Health surveys are one of the many pieces of gathering information that will help to best inform the development of the health care system. I have been working on designing a survey that will give us a clear profile of what people want from local health care and what challenges people are currently facing so that we can move forward with programs and applying for strategic partnerships, ie funding. Today we began the process.
It is really an honor to go to someone's home and sit with them for 30 minutes or so while they share their family history and hopes for the future of health in the New City. Even though I cannot understand most of it until a fellow translates for me, there is a lot to be gleaned from the animated tones and gesturing of the dialogue. Here is the order of operations: We go and introduce ourselves. Usually there is a fellow who leads the conversation in Igbo and I chime in with words like Dalu and Naan, which are standard greetings. After giving a brief overview of where we are in the project design, we offer to give them a family photo if they are willing to answer our questions. In this process, benches appear out of nowhere. They are long smooth wooden benches made from a single long plank with keyhole-type joints (no nails or screws). The children will carry them inside from outside if we are invited in. Or the adults will magically produce benches and stools to sit in the area of swept dirt outside the front door of their waddle-and-daub hut. The benches are dusted off and we sit.
The eight page survey takes about 30-minutes. When a man asked why we were asking all these questions because he thought I should know these things as a doctor, the fellow replied in Igbo that we have different diseases where I come from and so it is important to know what people here go through. It was a delicate situation handled well, although the statement is only partially true. Some of the diseases are different than what people experience at home, malaria typhoid guinea worm, but many of the diseases are the same, hypertension diabetes back pain. The conditions that produce the disease are different, but the human body has a limited set of responses that link us no matter where we are in the world. We are all human after all.
After going through the myriad questions, many of the families are pleased with the opportunity to have their photo taken. 'A snap' is the proper Nigerian term for the snapshot we take. To have a photo properly printed, one must trave 90 minutes to Onitsha and I can only imagine the hassle of actually locating a place that will print photos once you arrive there. This doesn't account for the fact that very few people have cameras. Almost everyone has a cell phone though, and many cellphones have cameras so the concept is not foreign. People get excited and dress up for the photos, and the photos are honest. They show families sitting in front of thatched roofs, women holding their children, and beautiful austere faces of people who are all hoping for a future that will provide relief from some of life's challenges.
Thursday, June 30, 2011
Sunday, June 26, 2011
Groundnut Soup on a Rainy Sunday.
After a day of staying inside due to the heavy rains, we feasted with a delicious Ghanian Groundnut soup prepared by Nuzrat Ngyamah-Poku, who is a Ghanian architecture student that I get to work with designing the health care program and facility. (Nuzrat, I am sorry your photo ended up sideways, but it took 75 minutes to load, so that is the situation.)
Nuzrat's famous Ghanian groundnut soup recipe (serves 12)
1 bottle groundnuts (aka raw/lightly roasted peanuts)
Fresh ginger, about 3 inches
Salt, be generous
Maggi (Knorr Chicken Bouillon is same thing)
Meat: we used 1lb of beef, cut in cubes. Shrimp, chicken, or tofu would also be delicious.
8 tomatoes the size of roma tomatoes, whole with skin
2 purple onions, quartered
1-5 fresh chili peppers, roughly chopped and seeded depending on spice preference
1/4 medium head of cabbage, shredded
Blend with water, ginger, salt until smooth. Add only enough water to make everything smooth. Should be about the consistency of Tahini.
Pour mixture into a saucepan, add 12oz water and chili peppers. Bring to a boil, then simmer for 30 minutes.
While this mixture simmers, combine desired meat (chicken, beef, shrimp, tofu), salt, maggi, roma tomatoes, onions, and 16 ounces of water in a separate large soup-pot. Bring to a boil and simmer, adding water as needed.
Now, combine the two pots together by adding the peanut mixture to the larger of the two pans containing the meat. Again add water as needed. We are cooking on kerosene burners that are hard to control, so the amount of water may need to be adjusted to your cookware. The final consistency should be like a thick creamy soup.
Allow this to simmer for 15 minutes.
Then remove all the larger pieces of vegetable: tomato, onion, pepper. Place these in a blender with enough liquid from soup to effectively blend. Once the mixture is smooth, pour back into the soup-pan.
Simmer for 45 minutes.
Serve hot over rice and with shredded cabbage.
Personal opinion: peanuts should always be sold in recycled liquor bottles.
Nuzrat's famous Ghanian groundnut soup recipe (serves 12)
1 bottle groundnuts (aka raw/lightly roasted peanuts)
Fresh ginger, about 3 inches
Salt, be generous
Maggi (Knorr Chicken Bouillon is same thing)
Meat: we used 1lb of beef, cut in cubes. Shrimp, chicken, or tofu would also be delicious.
8 tomatoes the size of roma tomatoes, whole with skin
2 purple onions, quartered
1-5 fresh chili peppers, roughly chopped and seeded depending on spice preference
1/4 medium head of cabbage, shredded
Blend with water, ginger, salt until smooth. Add only enough water to make everything smooth. Should be about the consistency of Tahini.
Pour mixture into a saucepan, add 12oz water and chili peppers. Bring to a boil, then simmer for 30 minutes.
While this mixture simmers, combine desired meat (chicken, beef, shrimp, tofu), salt, maggi, roma tomatoes, onions, and 16 ounces of water in a separate large soup-pot. Bring to a boil and simmer, adding water as needed.
Now, combine the two pots together by adding the peanut mixture to the larger of the two pans containing the meat. Again add water as needed. We are cooking on kerosene burners that are hard to control, so the amount of water may need to be adjusted to your cookware. The final consistency should be like a thick creamy soup.
Allow this to simmer for 15 minutes.
Then remove all the larger pieces of vegetable: tomato, onion, pepper. Place these in a blender with enough liquid from soup to effectively blend. Once the mixture is smooth, pour back into the soup-pan.Simmer for 45 minutes.
Serve hot over rice and with shredded cabbage.
Personal opinion: peanuts should always be sold in recycled liquor bottles.
Saturday, June 25, 2011
The Abandoned Government Hospital. Notes.
I am posting my notes from the Hospital. I will formalize it later, but if you have any feedback I would love to know your thoughts/impressions.
Tour of Vacant Government hospital:
(With Cecelia’s husband)
Closed since strike in February 2011.
Operating room. Working last year. 2-3 procedures performed.
Doctor brings medications with him when he comes.
No utilization of National Service Youth Corp.
Cost of delivering a baby is 5000N. This can be pain in increments.
Staff: 1 MD, 6 Nurse, 1 sister (Mary Paulette), 1 midwife. The latter two are from the church. There is no system for pregnant women to get care in their own homes.
Observations: mold growing in saline bag. Used needles hanging in operating rooms. Supplies for sutures are available and look new.
Chart notes are sitting out in entrance from 1994. Kids with diarrhea, 1yearold with fever.
No mosquito nets or fans in the wards.
(CECLIA nurse: was working in the farm prior to coming over. Kids ages: 9,8,5,2y7mos)
There is no water available in the hospital. How can you care for people when there is no water?!
Card costs 200N for each person or child.
No one has been coming here since the strike started in February. The doctor comes weekly on Wednesday.
When he comes, he sees 2-5 patients per day.
Cecelia now sees and treats what she can. She mostly treats malaria. She also delivers babies when it is not an emergency. Usually there are about 2-3 deliveries per month. If it is an emergency, she calls the doctor and he comes from Onitisha and usually takes these women away to his private hospital there.
REFLECTIONS AND OBSERVATIONS
Emphasize short community trainings. Better professional training.
Provide home services.
People think the clinic in Aboebgu is too far away to get there. (It is a short walk).
Who are the local leaders that could promote health training for the general public?
What are the best ways to educate people about basic health care needs?
What are ways to provide transportation and home visits?
Motos equipped with basic supplies for home visits (DM, HTN, rheumatism, malaria, diarrhea, etc) Nurses come to health center in morning, then go door-to-door during the day. At end of day, return moto and lock up equipment.
Shuttle from each settlement to hospital once per week.
How do we ensure that the medicines are getting to the patients and not going to the doctor’s private hospital?
Provide scholarship for agreement that the doctor will return to Ebenebe for 5 years to practice. Same thing for nurses. Health educators. Provide salary and transportation while working. As part of the agreement, they go site to site.
How do we communicate with public?
Promote classes.
Spread word about services.
Reminders about antenatal care.
Basic Health Topics:
CPR
Hemorrhage
Malaria
Diabetes
High Blood Pressure
Would the current nurses be interested in teaching/mobilizing to educate women and groups?
Topics: infectious disease, antenatal care, nutrition, ‘
Can we make it cost effective to go to people’s houses?
How do we create abundance mentality for employees, patients, community?
How do we make sure that they think there is enough?
Feeling of hospital: the wards feel terrible - tight and cramped. 12 beds in a room, no circulation. The outpatient facility was comfortable. I think starting with one consulting room is a good idea. Administration? Interesting.
Tour of Vacant Government hospital:
(With Cecelia’s husband)
Closed since strike in February 2011.
Operating room. Working last year. 2-3 procedures performed.
Doctor brings medications with him when he comes.
No utilization of National Service Youth Corp.
Cost of delivering a baby is 5000N. This can be pain in increments.
Staff: 1 MD, 6 Nurse, 1 sister (Mary Paulette), 1 midwife. The latter two are from the church. There is no system for pregnant women to get care in their own homes.
Observations: mold growing in saline bag. Used needles hanging in operating rooms. Supplies for sutures are available and look new.
Chart notes are sitting out in entrance from 1994. Kids with diarrhea, 1yearold with fever.
No mosquito nets or fans in the wards.
(CECLIA nurse: was working in the farm prior to coming over. Kids ages: 9,8,5,2y7mos)
There is no water available in the hospital. How can you care for people when there is no water?!
Card costs 200N for each person or child.
No one has been coming here since the strike started in February. The doctor comes weekly on Wednesday.
When he comes, he sees 2-5 patients per day.
Cecelia now sees and treats what she can. She mostly treats malaria. She also delivers babies when it is not an emergency. Usually there are about 2-3 deliveries per month. If it is an emergency, she calls the doctor and he comes from Onitisha and usually takes these women away to his private hospital there.
REFLECTIONS AND OBSERVATIONS
Emphasize short community trainings. Better professional training.
Provide home services.
People think the clinic in Aboebgu is too far away to get there. (It is a short walk).
Who are the local leaders that could promote health training for the general public?
What are the best ways to educate people about basic health care needs?
What are ways to provide transportation and home visits?
Motos equipped with basic supplies for home visits (DM, HTN, rheumatism, malaria, diarrhea, etc) Nurses come to health center in morning, then go door-to-door during the day. At end of day, return moto and lock up equipment.
Shuttle from each settlement to hospital once per week.
How do we ensure that the medicines are getting to the patients and not going to the doctor’s private hospital?
Provide scholarship for agreement that the doctor will return to Ebenebe for 5 years to practice. Same thing for nurses. Health educators. Provide salary and transportation while working. As part of the agreement, they go site to site.
How do we communicate with public?
Promote classes.
Spread word about services.
Reminders about antenatal care.
Basic Health Topics:
CPR
Hemorrhage
Malaria
Diabetes
High Blood Pressure
Would the current nurses be interested in teaching/mobilizing to educate women and groups?
Topics: infectious disease, antenatal care, nutrition, ‘
Can we make it cost effective to go to people’s houses?
How do we create abundance mentality for employees, patients, community?
How do we make sure that they think there is enough?
Feeling of hospital: the wards feel terrible - tight and cramped. 12 beds in a room, no circulation. The outpatient facility was comfortable. I think starting with one consulting room is a good idea. Administration? Interesting.
Friday, June 24, 2011
Abegbu, phase one.
On Saturday, we walked along the road to reach Abegbu. People in Anam speak about it like it is a ghost town that was abandoned when the market town of Otoucha grew and inhabitants left to live in a more urban environment. After visiting the intimate and organized Iyora community last week, I wasn't really sure what to expect.
We walked for maybe 30 minutes on the road, which is beginning to fill with water in the parts that have already worn away. Along the walk, we were passed by approximately seven Okadas (motorbikes). It was almost comical to see people stop their bike with multiple passengers on it before a small pond in the road and try to figure out how to drive along the 2-3 inches of hardened earth. I think walking was easier.
Once we arrived in Abegbu, we were welcomed into the Elder most man's home. His two story home was immaculately swept and organized with large photos of individual family members framed and hung neatly around the top of each wall. After welcoming us to Abegbu, he offered his support for the project and the planning of the new city in Anam. Then he told us the story of people in the area as far back as he could remember, which was his age: 97 - almost 98. I would like to repeat: he is 97, almost 98! He lives alone, has most of his teeth, stood to shake each of our hands, and remembered the story of his down since his childhood.
It is refreshing to be in a community that so deeply reveres the wisdom and experience of the elders.
After leaving his home, we toured the sprawling town. This was quite the opposite of a ghost town, but there was a large generational gap present. This is becoming a theme in the rural Anam communities. There are abundant children under 12. I counted 70 at one point when we were standing together. Their mothers and grandmothers can also be found, usually cooking in the kitchen or tending to the farm. And there are elders. But where are the Youth? Where are the able bodied 13-40 year olds? Answer: They have gone somewhere to search for better economic opportunities. So how can we design a city that will constantly have an abundance of employment and opportunity for growth? Let me know if you have any answers. I think there are some great ideas in the works here. Another time, I will discuss these projects and goals.
Anyhow, after we left we were invited into the pastor's compound to speak with his father, where he provided the universal sign of welcome: warm Coke in glass bottles. He used to work as a general contractor and he answered many of questions about the cost and process of building in Anam and even some of his impressions about health care. From there, we left and measured a number of houses. At one point while the architects were measuring a house and store front, we met with the women to discuss health care. They offered many helpful taking points and contacts. Here are some of my notes from the conversation:
There is a chemist shop in town that people go to. And a hospital that people can go to buy drugs or for antenatal visits. Currently there are no home visits, but this would be welcomed. Other services that people have to go use are in Miata and Otochua or Onitisha. There is a Sister that comes around. Sister Mary Paulette. The doctor who works at the hospital comes every Tuesday. Or you can call for an emergency. He comes from Onishita and can come in 2-3 hours. There are nurses. The facilities lack manpower. Yesterday a woman almost died in childbirth because the nurse was busy helping another woman. No one reported hearing of an Anam woman who lost a baby in childbirth. The young pregnant woman says that the gods have been kind to them. The older woman has rheumatism and she wants help. She wants services. She suggested free services for support - medical counseling and psychological services. She would like these to be provided by a trained medical professional ideally. It would be okay if these were by semi-trained people in the community. Just to provide psychological support for people.
My head was swirling with further questions and ideas that I look forward to asking in future visits. Their requests are reasonable, and unfortunately not unique. Now the task is to identify how to provide these services in a way that can be supported in the new city. The highlight of the trip for me was the amount of information I learned about available health care and desired services that people wanted to receive. On the walk home, we stopped at the abandoned government hospital that was built in 1988. This topic deserves its own post, however, and I promise to finish it soon because it highlighted the importance of my work here along with the added challenges that are specific to Nigeria.
We left Abegbu with more of a feeling of what happens in a sprawling Anam town. There were probably one to two thousand people living there, and yet the number of abandoned foundations or walls that had become gardens or just overgrown with the power of nature here. It was a strange mix; not quite a ghost town, but not quite organized or planned either.
We walked for maybe 30 minutes on the road, which is beginning to fill with water in the parts that have already worn away. Along the walk, we were passed by approximately seven Okadas (motorbikes). It was almost comical to see people stop their bike with multiple passengers on it before a small pond in the road and try to figure out how to drive along the 2-3 inches of hardened earth. I think walking was easier.
Once we arrived in Abegbu, we were welcomed into the Elder most man's home. His two story home was immaculately swept and organized with large photos of individual family members framed and hung neatly around the top of each wall. After welcoming us to Abegbu, he offered his support for the project and the planning of the new city in Anam. Then he told us the story of people in the area as far back as he could remember, which was his age: 97 - almost 98. I would like to repeat: he is 97, almost 98! He lives alone, has most of his teeth, stood to shake each of our hands, and remembered the story of his down since his childhood.
It is refreshing to be in a community that so deeply reveres the wisdom and experience of the elders.
After leaving his home, we toured the sprawling town. This was quite the opposite of a ghost town, but there was a large generational gap present. This is becoming a theme in the rural Anam communities. There are abundant children under 12. I counted 70 at one point when we were standing together. Their mothers and grandmothers can also be found, usually cooking in the kitchen or tending to the farm. And there are elders. But where are the Youth? Where are the able bodied 13-40 year olds? Answer: They have gone somewhere to search for better economic opportunities. So how can we design a city that will constantly have an abundance of employment and opportunity for growth? Let me know if you have any answers. I think there are some great ideas in the works here. Another time, I will discuss these projects and goals.
Anyhow, after we left we were invited into the pastor's compound to speak with his father, where he provided the universal sign of welcome: warm Coke in glass bottles. He used to work as a general contractor and he answered many of questions about the cost and process of building in Anam and even some of his impressions about health care. From there, we left and measured a number of houses. At one point while the architects were measuring a house and store front, we met with the women to discuss health care. They offered many helpful taking points and contacts. Here are some of my notes from the conversation:
There is a chemist shop in town that people go to. And a hospital that people can go to buy drugs or for antenatal visits. Currently there are no home visits, but this would be welcomed. Other services that people have to go use are in Miata and Otochua or Onitisha. There is a Sister that comes around. Sister Mary Paulette. The doctor who works at the hospital comes every Tuesday. Or you can call for an emergency. He comes from Onishita and can come in 2-3 hours. There are nurses. The facilities lack manpower. Yesterday a woman almost died in childbirth because the nurse was busy helping another woman. No one reported hearing of an Anam woman who lost a baby in childbirth. The young pregnant woman says that the gods have been kind to them. The older woman has rheumatism and she wants help. She wants services. She suggested free services for support - medical counseling and psychological services. She would like these to be provided by a trained medical professional ideally. It would be okay if these were by semi-trained people in the community. Just to provide psychological support for people.
My head was swirling with further questions and ideas that I look forward to asking in future visits. Their requests are reasonable, and unfortunately not unique. Now the task is to identify how to provide these services in a way that can be supported in the new city. The highlight of the trip for me was the amount of information I learned about available health care and desired services that people wanted to receive. On the walk home, we stopped at the abandoned government hospital that was built in 1988. This topic deserves its own post, however, and I promise to finish it soon because it highlighted the importance of my work here along with the added challenges that are specific to Nigeria.
We left Abegbu with more of a feeling of what happens in a sprawling Anam town. There were probably one to two thousand people living there, and yet the number of abandoned foundations or walls that had become gardens or just overgrown with the power of nature here. It was a strange mix; not quite a ghost town, but not quite organized or planned either.
Thirty!
Today I celebrated turning thirty! In Nigeria!
It was a really wonderful day. I woke up to my roommates crooning happy birthday to me while I lay ensconced in my mosquito net. Throughout the day, I received wonderful emails and messages from people all over the world, and I celebrated with two birthday cake surprises and a group of visionary experts with whom I work.
Let me explain the extraordinariness of the cakes. First, all our cooking is usually done on three kerosene burners outdoors. Secondly, one of the interns has been working on building a solar oven, but we lack certain reflective materials (enough beer cans), so the plans and skeleton of the solar oven live on the floor of our studio work space. Thirdly, the only sweets that we have access to are digestives, which are more accurately described on the label as 'wheatflour coasters.' Fourthly, chocolate is loosely interpreted as such in Nigeria.
So now, to the cakes themselves: a gluten-free chocolate-coconut-ginger cake ala Stacy and a frosted corn-muffin sponge cake decorated to say "Happy Birthday Julia" in pink frosting bought my a Nigerian architect, Deji, who transported it from Oniticha (the cake is more delicious than my description). I felt so loved and indulgent! I must give Stacy a little more credit for her feat of a cake. Having the forethought to bring gluten-free cake mix from New York, she steamed the cakes in a secret manner during the day using a double-boiler type system with kerosene burner, which is not the most consistent of flames. Then she made coconut-ginger icing and decorated the cake exquisitely. I would eat it again in a heartbeat!
Reflecting on the past year, it is amazing how much has changed. I celebrated my last birthday two days after graduating from naturopathic medical school in Seattle. Then, I passed board exams, completed an internship in Hawaii, decided that I was meant to be self-employed instead and moved to Austin in February, started a practice and network there, and then accepted a ten week public health internship to revolutionize the public health care model in rural Nigeria. What an amazing year! And I am pretty sure that the future only gets better.
I am looking forward to thirty - both this upcoming year and the decade. I like where I am headed. I love the people I have close to me in my life. And I sometimes, I cannot believe my fortune when I see how the pieces are all falling together.
It was a really wonderful day. I woke up to my roommates crooning happy birthday to me while I lay ensconced in my mosquito net. Throughout the day, I received wonderful emails and messages from people all over the world, and I celebrated with two birthday cake surprises and a group of visionary experts with whom I work.
Let me explain the extraordinariness of the cakes. First, all our cooking is usually done on three kerosene burners outdoors. Secondly, one of the interns has been working on building a solar oven, but we lack certain reflective materials (enough beer cans), so the plans and skeleton of the solar oven live on the floor of our studio work space. Thirdly, the only sweets that we have access to are digestives, which are more accurately described on the label as 'wheatflour coasters.' Fourthly, chocolate is loosely interpreted as such in Nigeria.
So now, to the cakes themselves: a gluten-free chocolate-coconut-ginger cake ala Stacy and a frosted corn-muffin sponge cake decorated to say "Happy Birthday Julia" in pink frosting bought my a Nigerian architect, Deji, who transported it from Oniticha (the cake is more delicious than my description). I felt so loved and indulgent! I must give Stacy a little more credit for her feat of a cake. Having the forethought to bring gluten-free cake mix from New York, she steamed the cakes in a secret manner during the day using a double-boiler type system with kerosene burner, which is not the most consistent of flames. Then she made coconut-ginger icing and decorated the cake exquisitely. I would eat it again in a heartbeat!
Reflecting on the past year, it is amazing how much has changed. I celebrated my last birthday two days after graduating from naturopathic medical school in Seattle. Then, I passed board exams, completed an internship in Hawaii, decided that I was meant to be self-employed instead and moved to Austin in February, started a practice and network there, and then accepted a ten week public health internship to revolutionize the public health care model in rural Nigeria. What an amazing year! And I am pretty sure that the future only gets better.
I am looking forward to thirty - both this upcoming year and the decade. I like where I am headed. I love the people I have close to me in my life. And I sometimes, I cannot believe my fortune when I see how the pieces are all falling together.
Wednesday, June 22, 2011
The notion of exercise.
After work today, a few of us from the workshop went to help unload half a trip of gravel and sand from a boat at the dock. If you are not familiar with how much a 'trip of gravel' weighs, well, I cannot really tell you, but basically it is a boat load. A heavy boatload. We joined a number of the day laborers from the construction site and carried the bags up to 15 feet. My arms were exhausted after lifting possibly 35 of these gravel bags.
When we returned to the house, it was time for our daily workout regimen. Since June 13 we have been doing Beach-Body-Insanity Workout videos after our workday. I really enjoy the group cardio work the videos promote along with the luxury of working out inside to avoid the mosquitos. We have a fluctuating group of people who participate and they make it easier to motivate to exercise every day. After lifting the bags of gravel, I had a hard time lifting my water glass to my lips to drink. Inevitably this added to the intensity of the Insanity workout.
The contrast of the physical labor with the forced exercise video struck me as absurd. I am not sure yet what to make of the situation, but it is helpful for me to conceptualize the physical demands that people in the new Anam city currently face and will be facing so that we can cater services and programs to meet those needs. For example, it becomes more important to make sure that nutritional needs are met with proper food storage strategies, food access routes, and relevant nutritional education. How to effectively do that is the question...
When we returned to the house, it was time for our daily workout regimen. Since June 13 we have been doing Beach-Body-Insanity Workout videos after our workday. I really enjoy the group cardio work the videos promote along with the luxury of working out inside to avoid the mosquitos. We have a fluctuating group of people who participate and they make it easier to motivate to exercise every day. After lifting the bags of gravel, I had a hard time lifting my water glass to my lips to drink. Inevitably this added to the intensity of the Insanity workout.
The contrast of the physical labor with the forced exercise video struck me as absurd. I am not sure yet what to make of the situation, but it is helpful for me to conceptualize the physical demands that people in the new Anam city currently face and will be facing so that we can cater services and programs to meet those needs. For example, it becomes more important to make sure that nutritional needs are met with proper food storage strategies, food access routes, and relevant nutritional education. How to effectively do that is the question...
Monday, June 20, 2011
Anam City Blog Post.
I wrote a post about Herbal Medicine in Anam City on the Anam City blog.
Check it out.
And then subscribe to the blog!
Check it out.
And then subscribe to the blog!
Saturday, June 18, 2011
Sandflies, mosies, and no-see-ums.
How can feet possibly be so delicious to insects!?!?!!?
And why can't I stop scratching mine!
I heard an insult today: 'I feel sorry for your shoes (pause for dramatic effect) because your feet must really stink.' I think I could add 'AND ITCH!!!!'
And why can't I stop scratching mine!
I heard an insult today: 'I feel sorry for your shoes (pause for dramatic effect) because your feet must really stink.' I think I could add 'AND ITCH!!!!'
Palm Wine + Kola Nut.
Friday we presented our workplans for the rest of the ten weeks. The scope of what everyone is trying to accomplish is humbling, ambitious, and extremely exciting! I managed to use clip art and colored arrows to present my timeline. I felt pretty proud of my attempt at graphics, considering I am working with people who are extremely talented with design softwares. Hopefully, someone will teach me how to use a snazzy program like Illustrator or InDesign.
After we presented our work programs, we celebrated! The fellows were thoughtful enough to bring palm wine and kola nuts with them in the morning, so we experienced the kola nut and palm wine ceremony with all its pomp and circumstance. The ceremony is a welcoming of guests, acknowledging that they are welcome any time. After the presentation of the kola nut and money from the male head of household to the guest, there is a five part call and response. One of the fellows translated everything from Igbo, the local dialect, to English so that we got the full effect.
Then the kola nut was broken and passed around. The bitter pink fruit is supposed to be extremely stimulating. One of the fellows said that students will use it to stay up for days. He also said that women will drink it to promote lactation. Then, he warned us not to eat more than a quarter of the fruit's flesh in this sitting.
Once we all had our kola nut, the palm wine was generously poured from a blue plastic gallon container that probably held some sort of fuel or oil prior to palm wine. Someone promised me it had been washed out. The palm wine tasted like a cross between coconut water mixed with pure fermentation. I helped myself to two generous glasses, which contributed to some extreme post-imbibing gastrointestinal bubbling. Someone told me that there was more alcohol in the palm wine than in a guinness. I doubt it. But it was delicious. And it was fun to just sit around and laugh together sharing in this tradition.
After we presented our work programs, we celebrated! The fellows were thoughtful enough to bring palm wine and kola nuts with them in the morning, so we experienced the kola nut and palm wine ceremony with all its pomp and circumstance. The ceremony is a welcoming of guests, acknowledging that they are welcome any time. After the presentation of the kola nut and money from the male head of household to the guest, there is a five part call and response. One of the fellows translated everything from Igbo, the local dialect, to English so that we got the full effect.
Then the kola nut was broken and passed around. The bitter pink fruit is supposed to be extremely stimulating. One of the fellows said that students will use it to stay up for days. He also said that women will drink it to promote lactation. Then, he warned us not to eat more than a quarter of the fruit's flesh in this sitting.
Once we all had our kola nut, the palm wine was generously poured from a blue plastic gallon container that probably held some sort of fuel or oil prior to palm wine. Someone promised me it had been washed out. The palm wine tasted like a cross between coconut water mixed with pure fermentation. I helped myself to two generous glasses, which contributed to some extreme post-imbibing gastrointestinal bubbling. Someone told me that there was more alcohol in the palm wine than in a guinness. I doubt it. But it was delicious. And it was fun to just sit around and laugh together sharing in this tradition.
Saturday, June 11, 2011
The Largest Market in Africa.
Today we went to Onitsha. It was part market-research, part cultural-shopping-adventure.
Anytime we leave our cloistered oasis, there are multiple steps involved. It is not arduous, so much as it requires a fair amount of organization. So sometime mid-morning, we boarded a wooden boat bound for Otocha where we docked at the ferry landing. The boat is best described as a long wooden canoe powered by a motor and bamboo pole. The captain drives the boat from the back with the first mate giving gestures and occasional verbal cues indicating upcoming obstacles - water hyacinth, fishing nets, driftwood. Once we docked at the landing, kids began to gather. White people are not a common sight, I suppose, and staring is socially acceptable. The kids were generally smiling and entertained by us, although only a few of them spoke english so communication was limited to body language and eye contact.
Otocha has a market that runs every day, with a large market rotating every four days. It is an interesting cycle based on the four days of the Anam calendar. You have to find out when the last big market was and calculate when the next one will be in order to figure out when to shop. Today was not one of the larger days so we got oriented while someone collected the cars and our vigalante escorts. The vehicles are now stored in Otocha since they cannot be stored at the site due to the wet, muddy road conditions.
We then drove for about an hour to Onitsha where we took in the market. We started with the food sections and then traveled to the heart of the market. It is said that if you cannot find it in Onitsha, you cannot find it in Africa. The scope of the market is expansive and quite ordered. There are separate sections for food, meat, clothing, books, electronics, construction goods, etc. This gives you the opportunity to comparison shop as well as take in as much sensory stimulation as you can handle. We had wonderful escorts and trying to maneuver seven interns and a number of staff through narrow stalls of goods is an adventure on its own.
After an afternoon of shopping and exploring market organization in the hot sun, we piled back into the van for the drive back to Otocha. It started to rain as we were driving back, which is not optimal when you still have a significant boat ride home. We tried to wait it out for a short period, but between the sun setting and the rain clouds darkening the sky, we needed to collect all of our groceries that had been purchased and head home. For this we needed a bigger boat. One of my favorite things about the ferry is that you just park your wooden boat and it will stay there. There is no security, nor any patrol of the boats. People generally know who's boat is who's (they are also labeled) and it brings bad fortune to you if you steal someone's boat. So it just doesn't happen.
Anyhow, we made it home in the cold, dark rain with food to feed 12 people for a week - 4 chickens and 8-20L water jugs included.
Tuesday, June 7, 2011
Location, location, location.
We have been here for almost a week which is hard to believe.
Before arriving, I was under the impression that we would be staying in thatched huts on the site. As with most things construction, there were delays. The huts and the staff quarters are not finished. So instead we are bunking in the Chife's house. It is really more of a mansion, a Trasarco McMansion, and we are really more like squatters. The house is brand new, almost completely finished, with floors and fixtures from Ikea and romanesque columns everywhere, and absolutely huge. Someone said the other day, "Nigeria is like Texas. They like everything to be bigger."
It is common in Nigeria that when someone from a community makes it big, becoming a Big Man, they build a large house in their village. Right now this white semi-Mediterranean style house stands out amongst the waddle-and-daub huts that dapple the countryside. Dr Chife grew up near here and his community raised money to send him to college. In addition to the New City Project, he has created programs, such as scholarship programs, that help to repay their support by reinvigorating the future of Anam. He models the principles that many aspire towards: success, generosity, vision. I look forward to hopefully meeting him this summer.
Anyhow, as far as where we are...Ebenebe is one of the eight Anam Communities located in Anambra State near the Ezichi and Niger rivers. It is primarily a farming settlement and some people live here permanently, while others just live here when they are farming. The landscape can be described as a forest-mosaic. What this means really is that it is part jungle, part forest, part farmland, part flood plane.
I share a sleeping room with two other interns, one from Spain and the other from Oregon. We all have foam mattresses and that are draped in mosquito netting each night to protect us from the mosquitos and their potential diseases. The room is part of Dr Chife's future office for the times when he is here. My suitcase is my dresser and I am grateful to be able to hang my toiletry organizer. We take bucket showers because although there is indoor plumbing, the electricity goes off for about six hours per day. The state put up power lines in the area years ago, but there is no power coursing through the wires. Instead, everything is run by generator.
Our office is the future living room and we have three large tables with various models of computers available for usage. Everything is open and studio-esque. The ten-week program has been reframed as a workshop, which emphasizes the nature of our work and the collaboration of everyone here because certainly everyone here has a lot of insight and knowledge to share. There are seven other interns total, six of whom are here. Five of us are American, one spaniard, one ghanian. I am really grateful to be a part of such a visionary and educated group.
All in all, it is a pretty good set up. We sleep, work, and eat in the house. We are close to the river and it is easy to explore the site. Things are off to a good start.
Before arriving, I was under the impression that we would be staying in thatched huts on the site. As with most things construction, there were delays. The huts and the staff quarters are not finished. So instead we are bunking in the Chife's house. It is really more of a mansion, a Trasarco McMansion, and we are really more like squatters. The house is brand new, almost completely finished, with floors and fixtures from Ikea and romanesque columns everywhere, and absolutely huge. Someone said the other day, "Nigeria is like Texas. They like everything to be bigger."
It is common in Nigeria that when someone from a community makes it big, becoming a Big Man, they build a large house in their village. Right now this white semi-Mediterranean style house stands out amongst the waddle-and-daub huts that dapple the countryside. Dr Chife grew up near here and his community raised money to send him to college. In addition to the New City Project, he has created programs, such as scholarship programs, that help to repay their support by reinvigorating the future of Anam. He models the principles that many aspire towards: success, generosity, vision. I look forward to hopefully meeting him this summer.
Anyhow, as far as where we are...Ebenebe is one of the eight Anam Communities located in Anambra State near the Ezichi and Niger rivers. It is primarily a farming settlement and some people live here permanently, while others just live here when they are farming. The landscape can be described as a forest-mosaic. What this means really is that it is part jungle, part forest, part farmland, part flood plane.
I share a sleeping room with two other interns, one from Spain and the other from Oregon. We all have foam mattresses and that are draped in mosquito netting each night to protect us from the mosquitos and their potential diseases. The room is part of Dr Chife's future office for the times when he is here. My suitcase is my dresser and I am grateful to be able to hang my toiletry organizer. We take bucket showers because although there is indoor plumbing, the electricity goes off for about six hours per day. The state put up power lines in the area years ago, but there is no power coursing through the wires. Instead, everything is run by generator.
Our office is the future living room and we have three large tables with various models of computers available for usage. Everything is open and studio-esque. The ten-week program has been reframed as a workshop, which emphasizes the nature of our work and the collaboration of everyone here because certainly everyone here has a lot of insight and knowledge to share. There are seven other interns total, six of whom are here. Five of us are American, one spaniard, one ghanian. I am really grateful to be a part of such a visionary and educated group.
All in all, it is a pretty good set up. We sleep, work, and eat in the house. We are close to the river and it is easy to explore the site. Things are off to a good start.
Sunday, June 5, 2011
Goat feast.
Today was the awaited Goat Feast.
Yesterday Mercy and Rose, our dutiful cooks, brought a goat back from the market. The goat was 2-3 years old, brown, and scared out of her mind after being transported in a car for a few hours. She cost about 150,000naira, which is approximately $100. I am not sure what the market rate is for goats at home, but for the amount of food that we are getting this seems like a deal!
Sparing the details of the processing, nothing from this goat is going to waste. Much of the meat was roasted over an open flame. Half of it was frozen. Some of it was stewed. (Goat head stew is a famous dish in northern Nigeria.) And some of it, I do not want to eat. It was quite delicious and more tender than I anticipated. I may not want to eat goat for a while after we finish everything, but for now I am really excited about this novel protein source.
One other note about today: A few of us went for an afternoon run and part way through a few kids began to follow us. There is a strange contrast to our need to go exercise and be physical after sitting most of our work days to the active lifestyle of the families in this area who are primarily farmers and laborers, but kids are a different story. They began to imitate us and we played along. We taught them some stretches and calisthenics and twirls for good measure and they practiced their new moves, laughing and smiling. Then we went down to the river for a quick swim and the kids watched us from the bank. One of their mates came along and we watched them explain what we were just doing, acting out the running and stretching and calisthenics. It was precious to see them laugh as they described what we did.
Also, my fingers are still burning from where I touched fresh chilis cooking last night. This is a true testament to the strength of the spiciness.
Yesterday Mercy and Rose, our dutiful cooks, brought a goat back from the market. The goat was 2-3 years old, brown, and scared out of her mind after being transported in a car for a few hours. She cost about 150,000naira, which is approximately $100. I am not sure what the market rate is for goats at home, but for the amount of food that we are getting this seems like a deal!
Sparing the details of the processing, nothing from this goat is going to waste. Much of the meat was roasted over an open flame. Half of it was frozen. Some of it was stewed. (Goat head stew is a famous dish in northern Nigeria.) And some of it, I do not want to eat. It was quite delicious and more tender than I anticipated. I may not want to eat goat for a while after we finish everything, but for now I am really excited about this novel protein source.
One other note about today: A few of us went for an afternoon run and part way through a few kids began to follow us. There is a strange contrast to our need to go exercise and be physical after sitting most of our work days to the active lifestyle of the families in this area who are primarily farmers and laborers, but kids are a different story. They began to imitate us and we played along. We taught them some stretches and calisthenics and twirls for good measure and they practiced their new moves, laughing and smiling. Then we went down to the river for a quick swim and the kids watched us from the bank. One of their mates came along and we watched them explain what we were just doing, acting out the running and stretching and calisthenics. It was precious to see them laugh as they described what we did.
Also, my fingers are still burning from where I touched fresh chilis cooking last night. This is a true testament to the strength of the spiciness.
Thursday, June 2, 2011
Site Tour and Context.
Day Two of Orientation focused on creating a context for the ideas of designing a new city. After arranging the tables and computers in our workspace, we began with a site tour after a hearty breakfast of eggs, oatmeal and nutella. (Mmmm...chocolate for breakfast.) We walked the 4km (~2.2 miles) from the north to the south end of the area designated for New City development. The site tour was helpful to develop an understanding of the land, its current uses, and to imagine the potential development of the city. We saw where the future hospital will go among a grove of mango trees; we stopped at the high grasses that are being cleared for the brick factory; we rested on the bamboo stoop of a neighboring family and counted 21 kids for the 4 women that were present. It is hard to explain what we are encountering. I wish I could post photos to highlight the natural beauty that surrounds us and the excitement of the people that we have spoken with. Even with photos, the kinesttic quality of being here is hard to describe. Everyone that I have encountered is fully committed and engaged in making sure that the New City is a success. They are passionate about making this a better place for their families to live and return to for generations and generations. There is palpable meaning in what we are here to contribute.
After concluding the three hour tour to the south end of Ebenebe, we took a boat back to our starting point. It was refreshing to see the land from a different perspective and it helped me understand the magnitude of how people here adapt to a changing landscape. For instance, farmland where yam and cassava are grown is dry right now, but soon will become flooded and the mounds of yam will be underwater. The tall grasses that border the river will be submerged in months time. It became easier to conceptualize that when the road gets flooded, people adapt. There is still access to neighboring communities by river. Essentially, the river becomes the road.
To celebrate the river, a few of us took a sunset swim in the murky waters at sunset. It was quite an adventure through someone's cassava mounds to get to the river, but we made it and had a glorious swim. It is hard to believe that we have only been here for two days as there is so much to see and comprehend. But I am beginning to see how things fit together and the specific possibilites of this collaborative project.
After concluding the three hour tour to the south end of Ebenebe, we took a boat back to our starting point. It was refreshing to see the land from a different perspective and it helped me understand the magnitude of how people here adapt to a changing landscape. For instance, farmland where yam and cassava are grown is dry right now, but soon will become flooded and the mounds of yam will be underwater. The tall grasses that border the river will be submerged in months time. It became easier to conceptualize that when the road gets flooded, people adapt. There is still access to neighboring communities by river. Essentially, the river becomes the road.
To celebrate the river, a few of us took a sunset swim in the murky waters at sunset. It was quite an adventure through someone's cassava mounds to get to the river, but we made it and had a glorious swim. It is hard to believe that we have only been here for two days as there is so much to see and comprehend. But I am beginning to see how things fit together and the specific possibilites of this collaborative project.
Wednesday, June 1, 2011
Ruban Workshop Begins.
After a full day of travel on Tuesday, we began our workshop on Wednesday.
I would like to start by describing our travel from Lagos to Ebenebe. Here's the plan: leave the hotel at 10am, fly from Lagos to Benin City at 11:40, drive for 2 hours to Anam, begin orientation. Sounds like a full day, but nothing too strenuous. I don't ask a lot of questions and I am up for anything, which is lucky. After breakfast at the hotel, we all load in the car and leave the hotel by 10:30am. Wondering if we are going to be late for check-in, we drive all of 100 yards to the airport. Realizing that we could have walked this far, we check in for our flight without showing any IDs. I wish I had taken a photo of the situation because well, it was unique. I have some photos from the arrival in Benin City (courtesy of Isabel). Anyhow, we make it through security with full water bottles. We were asked to take a drink from our bottles to make sure that it wasn't acid or something dangerous and then we proceeded to the boarding area. I think TSA could take a clue and follow this strategy instead of throwing out useful things all the time and banning water.
Inside the terminal, there were kiosks selling sundry goods from books to watches to edibles. Interestingly, the books mostly focused on bettering yourself in business, like focusing on management strategies or being a better consultant, or self-help/religious topics. I think I saw a medical dictionary too. We waited and our flight was delayed 30 minutes. Then 45 more minutes. When I asked our kind guardian and shepard Emmanuel if they gave a reason for the delays, he looked at me and laughed saying, "It is delayed because they are Nigerian!" I should point out, he is Nigerian and lives in Lagos. We eventually boarded the 40 minute flight and were greeted in Benin City by cars armed with police officers to take us to Ebenebe. The police officers are our security. They carry large personalized guns and scan the streets and onlookers for possible perceived threats. I feel extremely safe, but like a fish in a fish bowl.
Everyone I have encountered thus far is extremely nice and hospitable. It is hard for me to imagine anything going wrong. And at the same time, we drive for almost four hours and there are innumerable checkpoints where police stop cars and want money from vehicles that don't have security. So better safe than sorry. We stop at a market to pick up some mosquito nets and while a couple of people venture off, all of the new arrivals (the seven interns) stay in the van. We quickly become a spectacle. White people in a car in a town that may never have had a caucasian visitor. Kids run and tell other kids until there is a swarm of kids looking and watching. It is a little like we have paparazzi sans cameras. Thus the feeling of being in a fishbowl.
Our final destination is Ebenebe in the Anam region of Anambra state. We made it to our final destination after dark, perhaps around eight at night. This is one of the last days the road will be passable by car. Soon the rains will start and will flood the road making the river the only way to access the area. Already the road is rough and the vestiges of inadequately funded state road make themselves apparent as we pass from smooth developed road to mudholes that could swallow a car.
A feast awaited us upon arrival: greens, yam, casava, plantain, and fresh fruit for desert. We were exhausted and hungry after our day of travel and gratefully inhaled the deliciousness prepared for us. After dinner, we had brief introductions and watched an inspiring video from Dr and Mrs Chife welcoming us to the project. Then after settling into our rooms (which I may describe more later), we went to sleep.
The next day, the Rurban Workshop began.
When someone tells you that they are designing a new city that can serve as a model for African development, you know that it is going to be a big project. You assume that the project has immense potential to make a difference in the world and the lives of the individuals who will live there. But you don't really know how large the project is until you grapple with the master plan and the topics and concerns that have been discussed for years leading up to this moment in time. This project is especially wide in scope because it is so unique in evolution. The people in Ebenebe are building this city from the ground up, with every factor being weighed by the community elders. Our first day of orientation was all about understanding the Master Plan and the evolution of this project. After one day, I have a lot yet to understand.
I would like to start by describing our travel from Lagos to Ebenebe. Here's the plan: leave the hotel at 10am, fly from Lagos to Benin City at 11:40, drive for 2 hours to Anam, begin orientation. Sounds like a full day, but nothing too strenuous. I don't ask a lot of questions and I am up for anything, which is lucky. After breakfast at the hotel, we all load in the car and leave the hotel by 10:30am. Wondering if we are going to be late for check-in, we drive all of 100 yards to the airport. Realizing that we could have walked this far, we check in for our flight without showing any IDs. I wish I had taken a photo of the situation because well, it was unique. I have some photos from the arrival in Benin City (courtesy of Isabel). Anyhow, we make it through security with full water bottles. We were asked to take a drink from our bottles to make sure that it wasn't acid or something dangerous and then we proceeded to the boarding area. I think TSA could take a clue and follow this strategy instead of throwing out useful things all the time and banning water.
Inside the terminal, there were kiosks selling sundry goods from books to watches to edibles. Interestingly, the books mostly focused on bettering yourself in business, like focusing on management strategies or being a better consultant, or self-help/religious topics. I think I saw a medical dictionary too. We waited and our flight was delayed 30 minutes. Then 45 more minutes. When I asked our kind guardian and shepard Emmanuel if they gave a reason for the delays, he looked at me and laughed saying, "It is delayed because they are Nigerian!" I should point out, he is Nigerian and lives in Lagos. We eventually boarded the 40 minute flight and were greeted in Benin City by cars armed with police officers to take us to Ebenebe. The police officers are our security. They carry large personalized guns and scan the streets and onlookers for possible perceived threats. I feel extremely safe, but like a fish in a fish bowl.
Everyone I have encountered thus far is extremely nice and hospitable. It is hard for me to imagine anything going wrong. And at the same time, we drive for almost four hours and there are innumerable checkpoints where police stop cars and want money from vehicles that don't have security. So better safe than sorry. We stop at a market to pick up some mosquito nets and while a couple of people venture off, all of the new arrivals (the seven interns) stay in the van. We quickly become a spectacle. White people in a car in a town that may never have had a caucasian visitor. Kids run and tell other kids until there is a swarm of kids looking and watching. It is a little like we have paparazzi sans cameras. Thus the feeling of being in a fishbowl.
Our final destination is Ebenebe in the Anam region of Anambra state. We made it to our final destination after dark, perhaps around eight at night. This is one of the last days the road will be passable by car. Soon the rains will start and will flood the road making the river the only way to access the area. Already the road is rough and the vestiges of inadequately funded state road make themselves apparent as we pass from smooth developed road to mudholes that could swallow a car.
A feast awaited us upon arrival: greens, yam, casava, plantain, and fresh fruit for desert. We were exhausted and hungry after our day of travel and gratefully inhaled the deliciousness prepared for us. After dinner, we had brief introductions and watched an inspiring video from Dr and Mrs Chife welcoming us to the project. Then after settling into our rooms (which I may describe more later), we went to sleep.
The next day, the Rurban Workshop began.
When someone tells you that they are designing a new city that can serve as a model for African development, you know that it is going to be a big project. You assume that the project has immense potential to make a difference in the world and the lives of the individuals who will live there. But you don't really know how large the project is until you grapple with the master plan and the topics and concerns that have been discussed for years leading up to this moment in time. This project is especially wide in scope because it is so unique in evolution. The people in Ebenebe are building this city from the ground up, with every factor being weighed by the community elders. Our first day of orientation was all about understanding the Master Plan and the evolution of this project. After one day, I have a lot yet to understand.
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