PTP and Duogey Camps
I am in Grand Gedeh, a County an hour and forty five minutes away from Monrovia by chopper; twelve hours away by car. I chose chopper, putting the welfare of my ass out in front of bodily fear of flying in a plane without wings. My ears still ring from the grinding chutt-chutt-chutt of the massive main propeller. My hair is matted down from the sound shielding head gear. I remain impressed that the Ukranian flight attendant treated the fourteen or so of us oddball passengers as if we were seated in the first class section of a Boeing 747 Jumbo Jet.
“Thank you for flying with us today,” the flight attendant announced, “this UN X1_ _4_ Helicopter is equipped with three emergency exits. In the event of an emergency landing please open the doors as follows...” The flight attendant proceeded to run through three entirely different ways of exiting the dusty cabin. Door #1, turn the wheel counter-clockwise, flip the latch, push up, then out. Door #2, flip the latch down then up, push out with shoulder, making sure to hold onto the handle to prevent the door from swinging open too hard. Door #3 spin the wheel once left then right. Flip the latch across, push the door out then duck.
The consolation to the attendant’s unfathomably complicated non-implementable instructions was that no one was listening. The seven Pakistani soldiers seated across from me having not seen their wives in a year, looked with fascination and longing at the four foot nine petite blond with heavy incomprehensible accent in tight white blouse, black pants holding a clip board, not looking unlike a librarian. The three Chinese mechanics with oily stained fingernails were deaf to the world. They had lost the ability to accommodate long ago, gazing with dilated pupils and blank expressions out of respective cubbyhole windows as if to communicate, how the hell did we get here? Four Liberian officials were already sleeping with their poochie bellies. I ran my right hand down the front on my travel shirt to make sure I too had not become a overweight bureaucrat and thought, if this plane crashes we are dead.
Me with Emergency Program Manager
Zwedru City is the main city in Grand Gedeh, an amazingly modern city by Liberian standards. Zwedru was the home of former now earless (and buried) President Samuel K. Doe who after killing Tubman in 1980 as a low ranking soldier, ran Liberia for the next 10 years before being ousted, tortured and assassinated himself. Liberian politicians are not unlike U.S. Politicians: They take care of their own. Doe made many investments to Zwedru. The town has smooth paved roads with elevated sidewalks. There is an electric power grid and at night the streets are illuminated with hazy yellow light from slanted poles not unlike really tall ignited collapsing match sticks. There is a wastewater treatment plant. Even Monrovia, Liberia’s Capital, does not have a waste water treatment plant. Two-thirds of the population lives in Monrovia but since 2006, all watery refuse shoots straight into the brilliant ocean that borders the city on its west up and down
I have travelled to Zwedru to visit two refugee camps located outside of the city, where the International Rescue Committee (IRC) will be taking over health care activities beginning December 1. Doctors without Borders (MSF) has run the health operations at Duogee and Ptp camps since their opening at the peak of the Ivoirian civil war five months ago, but now that the situation has stabilized, MSF is moving out. Stable to MSF means that no one is getting shot at and that there are no epidemics. However heroic this organizational stance, there are still 52,000 displaced Ivorian refugee in Grand Gedeh in need of shelter, food, and services. A committee comprised of UNHCR, the Ministry and the World Health Organization (WHO) selected the IRC as the only NGO in the country able to fill MSF’s shoes. This is a great compliment to us but also a heavy burden. MSF comes with its own funding, staff, drugs, equipment, vehicles and protocols. It is the equivalent of the medical marines: They land in a place and do a job as they want to do it. The IRC in the context of development works with Ministries of health and donors to define an intervention with its outcomes and prerequisite funding in a lengthy complicated process rife with politics and differences in policy positions. UNHCR is notorious for asking organizations to accomplish lofty agendas but then nickel and diming them to the point of ineffectiveness. The Liberian Ministry’s interest is to retain its extant health workforce, so tries to set IRC wages at a rate, which will not result in Ministry clinicians leaving their jobs for greater pay. This may sound reasonable in the name of “sustainability”, but results in us not being to attract quality staff to remote places like Zwedru. Under the Ministry rate a physician assistant gets paid $180 dollars a month and a nurse $135 dollars a month. The IRC pays its physician assistants $450 and our nurses $350 dollars. Finally, the WHO basically has no power because it has no money to give and its scientific stances are backdated by years. Yet it espouses health trivia like a tool cool for school third wheel intellect on someone else’s date. It’s annoying and difficult to listen to.
Of course, refugee camps make no sense. I think this as our car pulls up to Dougee Camp, which currently has a population of 7,500 Ivoirians. People who have suffered need a place to be. These places must be obviously organized and well run with flowing water, clean latrines, health facilities, schools for kids to attend, jobs for adults to do, and tents for families to sleep. But if camps are too nice, you have just built a city where people will want to stay. The host country is then saddled with tens of thousands of foreigners to support while it can barely support its own citizenry, which is the case in Liberia, which is among poorest countries in the world. What is the balance?
Qui ettes vous?
The children at Dougee Camp are obvious and numerous. While our team tours the MSF facility, which frankly I feel is something upon which we will improve, a gathering of toddlers and kids amass outside to witness the newcomers. By the time we start our self-guided tour of the Camp market and living areas, we have a substantial entourage following us around. The interaction is undeniably sweet. To the older kids we speak French which result in shy responses and easy smiles. “Ca va?” we ask.
“Ca va bien, merci,” the kids chortle, hands over their mouths.
The younger kids take turn holding our hands. When we stop, they climb up onto our shoes leaning their backs into the crotch of our legs, grabbing them as if they are walking on stilts. Between this cohort there is no exchange of words. Everything is gesture. Everything is about comfort and trust. A few of the children can’t be more than two years old. I wonder the whereabouts of their parents and the trust or fatigue that they must possess in order to let their offspring roam so far from home.
Quick ties
I have experienced this dynamic in many sub-Saharan African countries: Parents entrusting their children’s welfare nearly completely to the care of strangers like myself. This can be something as life determining as the need to transfer a child four hours by long jeep-ride for surgery or something as simple as buying a Fanta for a boy from the neighborhood shack-store. Maybe I’m thinking too hard, but it seems that if you are overworked and tired you can only love so much. In the case of Dougee, parents have fled war, torture, and rape, seen their houses and loved ones burned down and literally carried their offspring in their arms and on their backs to safety. The parents simply don’t have the energy to play with their kids, the kids long for this and consequently they reach out to feel the void. Meanwhile, the parents understand the deficit and do not deprive their children of opportunities even from someone else. Simultaneously, they teach their kids to be self-sufficient, to be tough, to be able to forage and to fend in a world that cuts few people breaks.
As the group walks down the dusty road together, there is a kind of sadness and inevitability to our journey, especially as we IRC folk climb back into our cars. I swear given the chance, the children would not hesitate to hop right in. But we are not conscious interlopers, nor are we here to take anybody away. As I said, we are coming to Dougee and Ptp Camps very soon and as much as this can be said of the residents, are here to stay.
Three Kings
