The best career advice

A woman was asking a question in a facebook group of international development followers – she had been offered an (unpaid) UN internship, and due to a lucky situation with her scholarship, she could actually afford to do it. However, she heard it may look bad on her CV and she was worried that by doing that internship, she would miss out on other chances later or not land jobs.

I was stunned. It puzzled me so much, it stuck in my brain, and few days later I poured out all my thoughts to my boyfriend. How are we still living in a time where it matters more how something looks in your CV compared to how much you actually want to do this job because it is interesting and you are passionate about it? How are we still living in a world where even a six month or one year internship apparently can ‘spoil’ your CV – considering a forty-something-year-career? Where does this fear come from and how are we succumbing to it? Should it not matter most to do something you are really passionate about? And yes, maybe passion in the workplace is not for everybody – but at least do something that you are interested in? Also, we are talking about a job in international development. Am I asking too much if people should take those jobs out of interest or passion, and not because ‘it looks good on CV’?

The best career advice I have gotten was that the career will find you, if you keep doing what you are passionate about. I have been in a similar type role, working in the Ministry of Health and Sanitation in Sierra Leone for nearly six years now, and committed for another two years. Different directorates, different funders, always similar mission. Someone asked me recently if I am not bored. Again, I was puzzled by this question. This type of work is my passion, this is what fascinates me, day in and day out. Yes, some days are boring, but most days I learn new things, I understand a bit more, I see another piece of the puzzle, I try another fit, I fail spectacularly, I grasp another complex truth, I become more effective and better at what I do and achieve more.

Let me be honest – every now and then I also get caught up in the ‘CV worries’. People tell me I should leave, because “otherwise you will never get a job outside Sierra Leone”, they tell me I should not have left my senior management job because “people will think you were not good at it”, they tell me I need to get in with one of the big names (e.g. World Bank, WHO, Global Fund, Gavi, etc) now, otherwise “my CV won’t have weight”. But guess what I realized – people often give you advice and direction that validate their own choices as the right ones. And let me tell you another truth – our worklife is so long, we can easily fit several careers in there. I have worked for about 8 plus years now, and have at least another 35 years to go – see the dimensions?! One or two or three or even four more years in the same job won’t make any difference at all in the long run. Stop thinking so short term and take a deep breath.

We should all worry less about careers and more about passion in our jobs. And passion can be found in any job – when I was looking for a job for some work experience, none of my desired companies were interested in my application – I got rejected for two months with no positive replies. Finally, a company producing and selling flags hired me, so I went to sell flags. And yes, I became passionate about flag poles, flag designs, flag materials and customer service. You can have dedication in any job.

But anyway – I expect more from people in international development. I expect more passion, more dedication and less focus on a classical career as the main motivation.

My boyfriend patiently listened to me and then asked me why I didn’t give that lady this exact advice. A very valid point, so I went back to the facebook group and typed my answer. 26 people had replied before me and NONE OF THEM, not a single one!, had told her she should go for the internship if she is really interested in it. All 26 gave some answers relating to how it will make her CV look and how this will help her get into the next job or not, what else she should do to brush up her CV and so on. I closed facebook feeling a bit depressed with the (international development) world. We need to get better than this but until this happens, please – just keep doing what you are passionate about.

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To the hero of 2018: the nurse serving in rural Sierra Leone

Imagine yourself being a nurse, earning USD 110 a month, which makes you the main breadwinner of a family and extended relatives, married to a daily wage worker, who more often than not won’t find work. You have two children – a son and a girl, who you work hard for to keep in school, paying all formal and informal fees necessary. Then your employer, the government, posts you to a veryvery remote area, more than 8 hours from where your family lives, in an area with a different tribe and local language, with no warning, in the middle of a school year, and expecting you to resume work in your new duty station within two weeks. You are not given any relocation or transport money, but are expected to pay this out of your salary. You are also not given any salary increase – even though you could really use that, given you will have to continue to pay for your children’s home. You reach your new duty station via public transport and motorbike, and face a dilapidated staff quarter, barely any drugs available for treatment, and a community that is suspicious of this person from the capital. The chief sees you as his personal mistress, allowing him to sexually harass you, and given he is the local authority, who do you complain to?! The journey home to your family costs a third of your monthly salary, so you only go back once a quarter, and even though you wish you could bring your family to your new duty station, there are no schools in close reach – or the quality of the local school is not up to standards. Even to access your monthly salary, you have to travel 3 hours to the district capital, if you are lucky enough to be banking with a bank that has a local branch. To call your family, you have to walk 15 minutes to a spot that has network coverage. Once or twice a year a delegation from the district capital comes on supervision, and intimidates you with pages of checklists telling you a hundred things you need to change, of course with zero additional resources.
When you go back to visit your family, you know you are risking lives in the community where you serve, because no one is there to cover for you. Furthermore, when you finally see your children and husband again, you realize that he has found himself a mistress in the meantime, and you don’t appreciate the suspicious strangers walking in and out of your home, with vulnerable children being there.

Sounds grim, no? This is the reality for more than 500 nurses in Sierra Leone, serving in the most remote health facilities. 81% of all rural health workers are female – often having no other options but to comply to postings, as they lose their job otherwise.
I doubt anyone who is reading this post would agree to such work conditions, yet in Sierra Leone, these nurses still serve their communities in hard-to-reach, barely equipped health facilities, with small salaries and lots of demands placed on them. I have spent a lot of time in the last few months working with the government to better recognize, reward and motivate these health workers, and given that the majority of them are women, we spent time with communities, local authorities, health workers and policy-makers to discuss gender-specific issues. It is horrifying, and humbling, to hear all their stories, and to understand their struggle and their fight better. Female health workers in remote areas are my heroes of the year – and they deserve to be much more recognized for their sacrifice and service to this country. They are some of the strongest women that walk on this earth. I am sorry I have not seen your struggle earlier, and I salute you for your bravery and your service. You are heroes.

 

Sofa-Geschichten von den Lion Mountains

Was oder wie wurdest du erwachsen? Wann und wie hast du die Jugend hinter dir gelassen? Was war das Uebergangsritual? Fuer mich war das Zeichen von “Erwachsensein” immer ein grosses, schweres Sofa. So etwas macht dich traege, es wird schwieriger umzuziehen, es ist eine finanzielle Investition, es braucht noch mehr Moebel um richtig benutzt zu werden. Kurz: es macht das Leben komplizierter. Einige von meinen Freunden investierten schon mit 18 in grosse, teure Sofas – Ich mag mich noch gut an das Panikgefuehl in meinem Magen erinnern, wenn ich daran dachte, mich so niederzulassen. Ich habe daher im letzten Jahrzehnt entweder kein Sofa besitzt, oder das guenstigste Ikea-sofa gekauft (100 Franken, ein echtes Schnaeppchen), oder einfache Bamboo-sofas besitzt (weniger als 200 Franken fuer drei Sofas, auch ein echtes Schnaeppchen). Das Bamboo-sofa, das ich die letzten fuenf Jahre in Sierra Leone benutzt habe, hat Abel hergestellt. Er wurde ueber die Jahre ein guter Freund, und ich habe ihn an einige andere Leute weiterempfohlen. Er hat mir dafuer gedankt, in dem er eines seiner Kinder nach mir benannt hat. Es wurde aber ein Junge, also musst Naomi umgeaendert werden in die maennliche Form – was anscheinend “Nami” ist. Nami bedeutet auf Krio auch “Das bin ich”. Wenn ihn also jemand fragt, wie er heisst, dann antwortet er “Nami / das bin ich”. Etwas verwirrend, aber es scheint ihn nicht zu stoeren!

SOFA EINWEIHUNG

Also, zurueck zu Sofas. Nami’s Vater hat mein erstes wunderschoen farbiges Sofa hergestellt, das ich nun fuenf Jahre lang benutzt habe, und drei Mal gezuegelt habe. Ich habe kuerzlich herausgefunden, dass ich nochmals fuer mindestens vier Jahre in Sierra Leone sein werde, die Gruende dafuer erklaere ich euch sonst mal. In dem Moment habe ich auch realisiert, dass ich soweit bin – ich getraue mich nun in ein grosses Sofa zu investieren, mich niederzulassen (zumindest fuer vier Jahre), offiziell meine Jugend hinter mir zu lassen und das Gewicht eines Sofas auf mich zu nehmen. Eine Aethiopische Freundin hat ein grosses graues Sofa kreiert und zusammen mit Sierra Leonischen Schreinern hergestellt.
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Photo 1: Blen, die Sofadesignerin mit meinem neuen Sofa. 
 
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Photo 2: Die offizielle Sofa-Einweihungs-Sonnenuntergang-Snack-&-Drink Feier.
Ich habe gestern eine kleine Einweihungsfeier organisiert, mit Sonnenuntergang Cocktails, um diesen Anlass gebuehrend zu feiern. Jayne’s Kommentar: “Ah super, die letzte Einweihungs-feier die ich hatte war fuer einen Kirchenaltar – das Essen hier ist besser!”

JUNGE DAME

Obwohl ich den Eindruck habe, dass ich aelter werde (in weniger als einem Monat werde ich 30!), gibt es da auch andere Meinungen – vor allem an meinem Arbeitsort, im Gesundheitsministerium. In den letzten Wochen haben mich verschiedene Leute auf dem Gang mit “Guten Morgen, junge Dame” begruesst. Das passt mir aus verschiedenen Gruenden gar nicht, und ich habe diesen Leuten jeweils gesagt, ich bin nicht mehr so jung, und ueberhaupt sei mein Name Madam Naomi, was ja bekannt sei. Am Freitag habe ich mit anderen Leuten auf ein Meeting mit dem Gesundheitsminister gewartet. Der Vize-Gesundheitsminister kommt dazu und begruesst mich mit “Guten Morgen, junge Dame”. Ich blieb freundlich, aber habe auch ihm erklaert ich sei nicht mehr so jung, und er wisse ja meinen Namen. Er lachte und meinte “du kannst ja noch nicht 40 sein” – was ich zustimmen musste. Anscheinend sind alle unter 40-jaehrigen offiziell noch jung in Sierra Leone. Wenige Minuten spaeter laufen wir in das Buero des Gesundheitsminister, und er begruesst mich mit “Guten Morgen, grosse Dame”. Ich sag ihm, dass ich das besser finde als “junge Dame”, worauf er lacht und sagt “du kannst ja nicht aelter als 37 oder 38 sein, oder?”. Nachdem ich ihm erklaert habe, dass ich noch nicht ganz so alt bin, meinte er: “na, das heisst du bist noch ein Baby – ich habe gedacht du bist mindestens 37, mit der Arbeit, die du leistest”. Was ist so schwierig daran, mich mit Madam Naomi anzusprechen?! Mein Gesicht muss ihm deutlich gemacht haben, dass ich nicht sonderlich erfreut darueber war, “Baby” genannt zu werden. Als ich nach der Sitzung mich verabschiedete, sagte er “Auf Wiedersehen, schlaue Dame”. Besser!

BOOTSTOUR

Meine Abenteuerlust ist ungebremst, ob ich alt oder jung bin. Wir sind kuerzlich auf Besuch in den Distrikten, um unsere Distrikts Personalangestellten zu unterstuetzen und coachen. CHAI (wo ich arbeite) hat der Regierung geholfen, diese Reform einzufuehren, und das Personalwesen im Gesundheitswesen mehr zu dezentralisieren, naeher zu den Kliniken zu bringen, und damit die Transparenz und Rechenschaft zu foerdern, und gleichzeitig bessere Gesundheitsdienstleistungen anzubieten. Ich bluehe auf auf diesen Reisen ins Landesinnere, einerseits weil es sehr motivierend ist, die Veraenderung vor Ort zu sehen, und andererseits weil immer mehrere Abenteuer auf mich warten.
Auf unserem Trip vor ein paar Wochen mussten wir mit dem Boot auf die Bonthe Insel fahren, wo das oeffentliche Spital ist. Bonthe ist einer der entferntesten und am schlechtesten entwickelten Distrikten. Ich habe diese Bootsreise vor ein paar Monaten schon gemacht, aber immer nur mit einem eigens gemieteten Schnellboot, fuer 200 Franken, hin und zurueck, je 45 Minuten. Dieses Mal haben wir uns entschieden, die “Faehre” zu benutzen, die nur LE 15,000 kostet pro Person – weniger als 2 Franken, fuer die 90-120 Minuten Ueberfahrt, mit zwei Haltestellen auf anderen Inseln. Die richtige oeffentliche Faehre wird nicht betrieben und rostet vor sich hin, da die Betriebskosten zu teuer sind. Dafuer benutzt man ein hoelzenes Boot, das einmal pro Tag hin und zurueck faehrt. Die Regeln auf dem Boot sind klar angeschriben, und Bussen definiert. Ich mochte diese Regel am meisten: “Ich will kein Geschwaetz – Busse LE 50,000 (ungefaehr 6 Franken)”.
Wir sind also auf unsere Bootstour mit einer Ziege, einem Motorrad, 30 Passagieren und viel Gepaeck. Zwischendurch haben wir an einer “Raststaette” Halt gemacht – und konnten geraeucherte Shrimps, Nuesse oder Fische kaufen. Neben mir war ein junger Mann, dessen einzige Aufgabe war, das Wasser auszuschoepfen, das konstant stieg im Boot. Jede halbe Stunde war er wieder fuer zehn Minuten mit Wasser schoepfen beschaeftigt – meine Fuesse wurden kein einziges Mal nass, und wir kamen heil an.
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Photo 3: Am warten auf die Faehre in Yargoi. 
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Photo 4: Einsteigen! Das Motorrad ist auf dem Dach. 
 
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Photo 5: Ich will kein Geschwaetz – Busse 50,000. 
 
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Photo 6: Haltestelle, und Verpflegung mit geraeucherten Shrimps. 
 
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Photo 7: Auf der Bonthe Insel. 
 
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Photo 8: Am Schweizer Apfel essen, waehrend dem ich auf die Autofaehre nach Mattru warte!
 
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Photo 9: Das Team in Mattru. 
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Photo 10: Das Team mit dem Vize-Buergermeister in Bonthe.  
Ein weiteres Merkmal von Erwachsen-werden ist Weihnachten ohne Familie zu feiern. Wegen voellig ueberteuerten Fluegen, und anderen geplannten Reisen, werde ich dieses Jahr nicht fuer Weihnachten in die Schweiz kommen. Es wird mein erstes Mal ohne meine Familie sein – und ich spuere zu gleichen Teilen Respekt und Aufregung darueber, in Sierra Leone zu sein ueber Weihnachten und Silvester. Weihnachten hier sind viel weniger kommerzialisiert, was sicher erfrischend sein wird. Ich habe eine Woche frei, also falls mich jemand im garantierten tropisch warmen Wetter besuchen kommen moechte, nur zu – ich wuerde mich freuen!
Danke, an euch alle, dass ihr Teil meines Erwachsen-werden seit und Geduld mit mir habt!

Sofa-stories from the Lion Mountains

What is your own sign of growing up? What was the step that made you feel like you have left youth behind and moved into a new sphere? Like an initiation into adulthood – how does or did this look for you? For me, the symbol of settling down is a heavy, expensive sofa. It will make you want to move around less, it is a financial investment, it requires some other furniture to go with it. Some of my friends had the guts to get a sofa at the age of 18 – I remember the feeling of panic that grew in my stomach when I imagined having to buy a sofa myself back then!
So for the past decade, I have either not had any sofa, bought the cheapest and smallest Ikea sofa that was available (100 bucks, a real catch) or have lived off cane furniture the last five years (a whole sofa set for under USD 200, also a real catch). The latter is made by the apt Sierra Leonean Abel – Abel and Cain/cane, rings a bell? He has become a friend over the years, and I have recommended him and his business to many other people, to which he thanked me by naming his child after me. It was a boy though, so the name Naomi wasn’t fitting – he turned it into Nami (which in Krio means “this is me”). Nami is now nearly three years old, and he is talking, a conversation that goes like this:
Someone: “Hi little man, how are you?”
Nami: “fine, tell god tenki”
Someone: “and what is your name?”
Nami: “Nami”
Someone: “yes, but what is your name?”
Nami: “Nami!”
Someone: “yes, I know this is you, but what is your name?!”
Nami: “Mi name Nami!”
Someone: ??
I really feel sorry for inflicting this confusion on Nami – but he seems to grow up strong and healthy, so I am confident he will fight off any confusion easily.

SOFA INAUGURATION

So, back to sofas. Nami’s father made me the first beautifully colourful sofa in Sierra Leone, which has lasted me five years. I have recently found out that I will be in Sierra Leone for another four years – for reasons I cannot explain to you yet – and that was the moment I realized that I am ready. I am ready to invest in a sofa, to settle down (at least for four years), leave youth behind me and carry the weight of a heavy sofa around my neck (figuratively). An Ethiopian friend of mine designed and built a massive grey sofa with storage unit and colourful pillows together with talented Sierra Leonean carpenters and upholsterers.
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Photo 1: Blen, the designer, on the new sofa. 
 
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Photo 2: Snapshot from the official sofa inauguration sunset drinks and snacks event.
I had a little inauguration event of the sofa, to mark this significant event – to which Jayne commented: “Ah nice, the last inauguration event I have been part of was for a church altar – food is better here!”

YOUNG LADY

While I think I am growing up and growing older (less than a month to go before the big #THREEZERO hits me), clearly the folks in the Ministry of Health think differently. Several people have greeted me with “Good morning, young lady” in the corridor the last few weeks. Something about this really works me up, and I have replied quite harshly to all of them that I am actually not that young anymore and anyway, my name is Madam Naomi, in case they have forgotten.
On Friday, I was waiting with a group of other people for a meeting with the Minister, when the deputy Minister of Health came out and greeted me with “Good morning, young lady”. I tried to remain friendly, but also told him that I am actually not that young anymore. He laughed and said but I can’t be 40 yet – which I had to agree to. Seems like anyone below 40 is considered young in Sierra Leone. Few minutes later we are walking into the Minister’s office, and he greets me with “Good morning, tall lady”. I told him this is better than “young lady”, to which he laughed and said but I can’t be more than 37 or 38? When I told him I haven’t reached there yet, he said “well, that means I should call you baby – I just thought because of the kind of work you do you must be at least 37”. What is wrong with just calling me Madam Naomi?! My face must have clearly told him that I do not approve of “baby” – when I left he said “Good bye, smart lady”. Small victories.

BOAT TRIP

No matter if I am young, deemed young, or old, my thirst for adventures is never quenched. We recently went on supervision, to support district Human Resource Officers and assistants across the country to better manage and motivate the health workforce. CHAI (where I work) have helped government implement this reform to further decentralize the health system, and increase transparency and accountability, as well as improve service delivery.
I thrive on these trips, not just because it is very rewarding to see the change on the ground, but also because there are all sorts of adventurous experiences that make me feel alive. On our recent trip, we had to cross to Bonthe Island, which is where the government hospital is for Bonthe district, a very remote and challenging district for service delivery.
I have made this journey before, but always in chartered speedboats, which take you across in 45 minutes, but also cost about 100 dollars, one way. This time, we decided to take the “ferry”, which costs LE 15,000 per person – less than 2 dollars, for the 90-120 minute journey, with two stops on other islands in between. The actual government ferry is not used, as the fuel costs of running it are too expensive – so a wooden boat is used instead. The rules are clearly indicated on the top, with fines attached to it. My favourite one was “I don’t want palava – fine 50,000” / “I don’t want any gossip/big talks – the fine is LE 50,000 (about 6 dollars)”.
We headed off on our journey with a goat, motorbike, 30 people and bags on board. We stopped at a “service station” and were offered smoked shrimps, fish and nuts for sale. Right next to me, there was a guy solely responsible for draining the water that filled the boat in regular 30-minute intervals – whenever the water was just about to reach my feet, he started pouring it out again. I thoroughly enjoyed it.
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Photo 3: Waiting for the ferry at Yargoi. 
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Photo 4: getting on the ferry. Note the bike on top of it. 
 
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Photo 5: I dont want palava – fine 50,000. 
 
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Photo 6: pit stop on the way, to buy smoked shrimps. 
 
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Photo 7: On Bonthe Island. 
 
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Photo 8: Eating Swiss apples waiting for the ferry to Mattry, sponsored and delivered by Rachel!
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Photo 9: Team in Mattru, at the District Health Management Team offices. 
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Photo 10: team with the deputy Mayor on Bonthe Island. 
The other part of growing up is not celebrating Christmas with family – because of expensive flight prices, and other planned trips, I will not come to Switzerland over Christmas this year. It will be my first time celebrating without my family, and I am dreading it, while at the same time being excited to be in Sierra Leone for this celebratory season. I have some time off, so feel free to come join me here over Christmas! Beautiful warm weather guaranteed 🙂
All of you – thanks for bearing with me while I am growing up!

It wasn’t raining

It wasn’t raining when I arrived in Sierra Leone, five years ago today. British Airways was still flying back then (they stopped when Ebola broke out), and on my overnight flight from London to Freetown, to the new to-be-home, I met my first Sierra Leonean ever, and apparently fell asleep on his shoulders. I jumped into life in Sierra Leone with the same lack of physical and emotional distance as on this flight, extending trust and friendship far and wide, and largely being repaid with the same trust and friendship.

The second picture I took in Sierra Leone was the view from the Youyi building, that houses the Ministry of Health and Sanitation, where I was going to work for two years (I had no idea back then that I would still see that view everyday five years later). 2013-10-25 08.32.13.jpg

Today, it looks like this: IMG_2479

 

Seen much change? I know it looks fairly the same, so let me tell you of some of the other things that changed in those five years:

  1. They fixed the road in front of the entrance (go check again – see the difference?).
  2. Everyone is using email and whatsapp now (there was no internet in the Ministry, when I came five years ago.) Communication is much easier now – I remember how we struggled to get invitation letters for meetings to the districts. The Directorate of Primary Health Care had letter boxes for all districts, that would get emptied whenever the District Medical Officer was in town – no one really knew when and how often this would happen.
  3. The speed of implementation has increased. Maybe that is linked to the above point, or maybe I just know better how things work and how projects and reforms can be implemented.
  4. There is no more canteen downstairs. The Youyi canteen served me my first lunch in country (it was beans, plantain and fish) and has been a love/hate affairs for three years, before it closed down and was supposed to be re-opened by the sister of the then-President, but that never happened. Now we have a new President, but still no canteen.
  5. I have moved down one floor (did you notice the slight change of perspective on the pictures?). I started working on the fifth floor for 2.5 years, and have now spent the last 2.5 years on the fourth floor. The fourth floor is definitely more active.
  6. Mortality indicators have gone down and up and down. Ebola didn’t help us.
  7. I have a travel pillow now, so I don’t fall asleep on strangers’ shoulders in planes anymore.

What has not changed in the five years:

  1. My neverending passion for my job and Sierra Leone in general.
  2. My neverending fascination with my job and Sierra Leone in general.
  3. My neverending adventures in my job and Sierra Leone in general.
  4. My hopefully-ending-at-one-point frustrations in my job and Sierra Leone in general.
  5. My neverending gratefulness for the opportunities I have. Thank you.

I am glad I survived until my fifth Salone birthday – and look forward to more to come. By God in power.

 

Presidential-stories from the Lion Mountains

What story would you like to hear today:
a) how I ended up being followed with a photographer and a journalist for week; or
b) how I spent four hours sitting at a table with the President of Sierra Leone, worrying about my hair; or
c) why I started making chocolate; or
d) how I got stuck for half a day in the jungle close to the Liberian border?
I’ll leave d) for another blog post, as it is a beautiful little story – but that still leaves you with three choices, so choose well! Sierra Leone is in the election fever – presidential and parliamentary elections were on 7th March, the run-off is on the 27th March, and the current president – Ernest Bai Koroma – can’t stand for another term after 10 years or ruling, so there will be a change of leadership. Politics in Sierra Leone have been largely dominated by two parties – a green one and a red one (no connection with what we assign with these colours), the one from the South-East and the one from the North of the country. Party membership is often based on tribes and origin, and not so much on policies. It is always funny asking strong party members about the main difference to the opposition party and guess what – both would say “we are less corrupt than the other”. But that is the only perceived difference, making political discussions here very interesting. However, this time around, a third party emerged, with a very eloquent, charismatic and smart leader (guess where my sympathies lay…), who has forced the conversation into a bit more of “what actually needs to happen to move this country forward, and who has the best ideas for that?”. For the first time in history, there was a presidential debate with the six major candidates, which was streamed live on all radio stations, TVs and internet – and I had a (very emotional) blast listening to the various candidates’ ideas for speeding up development of Sierra Leone. One candidate seriously promised to improve the whole health system within three weeks – that sounds like a task for superman and wonderwoman.
There was also this ‘obama’-moment, when the same eloquent, charismatic and smart candidate gave his closing remarks – giving me goosebumps with “you touch one, you touch all”. For those of you who understand Krio, enjoy it here: (well spent 3 minutes, trust me).

 

Pic: my living room, just before the presidential debates started! The TV belongs to Elias, in case you wondered.
Being the President of Sierra Leone is a multi-million dollar job (a year…) and a way more influential position than we know it from our countries, so it is no wonder that the campaigns are fought hard and with whatever the candidates have. It is common practice to pay people money and give them a t-shirt with the party colours and symbols to go out on the street and rally for a certain candidates. So the strength of the different rallies are a good indicator of how much money each party has. See here for some insights from my balcony:

​Pic: the APC party rallying today.
 
Anyway. I am sure you’d like to hear about b) how I ended up sitting at a table with the President of Salone for 4 hours, worrying about my hair. Well, the very next day after the presidential elections, I went to the same venue where the debates were held, attending the launch of the social health insurance scheme of Sierra Leone. You probably know that I have worked on this extensively in my first two years in Sierra Leone, but then Ebola changed everything and other people took over. However, the President wanted to launch this before the end of his term, to leave it as one of his legacy projects. There were about 500 invited guests in the Bintumani conference center, with a big stage and high table at the front, including a red satin chair for the President.
Pic: the Bintumani conference center with the high table, for the launching of the Social Health Insurance. 
​Now, quick explanation – Sierra Leonean events or programs or workshops or trainings or birthdays or award nights or anything that is significant in life should have a high table, where distinguished dignitaries sit and give speeches, before the beginning of the actual program. This can easily take half of the total assigned time of the program, or even most of it. Without it, a program is not deemed ‘official’ enough and lacking ‘the appropriate weight’. So, high tables it is.

Well, sitting at the very back, I enjoyed watching all the paramount chiefs (there are 144 nationwide, and they are the key leaders on the ground) walking in their fabulous outfits, enjoying the feeling of being where just 12 hours before, the presidential candidates were for their debates. The program starts and Ministers are called up to the high table, leaving the red seat for the president. I suddenly hear my name being called “Naomi” and a finger being pointed at me, with several hundred heads turning to watch the white woman turning red. The lack of alternatives led to me being called up to the high table, supposedly giving a speech on behalf of development partners and observing the etiquette required around a head of state. Needless to say, I was not prepared and worried about what I would say and do and how to not get kicked out of the country by the President because I could tell him I actually don’t think that Social health insurance is a good idea now. Apart from worrying about my hair (I didn’t wash it in the morning, shame on me…) and worrying about my posture (all the TV cameras make nervous), I tried to get the message across the chairman, that I can’t give a statement, due to non-preparedness.

Pic: us standing for the arrival of the President, in the middle of the table. I am the pale woman on the very left. 
 
You won’t believe how many nerves it cost me, to be sitting at that table for four unexpected hours – do you pretend you are taking notes, when they make inappropriate jokes about the opposition party? Do you smile when they all clap for the president, can you clap as well – even though you represent all health development partners? What face are you supposed to make on a high table, when the President says something you completely disagree with? You can see the dilemmas and mind battles I was having, while on a bigger adrenaline rush that any caffeine or similar pill could give you. I did say “Congratulations for a bold initiative” to him afterwards, and left it at that. Time for a glass of wine…
I think I have rambled on enough and we will leave story a) and story c) for another post…

Spital Geschichten von den Lion Mountains

“Weniger Drama als in 2016”, war Monika’s und mein Neujahrsvorsatz fuer 2017. Na, 10 Tage ins neue Jahr lag ich zuhause am Boden mit schlimmsten Rueckenschmerzen und brauchte 20 Minuten um mich Millimeter fuer Millimeter zurueck zum 2 Meter entfernten Mobiltelefon zu robben. Die Ambulanz des besten Privatspitals in Freetown kam innerhalb von 20 Minuten mit der erloesenden Morphiumspritze, mein Freund Elias und der Schlosser waren auch innerhalb von 15 Minuten da um die Tuer zu oeffnen – die 10 Meter zur Tuere haette ich beim besten Willen nicht geschafft. Ich verbrachte die naechsten drei Wochen liegend und mit gluecklichmachenden Mengen von Opiumhaltigen Schmerzmitteln, bevor in die Schweiz geflogen wurde um meinen Bandscheibenvorfall konservativ zu behandeln. Viele Physiotherapien spaeter und einige glueckliche Wochen zurueck in Sierra Leone kamen die naechsten Schmerzen, diesmal war etwas mit der Niere nicht in Ordnung, ich solle das in der Schweiz mal abklaeren bei einem Spezialisten, wurde mir greaten. Long story short, ich hatte mittlerweile drei vollnarkotisierte Eingriffe im Spital und schreibe auch dieses Email aus dem Spital. Wegen medizinischen Risiken darf ich momentan nicht in Sierra Leone sein, das Risiko fuer lebensgefaehrliche Komplikationen ist zu gross.

Ihr seht, ich hatte gute Gruende, mich so lange nicht mehr zu melden, da ich mit meiner Gesundheit und den ungewollten Unterbruechen meines Lebens in Sierra Leone beschaeftigt war. Bin ich zwar immer noch, aber ich habe gedacht, das waere doch ein gute Zeitpunkt, mal ein paar Spitalgeschichten zu erzaehlen, davon habe ich mittlerweile genug!

Krankenhaus Fakten

Dank meines Arbeitsgebers habe ich eine sehr grosszuegige Krankenversicherung, die mir Zugang zum besten Privatspital in Freetown ermoeglicht. Das kann man aber doch nicht ganz mit unseren Spitaelern vergleichen, der einzige Arzt (ein Nierenspezialist, der meine akute Nierenentzuendung nicht diagnostizieren konnte) ist ein sehr netter und umgaenglicher Typ, schlaegt aber fuer jedes Leiden sofort eine medizinische Evakuierung vor – er kennt seine und Sierra Leone’s Grenzen. Ich war mittlerweile genug oft im Spital (und habe in allen vier Patientenzimmern schon mal geschlafen), dass ich das Personal gut kenne und sie mich auch. So war ich im Maerz wieder einmal da und verbrachte die Wartezeit damit, allen in ihren Bueros und Zimmern Hallo zu sagen. Wieder im Wartezimmer kommt ein Patient auf mich zu und sagt “Sie, ich haette noch ein paar Fragen zu den Unterlagen, die ich fuer meine Behandlung benoetige – Sie arbeiten doch hier, oder?”. Ich habe eindeutig zu viel Zeit im Spital verbracht dieses Jahr!

Being fed delicious Lebanese food and lots of Morphine during my back problem in the hospital in Freetown.

Waehrend meinem Bandscheibenvorfall im Spital in Freetown wurde ich regelmaessig mit leckerem Libanesischem Essen und viel Morphium gefuettert.

Ich habe ausgerechnet: in 2017 habe ich gleich viele Abende im Spital verbracht, wie in Restaurants, und insgesamt 42 Spritzen/Infusionen erhalten. Diese werden besonders in Afrika gerne verteilt, die Regel ist: egal welche Krankheit, damit du wirklich gesund wirst, brauchst du Infusionen und Spritzen, am besten in mehrere Koerperteile. Die Krankenschwestern waren immer sehr freundlich, bis auf eine, die auch nach 20 Minuten herumstechen meine Vene immer noch nicht gefunden hatte. Als ich ihr sagte, das sei jetzt doch etwas unangenehm, meinte sie “so wehleidig kannst du nie ein Kind kriegen, du bist viel zu schwach fuer eine Geburt”. Einen Spruch, den man als kinderlose Frau in Sierra Leone oefters hoeren muss.

 

I might not have a child, but I had a goat! His name was Nyandeyama and he sadly died at my birthday.

Ich bin zwar kinderlos, aber hatte dafuer eine Ziege! Er hiess Nyandeyama und ist leider an meinem Geburtstag gestorben.

Alternative Behandlungen

Alternative Medizin gibt es auch in Sierra Leone, einfach vielleicht noch etwas alternativer als unsere alternative Medizin. So hat mir eine Krankenschwester bei meinem dritten Aufenthalt innerhalb kurzer Zeit beim Spritzen verabreichen geraten, es waere jetzt wirklich an der Zeit, mal ein Huhn zu opfern, das ist ja kein Zustand, dass ich immer so krank sei. Sie koenne mir sonst jemanden empfehlen, mit hoher Erfolgsrate. Oder sie koenne auch ihren Pastor mal herbitten, der betet auch fuer Kranke. Schoen, Alternativen zu haben!

We don't really use chickens for medical treatment - but for Hen's nights! Jayne is starring here with cockerel Nathan.

Fuer medizinische Behandlungen brauche ich Huehner eher weniger, dafuer mehr fuer Junggesellenabschiede/Polterabende, hier Jayne & Hahn im Korb ‘Nathan’.

Mein Spital, meine Informationsquelle

Ich versuche, alle meine Besuche im Spital auch zur Erweiterung meiner Gesundheitsfachkenntnisse zu nutzen, als sogennante “Fieldtrips”, die mir dann bei der Arbeit im Gesundheitsministerium helfen. So erkundige ich mich gerne nach den Kosten fuer Geraete, Eingriffe und Medikamente, und bin echt immer wieder erstaunt, wie gut und wie teuer das Gesundheitssystem in der Schweiz ist. Fuer einen Nierenfunktionstest wird eine Maschine benutzt, die eine Million Schweizerfranken kostet – damit koennen in Sierra Leone 5700 Krankenschwestern fuer ein Jahr bezahlt werden (also 5400 mehr als sie jetzt angestellt haben).

Mit den Krankenschwestern in der Schweiz spreche ich auch gerne ueber meine Arbeit – die sind dann immer gleichzeitig fasziniert und auch froh, in der Schweiz zu sein. Mit einem Monatslohn von CHF 175 ist es auch in Sierra Leone nicht einfach, eine Familie durchzufuettern.

Seit knapp vier Jahren arbeite ich im Gesundheitsministerium in Sierra Leone daran, die Regierung bei der Gesundheitssystemstaerkung zu unterstuetzen. Ich kenne die Nummern, die Fakten, die Theorien, und doch ist es fuer mich immer wieder traurig und schockierend, zu sehen wie inexistent die Gesundheitsversorgung ist. Waere ich Sierra Leonerin, wuerde ich mit dem gleichen Nierenproblem sehr wahrscheinlich vor 35 an Nierenversagen sterben – einfach weil es nicht richtig diagnostiziert und behandelt werden koennte in Sierra Leone.

Women's March in Freetown: affordable care for everyone.

Frauenmarsch in Freetown: zahlbare Krankenversorgung fuer alle!

Hospital-stories from the Lion Mountains

“Less drama than in 2016”, was Monika’s and my New Year’s resolution for 2017. Ten days into the new year and I was laying on the floor in my house in Freetown with the worst back pains of my life. It took me 20 minutes to move back inch by inch to the mobilephone that laid 2 meters away. The ambulance of the best private hospital in Freetown came within 20 minutes with the relieving morphine injection. Elias came to the rescue and called a welder to break the door – I wasn’t able to move at all, the 10 meters to the door felt like an ocean. The following three weeks were spent laying down and with lots of opium containing painkillers, that kept me happy and hallucinating every now and then. I had to fly back to Switzerland to treat the disc hernia properly and was allowed back after many hours of physiotherapy. Some happy weeks in Salone later, the next set of pains started, this time something was wrong with my kidney. To keep the long story short: I have spent the last three months in Switzerland with several surgeries under full anesthetics and a very slow recovery process.  The risk of life threatening complications was big enough to keep me grounded in Europe!

Well, you see that I have been a bit busy the last few months taking care of my health and dealing with my interrupted life in Salone – apologies for all the silence this created! I thought this might be a good moment though to tell some of my hospital stories…

 

Hospital facts

I have a very generous health insurance, thanks to my employer. That means I can access the most expensive and supposedly best private hospital in Freetown – sounds good, but can’t really be compared to hospitals in Europe. The leading doctor (a kidney specialist who couldn’t diagnose my kidney infection properly) is a very nice and kind man, but recommends medical evacuations for basically any illness – he knows his’ and Sierra Leone’s limitations. Thanks to my regular hospital stays (I have slept in all four patient rooms already), I know the staff and they know me. When I was back in March for another visit and spent my waiting time saying hi to the nurses, I was approached by another patient who waited for his term and he said “Sorry, I have some questions around the documents that I need for my treatment – you work here, nottoso?”. I knew then that I have definitely spent too much time in hospitals this year.

Being fed delicious Lebanese food and lots of Morphine during my back problem in the hospital in Freetown.

Being fed delicious Lebanese food and lots of Morphine during my back problem in the hospital in Freetown.

It made me calculate: I have spent the same number of evenings in hospitals, as in Restaurants in the first five months of 2017. I have also received in total 42 injections – they are liked a lot in Africa, where the rule is: no matter what sickness, to get better, you need as many injections as possible, in as many different body parts as possible. The nurses are all very friendly, apart from one, who after 20 minutes of bloody failures to get my vein was as frustrated as I was. I told her that this is not very comfortable anymore, to what she replied: “pull yourself together, if you can’t take this pain, you will never be strong enough to give birth to a child”. Something that childless women hear every now and then in Salone!

 

I might not have a child, but I had a goat! His name was Nyandeyama and he sadly died at my birthday.

I might not have a child, but I had a goat! His name was Nyandeyama and he sadly died at my birthday.

Alternative medicine

Alternative medicine does exist in Salone as well – just maybe a tad more alternative than our alternative medicine. During my third visit within few weeks, one of the nurses recommended that “it really is time now to sacrifice a chicken, it just isn’t normal that you keep being sick”. She also told me she can recommend someone, with high success rates. Or she can also ask her pastor to come and pray, he also prays for the sick. Nice to have options!

We don't really use chickens for medical treatment - but for Hen's nights! Jayne is starring here with cockerel Nathan.

We don’t really use chickens for medical treatment – but for Hen’s nights! Jayne is starring here with cockerel Nathan.

My hospital, my source of information, my work experience

I am trying to use all my visits in the hospitals to expand my knowledge of health systems, and see them as “field trips” – hopefully helpful in my work at the Ministry of Health. I like asking for costs of equipment, medicines and procedures and it is shocking to realise how expensive the health system in Switzerland is. The machine used for a kidney function test costs one million Swiss franks (about 1.1 million USD) – with that money you could pay 5700 nurses in Salone for a year (therefore hiring 5400 more than what they have now). There have also been lots of interesting discussions with the nurses about my work and Sierra Leone – the nurses in Switzerland are usually fascinated, but also thankful to be working in Switzerland. Even in Salone it isn’t easy to feed a family with an average monthly wage of USD 180, that a nurse earns.

It has been nearly four years now that I have worked in the Ministry of Health in Sierra Leone, working on projects to strengthen the health system. I know the facts, numbers, the theories and reports, but it still hits me at the core how inexistent and incapable the health care is. If I would be a Sierra Leonean with the same kidney problem, I would probably have died before the age of 35 of kidney failure – just because Salone is not able to diagnose and treat it.

Women's March in Freetown: affordable care for everyone.

Women’s March in Freetown: affordable care for everyone.

Lachende Geschichten von den Lion Mountains

 

Es ist als ob ich mich total aus-erzaehlt habe an der African Night im Mai in Weinfelden – danke vielmals fuer die umwerfende Teilnahme! Mein langes Schweigen seit dann, hat aber auch mit meinem neuen Job zu tun. Ich habe eine neue Position angenommen wieder im Gesundheitsministerium, aber mit etwas mehr Verantwortung und damit auch mehr Arbeit. Das heist aber nicht, dass ich nicht weiterhin Geschichten gesammelt habe, die wurden einfach noch nicht aufgeschrieben. Sorry!

Ich habe kuerzlich mein dreijaehriges Jubilaeum in Sierra Leone gefeiert, wer haette gedacht, dass ich mich so verbunden fuehlen wuerde mit diesem einst unbekannten Land! In meinen ersten Monaten in Sierra Leone hatte ich den Eindruck, dass die Bevoelkerung grundsaetzlich optimistisch in die Zukunft schaufe (“alles wird besser”), bis Ebola kam und ein fast zweijaehriges Chaos startete. Seit dem Ende von Ebola ist die Situation weniger rosig, die Aussichten duesterer, der Bevoelkerung geht es schlechter. Der Praesident hat kuerzlich Sparmassnahmen angekuendigt, weil die wirtschaftliche Lage gar nicht gut ist. Diese Massnahmen werden in der Bevoelkerung laecherlich gemacht, zu Recht, sieht man doch weiterhin den Praesidenten jeden Tag zur Arbeit fahren mit seiner 15 Autos langer Karavane, wofuer die Polizei den ganzen Verkehr stoppt. Dabei verschwendet er genuegend Benzin um ein ganzes Haus mit Strom zu versorgen fuer einen Monat. Die lokale Waehrung, der Leone, hat fast die Haelfte seines Wertes verloren – in 2013 habe ich 4000 Leones fuer einen Dollar erhalten, jetzt erhalte ich 7500 Leones fuer den gleichen Dollar! Schrecklich, wenn man bedenkt, dass die Wirtschaft hauptsaechlich von Importen lebt, die jetzt teurer und teurer werden. Wir koennen also dankbar sein, leben wir nicht mit solch hoher Inflation!

Trotzdem gibt es immer wieder etwas zum lachen in Salone, lies selbst.

LACHENDES STRASSENLEBEN

Einer meiner Lieblingsbeschaeftigungen in Sierra Leone findet auf der Strasse statt: die vielen zufaelligen Begegnungen, lustigen Gespraeche, unerwartete Szenen man sieht auf der Strasse, ist faszinierend. Wenn immer ich einen Spaziergang mache, treffe ich mindestens einen Bekannten oder mache zumindest eine neue Bekanntschaft – das Sozialleben findet auf der Strasse statt. Es fuehlt sich fuer mich an wie in einem Dorf, aehnlich wie Weinfelden, wo ich aufgewachsen bin. Der einzige Unterschied ist, dass Weinfelden 10’000 Einwohner hat und Freetown 2 Millionen. Aus unerklaerlichen Gruenden ist jeder und jede immer unterwegs, die Strasse ist der Treffpunkt!

Ich habe auch staendig das Gefuehl, ich bin inmitten einer Modeshow. Sierra Leoner haben einen unglaublichen Modesinn und auch keinerlei Scham, absolut gewagte Kombinationen zu tragen, die immer irgendwie toll aussehen. Sierra Leoner tragen Socken am Strand, was ich unglaublich cool finde und daher zu einem regelmaessigen Ausflug gemacht habe. Socken am Strand – kann ich nur empfehlen!

 

Street fashion in Freetown

Socks on the beach!

Es sind aber nicht nur Menschen unterwegs, ich habe auch jeden Tag eine unglaubliche Auswahl von Voegeln vor meinem Balkon. Kleine blau schimmernde, grosse graue mit gelben Schnaebeln, Raben, Elstern, es hoert nicht auf. Zwei Spechte leben in meinem Strommasten, die haben sich ein schoenes Loch hineingehaemmert. Sierra Leone ist ein Vogelparadies und Vogellieberhaber kommen extra hierhin zur Vogelbeobachtung. Die Voegel wissen, wo das Paradies ist…

LACHENDES KRIO OEFFNET TUER UND HERZ

Es ist immer wieder erstaunlich, wie viel es hilft, die lokale Sprache Krio zu sprechen. Ich bin im Juni wieder in Salone angekommen mit vollen Koffern und hatte Respekt vor dem Zoellner – man weiss nie genau, welche Gesetze noch erfunden werden. Ich habe mit dem Zoellner auf Krio zu sprechen begonnen, mit meinem besten Laecheln, das er leicht erstaunt erwidert. Es ging so:

Noemi: “Hello sir, aw yu dey do? Aw di bodi?” / Guten Tag, wie geht es Ihnen? Wie laeuft’s?

Customs officer: “Eee Ma, di Krio sound na yu mot. Udat lan yu di Krio so?” / Wow, dein Krio ist fliessend! Wer hat dir das beigebracht?

Noemi: “Ar dey get mi padi dem. Dem bin lan mi smallsmall.” / Ich habe Freunde hier, die haben mir das gelernt.

Customs officer: “Wow, ok, fo di sake of mi brother, go go. Yu na mi sista now.” / Wow, ok! Na dann lass ich dich gehen, meinem Bruder zuliebe. Du bist jetzt meine Schwester!

Noemi: “No wahala, tenki sir!” / Kein Problem und Danke!

Wir sind beide laechelnd weitergegangen, ohne je ueber mein Gepaeck gesprochen zu haben…

 

LACHENDE KRANKENSCHWESTER
Wir haben kuerzlich ein Leistungs basiertes Finanzierungssystem fuer alle Gesundheitskliniken in Sierra Leone beurteilt. Unter anderem wollten wir wissen, wie die Krankenschwestern ihren Patienten Verhuetungsmethoden anbieten und erklaeren, da in Sierra Leone nur 16% aller Frauen irgendeine Art von Verhuetung benutzt. Die beste Andwort kam von Krankenschwester Isatu: “Na, wir sagen normalerweise allen Frauen, die am gebaeren sind, dass diese Art von Schmerzen einfach zu vermeiden sind mit anstaendiger Verhuetung. Das wirkt normalerweise.” Da habe ich keine Zweifel!

 

 

Nurse Isatu at her clinic

 

LUSTIGE SCHWEIZER

Die Abstimmung zum Grundeinkommen hat weite Wellen geschlagen. Regelmaessig triff ich wieder Sierra Leoner, die total erstaunt sind, dass die Schweiz einfach jedem Bewohner Geld geben wollte – und sie staunen dann aber noch mehr, wenn ich ihnen erzaehle, dass genau diese Bewohner gesagt haben, sie wollen dieses Geld nicht! Das Grundeinkommen hat mehr Wellen geschlagen als jegliches anderes Thema aus der Schweiz und ich finde es immer lustig, wie jede und jeder anscheinend davon irgendwie gehoert hat!