Wednesday, May 27, 2009

The Places We're Working

Cote d'Ivoire

Nestled between Liberia (our former home) and Ghana (our future home), Cote d’Ivoire has seen its share of troubles over the last decade. Once a stable and fairly prosperous land, since 1998 Cote d’Ivoire has been broken by civil war and turmoil, leaving its diverse population of nearly 20 million shaken and desperate for normalcy. The nation has settled a bit in the last couple years, but an uneasy peace remains. Much of the country remains dominated by former rebels, but at least the parties are talking and hope is high for new elections.
Since the colonial period, Cote d'Ivoire's economy has been based on agriculture, forestry, and fishing. Cote d'Ivoire produces 40% of the world's cocoa crop and is a major exporter of bananas, coffee, cotton, palm oil, pineapples, rubber, tropical wood products, and tuna.

Cote d’Ivoire is also a country where Renita will be active. As a regional partnership manager for Partners Worldwide, one of her responsibilities will be coming alongside business and Ivoirian organizations helping businesses grow—just like she’s doing in Liberia. In the process, she’s gotten to know her point person on the ground in Cote d’Ivoire—Dea Lieu(right). Dea, who received agricultural and theological training from the US, is introducing new methods to help Ivorian farmers get better yields. He also plans to share better animal breeding methods with farmers; help in macro-managing communities; and minister to spiritual needs to help them grow in their Christian faith. When farmers complete Dea’s program, they receive livestock and a loan to begin their own farm operation, so they can feed their families and eventually the community.
Until she can meet up with Dea in Cote d’Ivoire, Renita is doing what I’m doing—maintaining long distance connections through the Internet and telephone. She’s sharpening her French with Dea, and both are excited to be working together. Right now, Dea and the farmers he’s working with are focusing on raising chickens, pigs, snails, and a large rodent call a grass cutter or cane rat. I imagine its rather tasty.

The grass cutter (Thryonomys swinderianus). A good source of meat, and relatively easy to raise.

Snails for sale. Rubbery in texture, I think they taste like mud.

Making palm oil the old-fashion way.

Dea, dishing up the dirt on how to enrich soil for local rice growers.

Some of the women of the 18 Mountains Region, where Dea serves.

Monday, May 18, 2009

Father and Son Day at the Local Sanatorium

I think I left off with "...but I still feel very shaky." Turns out, I was only halfway through my bout with malaria and its complications. Last Sunday, the 10th, I began my medicine and by Monday I had lost my fever and body aches, but still did not feel over it. Tuesday came without much improvement, and by Wednesday, when I had to cancel a much anticipated trip to a Bread for the World meeting in Washington DC, my fever had returned, along with an alarming inability to catch my breath. Both my primary care doc and the CRWM missionary doc recommended that I find my way forthwith to the Butterworth Hospital Emergency Room. Got there around 7:00pm and was admitted a few hours later. My malaria, treated late, found enough time to leave a parting gift: pneumonia and edema. They hooked me up to several IVs, shoved an oxygen tube in my snout, and I settled in for another week of crapola.

On Friday the 15th, I had a visitor. Our fourteen year old son, Noah stopped by to say hi, although cheering up Dad was not his primary reason for being at the hospital. He was there to join me as a patient. He was scheduled for surgery in a couple hours.

I mentioned a few weeks back that he had speech difficulties stemming from a condition known as velopharyngeal insufficiency, which involves the lack of the soft palate to close off the throat properly during speech.

The two hour surgery on Friday was a work of art and very successful. I was feeling much better, so I was allowed to stroll over to the recovery room and join Renita for a reunion as Noah returned to groggy consciousness. We left the hospital together Saturday noon. He's healing rapidly and though sore and on liquids, felt good enough to attend the school dance on Saturday and is back to school today.
As for me, I feel great compared to how I felt. In about three days, I've lost 20 pounds of fluid from my body, my aches and pains are back to a normal 54 year old level, I'm treating the now mild pneumonia with antibiotics, and mostly I just feel like I have a cold and am still catching up on sleep.
Renita has set new levels of steadiness and strength during these two weeks. Both Noah and I in the hospital in pain, and she ran the show, took care of us, and never flagged for a minute in her other tasks. I marvel.
Ok, but that's enough about us for a while. Next time, if circumstances permit, I want to highlight some of the great work Renita is involved in-- in Côte d'Ivoire.
Below are a few more cheery hospital scenes.

Could really do without the tube, and the oxygen dried my nose, but I needed it.

Noah, ready for his Friday date with the scalpel.

Recovery room.

His whirlwind of a Mom adjusts something while Hannah hangs out.

Just a couple o' patients, swapping war stories.

Monday, May 11, 2009

Doin' the Malaria Mash... in Me
As you know I like to be pithy, erudite and educative on all my posts, but this requires more energy than I fear I can muster. We'll see. The short version is I have malaria, which occasionally happens when folks come back from the tropics. The disease is caused by protozoan parasites of the genus Plasmodium. Five species of the plasmodium parasite can infect humans; the most serious forms of the disease are caused by Plasmodium falciparum. Falciparum lives in the gut the female mosquito and when she bites, the microscopic little creeps enter through an anticoagulating mosqito slobber, and make a bee line to the liver.
Patton would be put to shame after discovering the brilliance of this little bug’s strategic assault on our body. The parasite basically infiltrates a Trojan horse into our liver, where it starts duplicating itself. Meanwhile, it is sending out a cloaking signal (similar to the Klingons in Star Trek) from within this Trojan horse so as to remain undetected by our body’s immune system. In my case, there it rested, in my liver, for at least six months.

Last Monday, however, it was time to come out and party. From Home Base Liver, the parasitical creeps searched for my juicy red blood cells. Penetrating those, it started duplicating within them as well. Usually such infected blood cells would be exterminated in the spleen. So to work its way around that, each of these little demons produces as much as 60 different types of protein which, when on the surface of the blood cell, make it stickable to the surface of blood vessels, hence avoiding potential doom by not making it to the spleen. And these proteins are the first moment when the parasites become detectable to our body’s immune system. However, by the time our body comes up with some antibody, the millions of parasites are already switching to one of its other 59 proteins. The body’s immunity system becomes a toothless bystander, because the number of different and constantly changing protein combinations are essentially infinite.

Then things get gruesome. About every three or four days all the infected blood cells burst, exploding from over population and sending a wave of fever onto Yers Trooly, so that the next batch of demon creep babies can go about the body in search of fresh red blood cells again.
As I say, Monday the 4th of May, at around 9:00pm, was M-Day. For the next four days, I suffered convulsive shaking and chills, disorientation, high fever, extreme fatigue and body aches, and constant headache. I thought it was "just the flu," so I decided to ride it out. By the end of the week, I understood how people could die from whatever it was I had. When I noticed signs of an enlarged spleen and anemia, I began to wonder. Then colleagues Mary Crickmore and Steve Sylwulka really raised my flu doubt even more by telling me, independently of each other, that it "sounded like malaria" and "are you SURE its not malaria?" Then I realized they were probably right. I'm very fortunate it did not develop into cerebral malaria last week when I was thinking flu, because in that case Renita would be writing this post, telling you that I am DEAD.
Sunday I was feeling so bad I knew I needed to see somebody. We first went to a Grand Rapids Urgent Care Center. The doc there-- real nice fella-- was worse than useless, did not understand or apparently believe it could be malaria and thought maybe I was having a heart attack. Or maybe it was Lupus? TB? Talk about myopic! We left frustrated and $350 poorer. Finally, I got hold of the CRWM doc, Dr. Holwerda, who in fifteen minutes diagnosed it correctly. I started $5.00 worth of medication immediately, but am still very shaky.
I was lucky. In Africa malaria kills 3000 kids every day.

The cycle. Note the juicy explosions, both within the liver cells and red blood cells. This party cost me a few million.

Love this National Geographic shot. An exploded red blood cell and another just about to go. Each yellowish projectile is yet another living parasite, ready to find a new blood cell in which to multiply.

Sunday, May 3, 2009

Missing Trokon

There are some blog posts that stay in my mind for a long time before I put it out there. There are a collection of themes rattling around in my head at any given moment, waiting for the time when it feels right to bring one of them out to you. This one has been in there for maybe two years.

Today, I’m musing about Trokon Morris. For some of you, especially those who followed us on the blog The Reeds in Liberia, the name is very familiar. A privileged few of you even met him. Trokon, now 14, lives in a 12’x18’two-room reed matt and zinc covered shack down the road from where we lived. Like his friends, and most children in Liberia, he is extremely poor, without access to health care, adequate food, shelter, reliable water, or sanitation facilities. He lives, not with his birth mother, because she says she is unable to afford to take care of him, but with another family. How his life would be any more impoverished with her instead of this family I cannot imagine, and I think he knows he’s been dumped.
His de facto mom, Sara, is on her own and cares for Trokon and three other birth children—Eastman, Jackson and Hannah. Sara suffers from severe vitiligo, a skin pigmentation disorder, which brings her shame and makes her something of an outcast. She survives by selling goods and produce from a small table in the Foster Town Market.

Trokon, along with Eastman, were the boys I came to trust the most in Liberia. They had more free access to us and our home than anyone we knew. They were with us every day, all day, and they became part of our family. I think of them like family, and I miss them a lot. They actively disliked each other, taunted each other and at times were viciously cruel , but they were almost always together-- perhaps they were competing for our attention. Eastman was-is- the simple steady one. Not particularly bright, he was the embodiment of loyalty and faithfulness. He was always there, usually in a good mood, and loved to pick at me. He was never happier than when I had him in a head-lock. Trokon on the other hand, was- is- charismatic, moody, intelligent, fickle, and a natural leader. When he was in a bad place emotionally, he was sullen, humorless, and everybody knew it. When his mood switched, as it often did quickly, he was mischievous, bright and eager to play. Far more independent than Eastman, he did not care so much about pleasing me—which pleased me even more.

I kidded both boys a lot, and they usually gave as good as they got, but in one area, Trokon was defenseless and by the time we left Liberia, just a certain look or a word could send him off screaming. See, I thought he was the most beautiful boy I ever met. His face was perfectly proportioned, and whenever I really wanted to get to him, I would attempt to compliment him on his perfect face. His pals would sometimes say he looked like a girl, so maybe when I said his face was perfect, he thought I was mocking him. But I wasn’t. Nevertheless, I knew just telling the truth would end any competition or playful debate. For me, his beauty added something to the mystery of the boy. I think it adds to the pathos of his story, and mine, and ours. His story is my story is our story. It makes it much more impossible to let him go. So I won’t.

I don’t know when I will see Trokon or Eastman again. But I know I will as soon as I get an opportunity. Renita and I have made some commitments to them regarding their education, and we maintain regular phone contact, so we are in for the duration. As I said, I’ve been thinking about this post for quite a while, and finally it’s a good time to show you his perfect face.

The troika: Eastman (actually Ishmael), Enoch and Trokon. happy in tee-shirts provided by the Calvin Team on their first visit-- summer 2006

A fierce competitor, Trokon takes on Romeo in football.

He does not like inactivity. He always brightens when he had things to do. Here making a toy truck entirely out of bamboo-- tires courtesy of discarded flip-flops.
He was forever hassling me to harvest coconuts and palm nuts from our trees. He trimmed the husks and sold them from a wheelbarrow for about 20 cents a piece.
Squaring off with Hannah. "Oh yea? C'mon then!"

Monitoring a footwashing holding Bandit the puppy. Eastman's feet were in terrible shape, and needed antibiotic care and also jigger removal.

There were some wacky moments-- I'm looking down on him at our small gate; he's covered in sticky red mud, trying to get in to give me a sloppy hug.

Decapitated by friends.

A very early shot. The secret to capturing this reaction? Get the camera ready, train it on the kid, and then suddenly and loudly pass gass.

Trokon and the Monk. He was rightly nervous around her, but he enjoyed provoking the viscious lil' whirlwind when at a safe distance.
A moody moment in the rice fields of Kakata.
His home. He calls them family but he knows his real mother is somewhere else, unable or willing to care for him. This abandonment was always a source of pain and anger for him.

See what I mean? Perfect.