lone strand of cow hair, and a burnt matchstick - all in one spoonful

Then there was a burnt matchstick in my food. Oh well, at least I didn't get coal. I take out the piece of skin/leather with hair, the matchstick, and continue eating my soup. I am not going to stop a little tuft of cow hair and burnt match ruin my lunch. I may have eaten some strands of hair here and there, but my stomach can easily digest that. Hell, it has digested worse things, what's a little hair going to do? Three of us finish eating, pay our bill, and I left the tuft of cow hair on my plate. Nary a word from my staff. They noticed the chunk of hair, but it didn't bother them. I assumed from their reaction (or absence thereof) it is common to have animal hair in your food. Once again, when in Rome...

We finish lunch, continue on our journey to Voinjama with bellies filled with cow meat and hair soup. Once in Voinjama, I had the best food I've had since I moved to Liberia. I discovered the United Nations Pakistani battalion in Voinjama. They let outsiders eat in their "officers' canteen". I had the most amazing Pakistani/ Indian food prepared by Pakistani chefs. Chicken jalfrezi, lamb korma, naan, dal, vegetable pulav, the list goes on. More about them in the next post.

Building stakeholder participation and the challenges of being an outsider

This week began with a frenzy of meetings and trips to the counties. One of the key steps in building capacity is seeking stakeholder buy-in. The recipients have to buy in to the principles before we begin building capacity and strengthen the health system. Stakeholder participation is key!

In my efforts to strengthen the Liberian health system, I am committed to build capacity at both central ministry and the county health department level. I have already made the rounds at the ministry, having met with the key deputy ministers, assistant ministers, and senior management. I presented my strategy and won them over. I have also convinced non-ministry stakeholders - USAID, NGOs, and EU - to support and participate in my efforts. This week I am focusing on county heath departments. I just returned from a trip to Bong and Nimba counties where I met with the County Health Officers and their teams.

The two counties were polar opposites. While the county health team (CHT) at Bong was unresponsive, aloof, and nonchalant, the team at Nimba was active, participatory, and invested. A sea of change. Our project (RBHS) is well entrenched in to the Nimba county health system. See picture below. Our County Coordinator and the County Health Department Director (CHDD) share the same office space. That shows how well we work with the ministry at county level. Perhaps Bong could use the same level of involvement in order to become more invested in our efforts. It's on my to-do list.

Integration between the County Health Department (CHD) and our project (RBHS)

It is always challenging for an outsider to get local stakeholder buy-in, especially when you are someone like me. But I like the challenge. It allows me to prove myself and gain the trust of stakeholders in the process. I am sure I am not the only one who experiences this phenomenon. The new person is always tested, especially if s/he is an expat. It is part of the game, and I like a good game. The situation gets worse when the new guy is promoted within less than two months on the job. While it is frustrating to deal with such petty drama, it also makes me stronger and more invested in doing what I came here for.

I am going to visit the remaining county (Lofa) this week. I am traveling with my staff to a town called Voinjama, which is less than an hour away from Guinea. Too bad I cannot cross in to Guinea... I need a visa. I do not have enough time to get a Guinean visa before leaving on this trip. Next time!!

I ate at a Bangladeshi restaurant during my trip to Bong and Nimba counties. We stopped in a town called Gbarnga (pronounced - banga) to eat at this restaurant called Mama Zone's. The name struck me as strange, especially for a restaurant run by a Bangladeshi man, but I guess they are trying to blend in to the Liberian society. I came to know the restaurant exists in Gbarnga because there is a big Bangla UN military contingent nearby. Word on the street is that there are around 2000 Bangladeshi military personnel as part of the massive UN military presence in Liberia. You cannot just walk in to Mama Zone's and order Bangladeshi food, you have to order it an hour in advance. They prepare according to demand. The Liberian food, however, is readily available. We called ahead and had chicken curry. It was quite mediocre, even a disappointment.  As wonderful as it is to see non-Liberian food in the middle of the country, it is disappointing when the food is not good. Lesson learned! Next time I will stick to potato greens and fish.

More to come later this week...my trip to Lofa, other happenings at work, and more importantly, food!!