Monrovia April 2-3, 2010

When I step back for a moment to contemplate it, I find the stark infrastructure and economic contrasts between capital cities truly remarkable. On my way home from Uganda last year, the acute contrast I saw within 24 hours was between Kampala and Reykjavik. On Friday, April 2 I spent 2 hours in downtown Brussels during a layover in the morning and then the evening in Monrovia, Liberia. One city with guilded exteriors, prolific chocolate shops (stereotypically true), and immaculately clean compared to another city with bombed out buildings from its country’s civil war, a few very well paved roads (a positive sign of improvement), and one not to be walked around at night. The rhetorical, perennial question lingering (when one brackets national sovereignty and history, of course): why do these stark contrasts persist?

In Brussels shortly before departure, we talked with Kimmie Weeks, a Liberian guy who has repatriated to Liberia after being in the US during Liberia’s civil war. He has been a significant child rights activist (http://www.youthactioninternational.org/yai/), and people at the airport from different countries came up to him given his past media presence and work. We all boarded, and Roona, Raj, and I landed in Monrovia later on April 2. As we descended in the air, I viewed the dense, verdant foliage meet up with the ocean with eagerness. The air appeared steamy – I knew what to anticipate weather-wise. We disembarked from the plane into 95F air with near 100% humidity. The familiar exhaust smelling air I’ve experienced on the airport tarmac in African and Latin American countries brought a flood of memories, reinforcing the power of the olfactory system in memory recollection. We waited in a chaotic line to have our visas stamped. Thankfully, my luggage arrived though Raj’s did not. We met a very kind Tiyatien Health staff member, Ben, after leaving the airport. We bought some delectable, simple bread at the roadside and started the 45 mile journey to Monrovia.

The Monrovia airport was built by the US military during WWII to facilitate exportation of rubber tires for the Allied forces in Europe. The location so far outside the city was chosen because Firestone has a nearby rubber plant. (Firestone has been in the country since around 1920). We passed many families on a very paved road as we left the airport. Rudimentary mud dwellings dotted the roadside, dense jungle-like foliage ended behind the homes, and a beautiful steamy sunset welcomed us as we drew closer to Monrovia.

The most memorable part of this road trip was Ben’s story during Liberia’s civil war. Trained as a physician’s assistant, he ended up provided care to the warring factions at different points in the war. One particular day, rebels had come near the school where his 2 children were attended. He found out that his kids were bused away safely, but rumors abounded that children were being abducted, adopted, and killed. He described the environment at the time, the fear, and the hopes for the future. As I felt in Rwanda and Burundi last year, the ramifications of such stories on a society and its individuals were rather unfathomable to me in the context of stable upbringing. We capped off a great conversation with a discussion about President Ellen Johnson-Sirleaf, the current president and the African continent’s first woman president. There’s an upcoming election, next year I believe, and we spoke about her and her competition.

We met up with Kerry Dierberg and Ana Weil, the former a Massachusetts General Hospital (Harvard) Durant fellow who agreed to work for Tiyatien Health in Zwedru during the fellowship. They were eating dinner at Golden Beach, a restaurant on the beach in Monrovia. Monrovia’s beaches are dangerous for expats in terms of security and undertow, and so being able to enjoy it at this restaurant was a great venue for us. We listened to Kerry and had some good introductory conversations about health in Liberia and TH operations in Zwedru. The connections among Raj, Ana, Kerry, and Roona are fun to trace. All of them except me have affiliations with Harvard and/or Johns Hopkins and had other contacts related to those institutions in Monrovia that they were not expecting. I enjoyed watching the energy of rekindled relationships.

Saturday April 3, we started the meetings en masse, which as I write this are ongoing through April 5 evening. We started on Saturday meeting with a senior leader in the National AIDS Control Program about an upcoming shared grant roll-out in Zwedru where we will be heading in a few days. (Zwedru, a southeastern Liberian town 20 miles from the border with Côte d’Ivoire, is TH’s main headquarters in Liberia.) We grabbed some street food and then headed to downtown Monrovia.

We bought some odds and ends on the main drag, Randall Rd. Events included a good falalel sandwich at a Lebanese eatery, stocking up on groceries and supplies before heading to Zwedru (all expensive because almost everything in this country is imported), and I thwarted an attempt of someone opening my backpack (I guess I learned some street smarts in Uganda). I should emphasize how friendly I find Monrovia overall right now! We then headed back to our air-conditioned guest house, a seductive luxury that we will quickly need to be accustomed to being without in Zwedru. As we were about to nap, we received a call from a programs officer at UNHCR-Liberia (United Nations High Commissioner for Refugees). A gracious man, we met with him and another UNHCR staff woman to talk about further building UNHCR’s relationship with TH. We also showed him a PhotoVoice project that took place in Zwedru with some former US TH volunteers. PhotoVoice (http://www.photovoice.org/) is an educational modality with a mission statement “to bring positive social change for marginalised communities through providing them with photographic training with which they can advocate, express themselves and generate income.” When that TH video gets posted on the internet, I will definitely post the link and provide more explanation.

We spent the rest of the day at the cafe of a nice hotel overlooking the ocean in order to discuss some issues in development work, goals for the upcoming weeks, and to enjoy the internet. All sorts of expat personalities shared the tables around us. Some military, some business, and most doing activities I can only imagine at this point. The stories here are undoubtedly plentiful and outside the type of my daily conversations in Chicagoland. The acronyms and vocab remind me again of my year in Uganda and some its excitement, success, frustrations, and failures. The evening finished with the appearance of one of Raj and Roona’s friends – Ranu – who is a medical resident in the Global Health Equity program at Harvard’s Brigham hospital and who is here independently consulting the Liberian Ministry of Health. His story is an entirely different post…

For now, listening to the delightful dialect of Liberian English spoken, re-immersing in the energy of change and all the complexities it entails, and working with an organization committed to community-driven solutions to problems keeps me revved. I leave this post with one comment by Kerry that I found inspiring that I will summarize and not do justice to in its eloquence: “some level of despair is what helps keep me motivated in advocating for my patients.”

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