The Toll of Ebola

I was interviewed recently about Ebola and my time in Sierra Leone in 2014 during the crisis.  In mulling things over I thought there might be a story there. So here it is.

Pay the Price

I watched his two brown fingers thump against my arm.  “Aha,” he muttered under his breath, then I saw the needle poised slowly before it plunged into the vein.  Has it come to this?  I thought morosely as I slipped away into somnolence while my blood dripped into the bag. Shortly, I awoke with a start to find Mamadou grinning down at me. “Okay, Jimmie,” he grimaced, “all done.”

“You rest until dark, then go. Arrangements are in place. You’ll be safe.”

I nodded assent. I was indeed ready to go.  Two and a half years in Sierra Leone was more than enough. I had dawdled and procrastinated, found myself bound by slippery ties to a place that I didn’t really like and to a culture that I could not fathom.  Yet that is partly why I stayed to try to make some sense of it all.

I spent nearly two years as a Peace Corps Volunteer English teacher at St. Joseph’s Secondary School in Bo.  Initially, I enjoyed it immensely. The wonder and exoticness of it all overwhelmed me. There I was in a small trading town in the heart of Africa charged with the responsibility of inculcating the virtues of the English language to several hundred eager young minds.  It was certainly a task.  At first I could not understand their upcountry palaver. In turn they found my American English distinctly different from the British inflected pronunciations Sierra Leoneans judged proper. We worked through this, however, and focused a bit on grammar, but mostly on the memorization of poetry and Shakespeare and whatever else was prescribed in the national curriculum.  I found that a teacher’s authority was conscribed. Innovation was frowned on.  Classes became repetitive.  It soon became a job.  But still the students were fun. Their ideas and questions about American cowboys, about snow, about Obama, all provided grist for conversation. They, in turn, readily talked about their villages, the roles of women, age ceremonies and witchdoctors. Witchdoctors intrigued me. As time permitted I sought out a few traditional healers and asked them to explain their craft.  Few spoke even rudimentary English. While they were willing to treat me or sell me various potions for this or that, virtually all were reluctant to reveal any secrets of their very mysterious operations.

 

I guess in the absence of other diversions, I became fixated on learning more about the witchdoctor business. So when my Peace Corps assignment ended I cashed in my plane ticket home and tapped my re-adjustment allowance and stayed on in Sierra Leone.  I moved east to the town of Kanema, over towards the Liberian border.  There I found a room in a house allocated to Raymond Chretien on the medecins sans frontiers compound.  Raymond was fiftyish, a medic of some sort with the Foreign Legion, who had signed up with MSF apparently to atone for a life of sin.  In any case he was a quiet man utterly devoted to his new calling.  Although house mates, we led solitary lives.

I contacted several of the notable healers in the area.  I explained I was interested in the psychological aspects of their work, that is did healing happen because patients thought it would?  No one was able to separate out this aspect of their calling, for them it was a holistic undertaking.  Of course folks felt better, they told me, because the cures worked.

Perhaps I got to know a man named Mamadou best. He had more English that the others and practiced at the crossroads of Kalihoun, about twenty clicks from Kanema.  He would let me sit and observe his consultations, his preparations of remedies and his incantations as he administered them.  He and other practitioners claimed real knowledge. My judgment was that it worked. Some of the herbs obviously had real medicinal value, but importantly, the people believed.

I fell into a routine: visiting, watching, talking with patients afterwards, writing up some notes.  Back home in Kanema I became friendly with Isobel, at first it was just a sexual transaction - she was very good at that - but I became fond of her and she sort of halfway moved in with me.

Then it began.  Raymond came home exhausted and agitated. He reported the clinic was being overwhelmed with sick and dying patients.  All had contracted a hemorrhagic fever called Ebola.  They ran high fevers, had aches and pains, vomited and quickly died.  The disease spread rapidly, already several of the nurses contracted it.  Apparently, the contagion passed through bodily fluids. After a week a nationwide emergency was declared. Roadblocks were established. Kanema was quarantined. No one in, no one out. People were admonished not to touch the sick or wash the dead. Public funerals were prohibited. These strictures caused chaos and panic in the region.  Who was infected? Who was not? What could you eat or drink? Who could you touch?  Paranoia became widespread. Everyone was suspected of infection.  I too panicked.  This was not my country, not my people, not my disease. Time for me to leave.

I formulated half a plan to get up to Kalihoun near the border with Guinea and then onwards to Bamako, Mali and out of Africa.  Just as I was beginning to pack, Isobel arrived.  She pecked me on the cheek, said that she was feverish and asked for some aspirin. I gave her some.  She collapsed on the bed.  I felt her forehead, indeed she was hot.  Too hot for a headache!  I panicked anew.  If she had Ebola she would be dead in days, me too if I stayed.  I kissed her sweaty forehead, said I had an appointment in Kalihoun and would be back tomorrow. I left.

Local transport, i.e. a beat up old pickup truck, was still going north. I paid my fare and jumped on the load.  Mamadou greeted me cordially when I entered his compound. “Jimmie, you are welcome. What brings you to my humble abode while all this fracas is going on?”  I explained that the quarantine and the curfews had forced me northwards. It was time for me to leave Sierra Leone. I could not get to Freetown. Monrovia too seemed like a bad idea. I needed to keep moving north. Could he help?  Mamadou pulled on his raspy beard and agreed to think the matter over.  Later over a cup of sweet tea, he opined that he could help, but that it would come at a price.   “Certainly,” I agreed, “I am ready to pay.”

“No, not money,” he said.  “Blood.”

“Blood,” I asked?  “Yes,” he replied, “your blood.”

He elaborated, “You see Jimmie, white man’s blood is an effective medicine against this Ebola.  We have learned this because the white men, the doctors from Liberia who contracted the scourge, did not die from it. They lived. Their blood was powerful. Their blood was able to fight the fever back.”  Mamadou paused. Then continued, “That’s what I need, your blood. I need it for me and I need it for my patients. Blood is the price for my help.”

I mused this over.  Asked what help he could give, Mamadou said his brother was a trucker who travelled back and forth to Bamako.  Currently he was in Guekedou, Guinea. If I got to him he could deliver me to Bamako.  Mamadou added that his brother would expect money.  And for getting to Guekedou,  Mamadou said a nephew regularly made the trip by back paths on a motorcycle.  Again for a fee his nephew could take me there.  I only pondered a short while.  “Agreed,” I sealed the deal.

In the morning, Mamadou sat me down and prepared to draw blood.  “Don’t worry,” he said, “I have done this before. My equipment is boiled clean. There will be no infection.”  I gritted my teeth, told him that I hated needles. “Then, don’t look,” he wisely advised.  Sadly, I did look, but it was over quickly.

That afternoon his nephew arrived as promised.  We skirted out of Kalihoun down forest paths, splashing though shallow streams and swarms of butterflies. We crossed several larger streams in pirogue canoes. The paddlers knew the drill. Theirs was a standing arrangement.  One time the motorcycle went in one boat and we in another.  It was all very efficient.  Apparently we crossed into Liberia first and then on into Guinea. I was mesmerized by the droning motor, the weak light probing ahead and the shear need to stay awake enough to hang on. We snuck into Guekedou just as first light was breasting the eastern sky.  I paid and tipped the nephew nicely as he turned me over to Mamadou’s brother.  Soon our truck headed north.  I was well hidden under the load in order to pass the border station into Mali.  Brother explained that the border was technically closed, however, “local considerations” took care of that.  Afternoon found me in Bamako.

Air France judged my Dad’s credit card was valid so sold me a ticket to New York.  Despite a bit of a hassle at the airport because I did not have Malian stamps in my passport, I left that night for Paris.

I am writing this summary of the past few days as I fly towards New York.  I don’t see it as a justification for my action, which was probably morally despicable. Rather this is an explanation, perhaps written with some premonition.

CDC CASE FILE 0044 of October 1, 2014.   The journal replicated above was found at the Econolodge near Kennedy airport amongst the belongings of James R. Greer of Tulsa, Oklahoma.  Mr. Greer called 911 on September10, 2014 to report that he was sick, probably with Ebola.  Appropriate medical teams evacuated him to Jamaica Hospital, Queens where he lapsed into a coma and died on September 13.  Greer’s room was sanitized and tracing conducted for all his contacts. All of the passengers seated near him and the crew in the rear cabin of the Air France flight were isolated, similarly with the staff of the hotel. As of October 1, the taxi driver who drove Greer to the hotel has not been identified, however, given the passage of time it is improbable that he was infected.  French authorities traced possible contacts at Charles De Gaulle airport and with Air France staff in Bamako. Malian officials also tracked contacts in their nation.  Happily, no confirmed cases of Ebola have yet been identified arising from links to James R. Greer. Finally, interestingly, Mamadou Deng, the well known traditional healer from Kalihoun, Sierra Leone is reported to be a survivor of Ebola.  

Chad - The Reality of Africa

This is a review of Ambassador to a Small World - Letters from Chad by Christopher E. Goldthwait, Vellum, Washington, D.C. 2015. Note that I did two stints at the U.S. embassy in Ndjamena, so can readily attest to the validity of this memoir. 

In this memoir Ambassador Chris Goldthwait recounts his nearly four years (2000-2003) as the U.S. envoy to Chad.  Among other things it is an interesting recitation of travels to exotic locations, often over difficult roads, in one of the world’s most out-the-way nations.  However, wherever he went - and he apparently went almost everywhere one could go in Chad - Goldthwait encountered friendly hospitable folks who always offered refreshments and food. He went to the stark northern deserts, to nomadic enclosures near Lake Chad, to Zakouma Park, to the far eastern border (before the area became inundated with refugees from Darfur) to the impoverished, neglected (but better watered) south, and to the oil fields both before and during exploitation. Goldthwait describes the protocols of ambassadorial travel in Africa - official calls on prefects and chiefs, meetings with elders, meetings with communities, meetings with civic groups - all replete with endless rounds of speeches, explanations and requests for assistance.  Goldthwait notes that the objective of such travel was to learn about the hinterland, about the people and their problems. He accomplished that, but a key impact of his visiting was simply for an American ambassador to be present.  Presence alone demonstrated that the wider world recognized the struggle of life in rural Africa and validation of the hopes and aspirations of its inhabitants. 

Goldthwait also provides wonderful descriptions of the capital city of Ndjamena and its residents ranging from the most distinguished to those of lesser means.  Additionally, through Goldthwait’s eyes the reader gains solid insights into Chad’s turbulent history, its relations with France and with neighbors, its troubled internal politics, and its near constant state of conflict and rebellion.  Despite faltering, the ambassador saw some progress and more avenues for additional progress as Chad slowly sheds its provincialism and emerges more fully into the modern world. 

While the memoir describes the life of an ambassador - and Goldthwait made clear that he disliked some aspects of the job - it does pose and ponder a number of questions related to American policy toward Chad, whether democracy objectives are obtainable, whether international oversight of Chad’s oil revenues is workable, and whether western development assistance is the right approach to the pervasive problems of poverty.

The memoir is constructed by juxtaposing a series of letters that the Ambassador wrote to friends back home.  Although while taken together the letters provide a cohesive portrait, they appear in the book in a non-chronological order. A reader can get confused about what happened when. Also there is a bit of redundancy as various letters re-plow the same ground.  That being said, the book is a must read for any outsider on his way to Chad, but it is also relevant to those who want to understand Africa and/or the roles that United States ambassadors play there.

Embassy Monrovia Under Fire

This is a review of The Embassy - A Story of War and Diplomacy by Dante Paradiso, Beaufort Books, NY 2016. 

This book tracks the violence in Liberia during the fateful summer of 2003 when the ineffective opprobrious government of warlord risen-to-president Charles Taylor was under siege from several groups of equally repugnant rebel forces.  The capital of Monrovia became the focus of conflict with rebels pushing into Bushrod Island and the port area where they confronted Taylor’s rag tag militias defending bridges to the city proper. It was a maelstrom of horror, of indiscriminate shooting and shelling, of intimidation and extortion, of food, water and electrical shortages, of limited medical services.  Thousands perished.  Yet neither side was able to dislodge the other, so the situation spiraled ever downward for the hundreds of thousands of civilians caught in the fray.

Even as conflict raged Liberians, including representatives of the rebel groups, met in Ghana in an effort to devise a negotiated solution to the crisis.  While they blathered, Taylor stubbornly sought to save his skin and rebels consolidated their positions.  Surprisingly the Ghana talks ultimately devised a solution that would require Taylor to step down, rebels to withdraw, a regional peace keeping force to be inserted, and a transition established that would lead to an elected constitutional government.  The problem was to put this into effect. 

Readers may recall that the United States had a special relationship with Liberia because it was created by freed slaves being repatriated to Africa in the early 19th century. Although never a colony as such, the U.S. always kept a watchful eye on Liberia and that friendship was reciprocated.  Liberians always looked to America to help sort out their internal difficulties. The fact that the U.S. had not acted earlier to refute Master Sergeant Samuel Doe’s bloody takeover, nor thwarted Charles Taylor’s violent accession to power notwithstanding, the expectation for America’s help in 2003 was widespread. 

The violence chased most embassies out of Monrovia, and more expatriates left as conditions deteriorated, but the U.S. embassy headed by career diplomat John Blaney stayed on. At his instigation the ambassador himself and his staff sought throughout the turbulent months to maintain a presence and to work to halt the conflict.  They were regularly under fire as shells rained down on the embassy compound and because of that under enormous pressure from the U.S. military to evacuate, but the ambassador recognized that the U.S. presence was key to morale in the city and could be instrumental in achieving a cease fire and in implementing the political transition.   Blaney convinced Secretary of State Powell of the righteousness of this view and so stayed at post.

The book then is a blow by blow, conversation by conversation, policy thought by policy thought of what transpired inside the embassy during this period. It gives an inside look at how diplomats saw the crisis and what they did in response. Indeed, they were collectively a heroic bunch.  They put their lives on the line more than once, no more so than when the ambassador led a foray across the battle lines into rebel held territory to meet with rebel leaders. Certainly it was this activism and later follow-ups that compelled the rebels to withdraw and to turn over their positions to the regional peacekeeping force. 

The book is written in the present tense, so the reader remains engaged as the saga unfolds. The author employs lots of quotations, citations that were obviously drawn from memory and recorded during interviews with folks many years afterwards. This, of course, permited selective recall of what one would have hoped to say.  Additionally, the book is interesting because the author did not rely upon any official documents so there are no references to embassy reporting that would have unequivocally buttressed the narrative.  However, despite the fact that this is an unconventional history, it is an accurate one. The events described did happen and did unroll along the lines discussed.  Praise is due to the ambassador and his team for their insight, perseverance and competence in damping down a war and helping Liberia achieve peace and progress.

The President's Father - Who was He?

Following is a review of The Other Barack - The Bold and Reckless Life of President Obama’s Father by Sally H. Jacobs, Public Affair, NY, 2011. 

This is a fascinating detailed look at Barack senior, a brilliant man intellectually, but burdened with foibles that hampered, and ultimately ruined his life.  To start with, however, Barack was a marvel.  He was bright, inquisitive and, above all self confident.  He came from a Luo tribal clan that inhabited a village on the shores of Lake Victoria Nyanza in western Kenya.  Barack’s father Onyango was forward looking and early on sought wider horizons by signing up for World War I and then becoming a cook for expatriate families in Nairobi.  Onyango was a distant parent, very authoritarian and demanding. His relationship with his children, Barack in particular, was fraught with strict discipline, including beatings.  Barack, in turn, would mirror such behaviors in dealing with his own children, that is, those who lived with or near him in Kenya.  (Obama junior, never really lived with his father, so avoiding learning to imitate such abusive behavior.)

Barack senior was the star of his schools from elementary forward.  He arrogantly asserted his superior knowledge and frequently was at odds with authorities.   This pattern of questioning, belittling and demeaning others was to mark his personality throughout his life.  Barack thought himself and his opinions infallible and he never learned to get along with superiors, especially in academic or workplace settings.  In fact, his obtrusive behavior, not his academic performance, prevented him from going on to higher school and university in Kenya. Also it later, along with his unconventional life style - two wives and families, partying and drinking - kept him from getting his Phd from Harvard. 

Barack left his first wife Keiza and two children in the village while he worked in Nairobi. With help Barack lucked into a university opportunity in America. He chose Hawaii where he stood out on campus not only because he was the only African, but because of his formal dress, white shirt and long pants, on America’s most laid back campus. Although he studied hard, he also partied hard. Known for his acerbic wit and svelte dance moves, Barack was also a ladies man. He met Ann Dunham and swept her off her feet. She became pregnant and they married.  Barack successfully dodged questions about his Kenyan family.  Obama Jr. was born IN HAWAII, but Barack and Ann never really set up a household together.  Within a year of the baby’s birth, Barack Sr., armed with a degree, was off to Harvard.  Ann and the baby never followed.  At Harvard the patterns repeated.  Obama worked hard and focused his mathematical prowess on the new field of econometrics, where he became one of the cutting edge practitioners. Outside the classroom he made the rounds of bars and clubs. He wooed and won a young woman named Ruth Baker, and promised to take her back to be his white queen in Kenya.  Although Barack admitted he had a wife and children in Kenya, he apparently never mentioned Ann or Barack Jr.  He ultimately fathered two children with Ruth and one more with his last wife Jael.  

    

Back in Kenya Barack always had a chip on his shoulder. He thought he merited more - better jobs, greater recognition and greater recompense than he received.  He was enormously self-focused and although generous in the sense that he freely spent what he had on entertaining friends, i.e. drinking, and in support of “big man” obligations towards extended family, he never developed warm personal uncritical relationships, apparently with anyone.  He did however, have legions of acquaintances and social relationships with Kenya’s Luo elites.  Often they were in school together or had formed interlocking ties as part of the new ruling elite. Luos especially pulled together in Kenya’s early years as they justifiably felt they were being side tracked by Kenya’s ruling Kikuyu elite.  Barack went though a half dozen jobs, but his arrogance, poor attitude and alcoholism - he was always hung over and often drunk during the day - regularly overshadowed his solid economic work. Due to drinking, his family and financial situation became increasingly chaotic. As his star sank, friends rallied around less and less to help out financially or calm family tensions.  One night, drunk as usual Barack, aged 46 rammed his vehicle into a tree and was killed instantly.  

  

Throughout this book, author Jacobs accurately sets the context, both cultural and political.  Barack was hemmed in, bound, if you will, in many ways by his Luo cultural heritage where the roles of men, women and children were elaborately prescribed. Men were dominate and enjoyed almost absolute freedom.  Barack certainly reflected that value.  Perversely that value did not translate well into American society or into westernized mores of contemporary Nairobi.  Secondly, Jacobs keenly understood the political situation in Nairobi in the independence era. She aptly describes the Kikuyu/Luo tension, Tom Mboya’s role and after his assassination the descent into even more acrimony.  Although Barack Obama senior was a man of both the village and the city, he was caught between worlds - between rural culture and modern times -  and never really found his way.  Personality wise, he could never make the adjustments necessary to adapt. Indeed there is no evidence that he even tried.  As uncomfortable as it was, he seemed content to be who he was. 

Comment: Obviously the reader must draw his own conclusions about how and why Barack Obama Junior turned out so differently from his father. The contrasts between the two men are astonishing. Barack Senior was a self-absorbed egomaniac whereas Junior is a man of vision, empathy and compassion.  Such are the mysteries of humanity. 

Validation:  I was a Peace Corps Volunteer in Nyanza Province in western Kenya from 1968-70.  Being in the heart of the Luo tribal area I absorbed by osmosis and interest their view of national politics and their judgment of being discriminated against in newly independent Kenya.  I was tear gassed at Ahero when Tom Mboya’s funeral cortege came through and cautiously stayed home when Kenyatta visited the Kisumu hospital. The theme of exclusion that is so prominent in this excellent summation of Barack Obama Senior’s life indeed permeated down to the most rural of Nyanza’s villages.