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Post-Ebola: Grief and Hope
Visiting our friends in Sierra Leone was poignant.
I was so glad to meet with our friends who survived Ebola. So many died, and no family was spared. We got to listen to stories of so much grief. Bearing witness is so hard and so necessary for us.
We were warmly greeted by Dr Bome, the District Medical Officer now in the Pujehun District, and a long-time colleague. He crowed with delight when we walked in the office and a grin almost split his face.
Then we talked about Ebola and his face drooped with sadness. "They went so fast. They'd get sick, then they'd be gone. So many died - more than the records show. Whole families were wiped out within days. We tried to protect ourselves, but that meant we couldn't see our friends and neighbors, We had to turn away. I thought I would go mad."
He went on to say, "We need MOMS work more than ever. The women you trained made such a difference. They were willing to work when everyone else was afraid. When can you come to my district? I need you."
So many of our friends told us about the deaths of their husbands, children, parents, siblings. Adding to the loss was a sense of personal failure. They weren't able to protect their loved ones from the disease, then they weren't able to care for them but had to watch them hauled away by people in grotesque clothing. Sometimes they didn't know for days that their loved one died. They weren't able to follow their traditions to say goodbye, but had to deal with the fact that many had been shoved into mass graves.
Paramount Chief Kallon, who was the one who first welcomed us to Sierra Leone and was our first sponsor, shook his head. "It was like the war. Every day, more people died, and we had to bury them fast. Every day, they brought more bodies for burial, and we didn't even know who they were."
Chief Kallon lost his beloved wife and a child. He took himself into the bush and isolated himself for 21 days after tending his wife and child. He knew that the people would insist on tending him if he fell ill. He remained healthy and returned to a chaotic scene. Most of the clinic staff had died and he thinks that hundreds of his people died, but he'll never know the truth. "Oh, it was horrible, so horrible. I don't know if I'll ever get over this."
Coming back through Washington Dulles Airport, we sat in a small room with others coming from West Africa. Homeland Security wanted to take our temperature and ask questions, repeatedly, before they released us. We talked with the others waiting with us. One man's face twisted with grief as he talked about the death of his brother. "I couldn't see him, couldn't touch him, couldn't say goodbye." He shook his head. "It was so hard. So hard."
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And hope remains
People were talking about the future. "Once we beat this, we'll have to work hard to make up what we have lost." "We have to get back on track." "We will move forward, we must."
We talked to two other District Medical Officers, in the Kailahun and Bo Districts. With Dr Bome of Pujehun, all are eager for us to train more women to serve their communities. Dr Squire, of the Kailahun District, told us about the communities that are 4-5 hours from the hospital by vehicle - and it takes 4-5 hours for a vehicle to get thereas none of the residents have a car. "The women need someone to teach them to be healthier and reduce the number of complications. Preventive care is essential, and your work will make the difference. Please come back as soon as you can."
We talked about our hope of training local trainers in 2016 - if we can raise the money. Dr Bome said, "We will pray. They money is out there. We will pray."
A few bright spots shined. Each District (like a county in most US states), now has at least five ambulances. Travel time is still slow, of course, but now the people have a way to get to the District Hospitals.
And in the By-Laws that the Paramount Chiefs instituted across the nation, one clause outlaws the cutting of women's external genitalia. The government made a major effort to finally outlaw cutting and inform the Sowies, the cutters. As many of you know, the women we teach are also Sowies.
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Our new class
The journey to Tikonko, our teaching site, was one of the easiest we'e ever had! Tikonko is less than 10 miles from our headquarters in Bo. So we stayed home, and commuted over roads which steadily deteriorated in the monsoons. The first trip took about 20 minutes or so, but by the end of the training, the trip took about 45 minutes.
Getting started
This session was different in other important ways. This was the first time that we have licensed our curriculum to another agency. The Rural Health Care Initiative (RHCI) was started by a Sierra Leonean woman who was a refugee during the Rebel War. After her husband's death, she and her children traveled to Minnesota to start a new life. But she didn't forget her home. RHCI works to support the clinic in Tikonko and extend health care more widely in the community. Dr Carol Nelson, an RHCI board member, joined us to teach our program, and RHCI is now set to continue.
Results begin rolling in
Each morning, we always ask, “What did you learn yesterday?”
The women said,
- You told us that forcing out the babies by pushing on the uterus can be dangerous. We won't do that.
- You told us that labor is work, and women need food and water during this work. We will make sure that women get what they need so they have strength.
- You told us that women who move around during labor and stay off their backs often have smoother labors. We will support women in getting into positions that are better for them.
- You told us that scar tissue stretches poorly, and we know the government has banned cutting. Now we also understand that these tissues have a purpose, and cutting a woman does long-term harm. We will not cut - and we will explain why it is not good for women.
We worried because several of the women just didn’t seem to be retaining the material very well. We redoubled our efforts to review the material. As they came to understand that we were serious, and that women who fail the exam do not get certificates, they started studying at night and on weekends. Because the women have little experience with schooling, they must first learn how to be good students, then learn the material. This can be a real challenge for them and for us.
On the day of our grand review, our hearts sank. In spite of the reviews and activities, about eight or nine of the 34 women did very poorly. On exam day, we were really nervous – how would we handle it, if so many women failed the test?
And the test....
They women did well, overall. Sixteen of them got 90% or better! We were so happy and relieved!
We did have three women who did not pass the exam. We consulted with the head woman of the group. She wanted us to talk to these women right away, so we did. We explained that they are still part of the group and are valued. We also told them that they can retake the course when it is offered again. They were very sad and a little angry -- and we accepted their anger and sadness.
Our class isn't easy, and those who pass the exam have accomplished something that is really significant. Our certificates don't come cheaply; they mean that the holders have demonstrated important skills and knowledge.
The celebration, attended by many in the area, was wonderful. Several women participated in skits and taught the audience about key concepts. The people seemed a little surprised at the women’s confidence and knowledge. We were delighted at how well they did, and they were justifiably proud of themselves.
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A real home for MOMS
Our long-time supporters have read the stories about our moving headquarters. I've tried to not burden you with the tales of vermin, theft, and devious landlords. But we have survived more than a few challenges in having a safe space.
Well, it is done. We now have a place where we can relax and stay for a while. Jitta and Junior (our Sierra Leonean staffers) have built a house which MOMS can use as a headquarters. We are located on Vandi Street, in New York Section, Bo City.
We have bedrooms for volunteers, a dedicated office space, and a store room, along with a parlor, dining room, and kitchen. The location is safe, and we have a good, deep well. Junior and Jitta are planning a tower to hold water tanks, allowing us to have running water! Once we figure out how to best get electricity (we do not want to pay for installing 16 poles and stringing the lines, only to have an unreliable, weak supply), we'll have internet access and can run our laptops.
We still have to get furniture and finish the outbuildings and wall, but the house is bright and airy and will be a good place for us to rest and work. We'll have some signs built and post them proudly.
The Government of Sierra Leone requires us to have an in-country office, and specifies some of the furniture and signage. We are glad that by the end of the year we should be fully compliant with these regulations.
The Government also requires us to have certain levels of staffing and they want us to buy a vehicle. We have our two paid regular staff, and we pay stipends to the members of our MOMS Advisory Council. We are trying to hold off on buying a vehicle. We need a really sturdy 4WD truck-based vehicle to get us into the remote hills and swamps - and back - and those are expensive!
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And the future?
District Medical Officers in three areas have formally and privately invited us to work in their areas. Dr Bome, who had been in Kailahun District and has moved to the Pujehun District, begged us to begin working there. Dr Squire, who is now in Kailahun District, said there are so many areas which need MOMS, and he needs to replace the many who died in the Ebola epidemic. Dr Turay of the Bo District, where Tikonko is located, said he hopes that Tikonko is the first of many MOMS sites.
We must begin our delayed dream of training local people to be trainers. This requires us to teach them how to use MOMS model of training, which is unlike anything they have seen before. We must also then work with the new trainers with three cohorts - they watch the first time, they work with us the second time, and they conduct the course under our supervision the third time. We must then provide them with the visual aids they need.
This will cost about $50,000 or so. Not much when you think about the politicians who host dinners where their supporters pay $50,000 per plate. But for me, it is a lot. I need help raising this.
We have identified two grants that we will apply for. We applied for another last week. We received a small grant last month. We will keep plugging away because we promised that we would "shake the trees" to get the green leaves that enable us to make a difference in Sierra Leone.
Do you have some time? Do you have a little extra money? Please help. Women and children will, quite simply, die without your help.
Not drama, just fact.
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Thank you
We rejoice in our many successes and your help. We are delighted with the prospects. If you want to know more, just ask me!
Now we are back from working the long days and slapping mosquitoes, we must do what for us is the hardest work - raising money. We must also prepare the material for the Train-the-Trainer sessions and plan the implementation in detail.
You, obviously, are critical to our success. You make it happen.
We ask your continued support. Please be generous. Please volunteer.
Thank you, thank you.
Trish Ross and Chris McManus
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Contacting MOMS…
We want to hear from you, so we make as easy as we can.
Web site: www.GlobalMidwives.org
On our website, we've tried to include lots of info for our supporters and possible volunteers. You'll find links so you can donate via PayPal or Razoo. Let us know if you would like to see other or more info.
Facebook: www.Facebook.com/GlobalMidwives
On the Facebook page, we offer regular updates, photos, and stories, with links to articles and info about organizations doing similar work. Under the cover photo, you'll find a link that takes you to Razoo.
We also cheerfully accept checks; make them out to MOMS.
Mailing address: PO Box 1656, Gualala, CA 95445
Phone: 707-884-3621
MOMS is a 501(c)(3) so gifts usually are tax-deductible. Our Employee ID Number, EIN, is 93-1254632.
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