Sunday, August 31, 2008

Indonesia

After a grueling 10 hour flight from Monrovia and a 15-hour flight from Amsterdam, I arrived in Jakarta last Friday. Thankfully the flight from Amsterdam was nearly empty so I had a whole row to myself and actually slept for about 7 hours! I arrived in Jakarta at 5pm on Friday, just in time for rush hour traffic. I didn’t realize how bad this would be. It took 2 ½ hours to get to the hotel! After a 15-hour flight I was ready to cry! The traffic in this city of 23 million (23 million!! That’s almost as many people as in all of Canada!) is appalling…we crawled along as thousands of motorbikes and scooters buzzed by us. I told Eric I felt like I was in Blade Runner…the city at night has a weird post-apocalyptic feel to it, with neon lights flashing through the smog and ultra-modern architecture interspersed with shanties and ramshackle buildings. I was so relieved to get to the hotel and crawl into bed. Unfortunately I woke up 3 hours later, my body clock so screwed up that I ended up watching a couple of episodes of Desperate Housewives (my new most favorite show ever!!) and eating Instant Noodles – the ubiquitous food of Asia – from the minibar at the hotel.
The next day I repeated the same journey in reverse but with much less traffic – only took 45 minutes this time. Got to see a bit more in daylight, but not much…the air is choking smog that limits visibility substantially. Like Beijing’s. Ick. And it’s very hot and humid to boot. An asthmatic’s nightmare.
Thankfully the air in Banda Aceh is better. Got here on Saturday afternoon. My first impression was that you would never know that a tsunami completely destroyed large swaths of the city 4 years ago. And that it is completely and utterly different from Africa. It is a fairly modern city of about 400,000 people. The roads are paved, there are traffic lights and things function as you would expect in a major city.

I am living in a fairly nice (way too big, cavernous actually for 2 people to be rattling around in) house with my colleague Geraldine, a lovely girl who has worked at HQ and in Chad. She is French. She looks after the finance and administration here, which is great as I don't have to deal with it (my least favorite part of the job). We have a housekeeper who does all of the washing and cleaning and shopping for us. Food is incredibly cheap (a big relief after Liberia). You can buy fruits and vegetables for a week for under $10. And the variety is huge, every fruit and vegetable you could imagine is available (including the notorious durian fruit, or stinkfruit, which is supposed to be tasty but reeks so bad that some hotels ban people from bringing them in). So I've been eating really well!

Every street is packed with little kiosks selling cooked food - mostly the ubiquitous nasi goreng (fried rice). Literally every street corner has a couple of little "restaurants", which are little boxes often attached to a motorcycle. You sometimes see them driving slowly down the street, with the driver/chef dinging a spoon on a bowl....like the ice cream man. THere is fresh fish and seafood galore, but obviously no pork as this is a muslim area. I stopped one night and bought about 2 pounds of satay - pieces of meat marinaded in spicy sauce, threaded on skewers and grilled then coated in a spicy peanut sauce - for like $2. There is KFC, pizza hut and A&W here as well. The only thing missing is a Starbucks.


I got a membership at the gym at the posh hotel in town so am able to run and swim laps and do weights at the pool (can't run outside because I'd have to wear long pants and shirt and I would die in the heat). On the weekends I work out and then sit at the pool and read or surf the internet. Not a bad life for the moment, but a bit boring, which I shouldn't complain about after the 24/7 work schedule in Kenya. Geraldine has a boyfriend who is in town on the weekends so I spend them by myself, which I absolutely do not mind! We have loads of DVDs (they have every tv series and movie ever created for sale for less than $1 each) so between TV and internet I can amuse myself for hours. Since our housekeeper doesn't speak english and Geraldine says that she isn't a very good cook i've actually been cooking for myself, but of course nothing fancy (as everyone knows my culinary skills are nonexistent) but i can stir fry vegetables and make rice and that's dinner!

This programme has been running since 10 days after the tsunami in 2004. We've trained over 4000 health care workers in malaria and dengue case management, provided drugs and diagnostic tools to all of the health facilities in the province and done spraying in a large number of communities. Immediately after the tsunami we distributed insecticide-treated plastic sheeting, which is used to create shelters and is very effective at keeping mosquitoes away.
Indonesia has a double-whammy of malaria and dengue. Malaria isn't such a huge problem but dengue is quite bad. And there is not a lot you can do about dengue, as it is transmitted by Aedes mosquitoes that bite during the day. There is no treatment as it is a viral disease and no vaccine. In most people it is a mild illness but in some cases it turns into its deadly form, dengue hemorrhagic fever, which is very serious and can be fatal.

It is hot as blazes and very humid. A bit like North Carolina in August except hotter. I break into a sweat as soon as I step outside the air conditioning. Unfortunately for me, this is a muslim province under Sharia law, so I have to wear long sleeves and long pants everywhere! At least I don’t have to cover my head like the women here do. They all wear hijabi (I think this is how it is spelled) and I don’t know how they stand it.

So the fact that the city is muslim influences all aspects of daily life. It starts with the 5am call to prayer, which is repeated five times a day. On Fridays, the men go to the mosque for two hours at mid day so we extend the working day. The Sharia police roam the streets on Fridays looking for men as they are supposed to be at the mosque. Women who get caught without hijabi get hauled to the police station where their parents or husband have to come and bail them out. Forget about alcohol. It can be found but you have to know where to get it and you have to ask the shopkeeper in some secret code and they bring you your “package” already wrapped up. There are a couple of restaurants where you can get beer, one of which is a German-run place that has “super beer” on the menu and they bring it to you with a cut-up coke can wrapped around the beer can.

Ramadan is about to start next week and it causes a drastic slowdown everywhere. Everyone fasts from sunup to sundown, no water, food, cigarettes, or anything. As you can imagine by the end of the day everyone is dragging. At sundown some sort of signal goes off and everyone eats, drinks and smokes like crazy (I have not met a single man who does not smoke here, everywhere you go there is a cloud of stinky cigarette smoke, which is disgusting). Everyone takes time off to go visit their families the last part of September/beginning of October so that slows down work as well.

I’m having a bit of culture shock, actually, especially coming from Africa. I might as well have landed on another planet. Its going to take some time to get used to it! The people are nice, but more reserved than Africans. There is also a big language barrier as not everyone in the office speaks english and those who do don't speak it fluently or understand everything so communication is a bit frustrating. Geraldine also isn't totally fluent in english so conversations are slow and I have to be very patient. None of the drivers speak more than a few words of english. I find it exhausting. I'm trying to learn a few words of Indonesian so i can at least give directions.

I had to go to Singapore last week to renew my visa (yes, after being here only a week, a long story involving the massive and complicated government beauracracy here). It is a beautiful city. Incredibly clean, landscaped with lush tropical plants everywhere, totally modern and one big shopping mall!! I've never been anywhere that seemed so obsessed with shopping! Every subway station is a shopping mall. Not that I could afford to buy anything...it was all Gucci Prada Cartier super high end shops. I bought some starbucks coffee (the stuff here is too strong for me! burns a hole in my stomach!) and some books, and got my hair done.

After Singapore I flew to Jakarta for meetings with our donors. We sat in a taxi for 4 hours to get to 2 meetings. The traffic is totally insane. Did a bit more shopping, I found the running shoes that I pay over $100 in the US for less than $70 here. Bought my colleague Geraldine an 80G Ipod for $200. Stuff is cheap here, i guess cause they make it in Asia.

So back to work this week after a week out of town, it will be nice to get back into the routine of work, gym, etc.
Here are some pictures:



Banda Aceh

Our house
Hermes Palace swimming pool and Geraldine

i


Geraldine and some of the team at going away party for Panos, outgoing Programme Director



Preparing the barbeque for fish - burning coconut husks to add extra flavor



Rathmat, our data manager, and his daughter



Riza, my assistant (can you believe I have an assistant?) and his adorable boys


Singapore

Hindu temple in Singapore

Jakarta traffic jam

Yes, that is a real Krispy Kreme - in Jakarta!

Thursday, August 21, 2008

Re: Liberian English

got an email from a fellow "lost in translation" Liberian traveler who gave me a link to a great video that demonstrates Liberian english:

http://www.youtube.com/watch?v=_j5CeHyzZKI

Yes, they really are speaking english!

Wednesday, August 13, 2008

Not Stuck in Liberia!

The strike is over and flights have returned to normal in Brussels so I am out of here this afternoon!! thank god, it's another dreary rainy depressing day in Monrovia. I am looking forward to leaving!!

Tuesday, August 12, 2008

Stuck in Liberia

Brussels airport is shut down because of a baggage handlers' strike. Guess where I'm supposed to fly through tomorrow night? Brussels. Looks like I'll be stuck here until at least Friday, possibly Sunday. Apparently some long-haul flights are going in, but for sure my connection to Amsterdam will be cancelled, and for absolute sure my luggage will be nowhere to be found. There are thousands of people stranded at the airport so there won't be a hotel room to be had.

Arranging the itinerary through to Jakarta was a nightmare, and now it's out the window and will have to be rebooked, along with hotels in Brussels and Jakarta and the flight from Jakarta to Banda Aceh.

I am all packed and am SO ready to leave here, and am very bummed that I will be stuck here for longer than I was supposed to be!!

Sunday, August 10, 2008

Leaving Liberia!

Wednesday is my last day in Liberia. While I’ve enjoyed working with the team here there are many things that I can’t say I’ll miss. While the strange generator schedule (on till 2am every night but off all day Saturday), bad (and expensive) food, nearly continuous rain and horrid roads are on this list, the thing I’m happy to be leaving behind the most is the Ministry of Health. These guys take the corruption cake, down to the last crumb. Trying to work with this incompetent, lying bunch of crooks and fools has been infuriating, ridiculous and sad.

There is a lot of humanitarian and development money coming in to Liberia, and everyone, especially the government, is trying to get their fingers in the pie. Unfortunately when the money goes to the government, it is more likely to disappear into someone’s pockets than go to benefit the people it was intended for. Everyone here talks the talk about “building local capacity” and says nice things at meetings when the government is in attendance like “partnerships” and “joint implementation strategy” but underneath the façade of a desire to involve locals in improving the country and behind closed doors, many NGOs express extreme frustration with working with government. Everyone is competing for development dollars including the government and local NGOs. The competition can get ugly. We NGOs are accountable to our donors and demonstrating that we spent their money responsibly. We are also required to work with the government. Unfortunately having two bosses can lead to problems, particularly when one of them is more interested in lining their pockets than helping their people.

I’ve spent a great deal of time since I’ve been here working on sorting out a fiasco with a mosquito net distribution. Few people understand the problems involved in distributing these items, which at $5 each are a valuable commodity. Unless a distribution is done correctly (including physically removing the net from the package and hanging it in the recipient’s house), the nets will be on the market within 5 minutes of being given out. I can understand why, $5 will buy a lot of food, and if people don’t see the benefit of the net (perhaps because they don’t know that mosquitoes transmit malaria) then they are likely to sell it, use it for a fishing net or a wedding dress (we’ve seen all sorts of original uses for mosquito nets). A bigger problem is large-scale theft of thousands of nets during the distribution. Unless properly supervised there is a huge risk of large quantities of nets disappearing. The problem is, who do you trust to do the supervision? How do you get enough trustworthy people to carry out such a massive operation in remote areas with little access?

The methods of theft are very creative, and can happen at all levels. Forged documents, faked signatures, lying government officials and stealing staff all play a part. I can’t get into the specifics because of the political implications, but a large quantity of nets from a recent distribution of nets purchased by a European government have turned up on markets in neighboring countries. There will be huge political fallout from this and there were several local and international NGOs involved. The Ministry of Health insisted that the NGOs use local people including local Ministry staff for the distributions. Guess what, nobody can account for all of the nets they were given! The Ministry is doing its best to discredit the international NGOs while not criticizing the local NGOs involved in the process (and a key figure at the Ministry has his own local NGO that was awarded a contract to do the distributions – can you say conflict of interest?) so that they can get the contracts for future distributions. The Minister of Health and the ambassador for this country is involved.

Every time I go to a meeting the government people tell us international NGOs that we are here working for them. However, as I said, we are accountable to our donors, not to the government. The government is trying to convince donors to give money directly to them instead of to NGOs. They want to be in charge of money and programming but they are so utterly incompetent that donors will never fund them directly.

I went to a meeting on Friday at the National Disaster Management Commission. There has been huge flooding in Monrovia and the NDMC wants to do an assessment of the scope of the problem. We have the capacity to do indoor spraying to help prevent malaria so I went to the meeting to see what they planned to do for this “assessment”.

They spent the first hour arguing about how to conduct the meeting and who was going to be in charge of what. I thought I was going to lose my mind. I brought up the point of what exactly are we going to assess? Nobody could answer that. Do we want to count the population affected? How do we do this? Do we want to do a survey of how many people are sick? How do we do this? They had absolutely no clue as to what to do. They have no vehicles, no camera, no fuel, and clearly no technical skills to carry out any type of meaningful assessment. Every time I tried to bring up a point I was shut down by the Ministry of Health representative, who clearly did not want to hear any criticism or suggestions for how to carry out the work. So I decided to keep quiet and never attend another meeting. There is little point being involved in such a useless activity, especially if they don’t want to listen to and learn how to do it right. The guy listened to all of the input from the Liberians, but would hear nothing from me.

I was warned about the hostility towards international organizations and staff, and every time I go to a meeting I see it. The Liberians certainly don’t want anyone telling them how to run their affairs, even if they are totally incompetent. Fair enough, but then in the next breath they are asking us for money and support. You can’t have your cake and eat it too!

Here’s another example. We have been trying to set up a sentinel surveillance system for malaria in the country. This is a simple reporting mechanism where a few facilities are chosen and people trained to report on malaria incidence to monitor trends and watch out for epidemics. Obviously we have to work with the Ministry of Health on this. However, they have made ridiculous demands like we need to buy them vehicles, provide fuel, computers, and per diems (oh my god the omnipresent demand for per diems to do anything, I’m so sick of it!!), none of which are necessary to develop this system. There is no money in the budget for any of this. They have ground the discussions to a halt over these demands. Greedy, greedy, greedy. Who cares about helping people? I want a new Landcruiser!

So many of you are probably asking why I continue with this work with this level of frustration. Believe me there are days when I ask the same question of myself. However there are other days when things go well with my own staff, when I get to teach someone something new, or I learn something new that make it worthwhile. Of course the ultimate goal is to reduce human misery and suffering, but on a day to day basis you never get to see this happen. You have to take your victories when they come, because they are few and far between!

I’m sure that it is much the same in Indonesia, but at least I’ll be in a much nicer setting, with beautiful beaches, good food and plenty of things to do outside of work! Unfortunately it is going to take me 3 days to get there!! I overnight from here to Brussels, 12 hour wait in Brussels, go to Amsterdam, then 15 hours to Jakarta, overnight in Jakarta, then on to Aceh. What a nightmare!