We are in the midst of a national emergency and no one is talking about it

The title to this article is actually not fully correct. Every now and then, especially around the elections in March 2018, I would hear people in the streets, in the taxis and kekes complain. They would complain about the fact that life for the ‘small borbor’, the common man and woman, has become harder, while the rich become richer.

Based on the Global Rich List, I am definitely among the top 10% richest people on this globe. That also makes me more blind and deaf to those claims, as it is not my experience the people on the streets are sharing. I listen, keenly, and try to live in a way to mitigate some of these effects, both with the way I deal with my personal finances and my professional life. I try to give generously, my friends and I provide unconditional cash transfers to a community school in the East of Sierra Leone and I focus my work on providing the evidence needed to solve problems in the health sector with local, sustainable solutions.

However, being a numbers person, reality really only hits me when I see statistics. Numbers can tell me whole stories.

And I heard such a story scream at me, when I read the report from the Sierra Leone Integrated Household Survey (SLIHS) 2018, which was just released. The overall headlines already are not great – food poverty increased in the last seven years, which basically means more Sierra Leoneans now go to bed hungry than seven years ago. The overall poverty rate in rural areas has stagnated – despite the fact that based on information from the Ministry of Planning and Economic Development, more than USD 4 billion have flown into the country from various donors. And despite all this, extreme poverty has increased across Sierra Leone. That in itself is reason enough for a national outcry.

But then, on page 193, it hits me: “The Gini coefficient calculated on per capita income is about 0.701 compared to 0.297 in 2011.” Let me explain – the Gini coefficient measures the income inequality in a country. The closer it is to 1, the more unequal a country is. That means that in the last seven years, Sierra Leone has become a VERY UNEQUAL society. It used to be about as unequal as Austria, and now joins other African countries who are much more unequal. It also means that the billions of dollars that have flown into this country have gone to the richest 10%, in its totality. The report even states that the household consumption of all but the richest 10% has decreased in the last seven years (page 273).

This is a national emergency, hidden on page 193 in this report. It deserves a national outcry, it deserves its own commission of inquiry, it deserves a lot of personal reflection. I have been here for five out of these seven years in between the two reports, and I also have not done enough to prevent this. We need to urgently revise not just our own personal finances, but also the way we do development – how do we achieve it to be inclusive? How do we make sure that more of the money that flows into this country reaches those that it should actually reach?

I am a strong defender of (un)conditional cash transfers – and it is not just my opinion, but there is a lot of strong evidence supporting the fact that really, we should focus development work on providing cash to the poor. And the rest – let governments and private sector figure that out, and citizens hold them accountable.

I know many Sierra Leoneans who have good solutions to the problems here, so please – make your voices heard and make sure in seven years we see a reduced poverty rate, reduced inequality and happier people on the streets.

Women get special treatment and I am so done with it.

We get special treatment. In Switzerland, we women were seen as so special, it was not until 48 years ago that we were given the right to vote. Until 30 years ago, wives were seen as so special, they were obliged by law to manage the household for the family, the husband was officially the head of the household. We were treated so special that we had to wait until 2005 to have right for paid maternity leave, and it wasn’t until 2013 that we finally were able to choose our family name after marriage, instead of automatically taking the husbands name. Switzerland truly is a developing country when it comes to gender equality, and the experts from the Global Gender Gap Report are telling us that it will take another 108 years until we will reach true equality in terms of education, economic participation or health. At the pace that Switzerland is going, this is an utopia, and it will probably only be my grand-grand-grand-grand-grand-(add more if you are less of an optimist than me)-children that will live in a gender equal society.

I am so done with that special treatment. Time is up. We need gender equality now, not tomorrow, and not in a 108 years.

Here is what you can do:

  1. Remind your family and friends that we still have work to do.
  2. Vote for women, and vote for political parties that regularly push through initiatives to balance out inequalities;
  3. Don’t interrupt your female colleague when she is making a point in a meeting;
  4. Actively re-iterate what your female colleague said in meetings, e.g. “as Purava mentioned, this and this is what needs to happen”;
  5. Listen and believe when you hear stories about sexual harassment, and don’t play them down if you experience it;
  6. Don’t make comments like “oh you are smart in addition to beautiful” to a woman;
  7. Go and strike together with the thousands of other Swiss people today;
  8. Encourage your female friend to apply for this promotion/job, even if she probably says “I don’t fit all the criteria” but you believe she does;
  9. Women: stop bodyshaming yourself, especially in front of others;
  10. Celebrate and support people who are challenging gender norms: the female engineer, the stay-at-home dad, the female company CEO, the girl who wants to become president, the ones breaking glass ceilings in ordinary and extraordinary ways everyday.

Find out more here: https://www.14juni.ch/

Und fuer ali wo Schwiizerduetsch verstoend, do no en chline Iblick i min persoenliche Alltag:



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.


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!”


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.


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.


Insomnia musings: Why am I in Sierra Leone?

I just recently returned from holidays in Europe, and enjoyed the long and warm summer days, the abundance of fruits, vegetables, hot pressure showers and cool baths in beautifully clean lakes, the consistent availability of power, selections of cheese and yogurt. The majestic mountains you can climb on well prepared pathways, free of potential snakes and malaria-infested mosquitos, the always punctual trains that get you anywhere in no time and let you read your book in peace and quiet, while even providing functional toilets. The spontaneous gatherings with friends on Friday afternoons sitting in the sun at the river, enjoying a wide selection of cocktails and planning the weekends, full of family and friends who have known you for ages and where you feel home, and happy. The endless sale sections, with beautiful catches and super tempting bargains, providing whatever the heart desires. The closeness of Europe, where you can travel to any major city in few hours from Switzerland, being inspired by the French laissez faire on one day, and enjoying hearty Austrian sausages the next day while watching the Alps eternally beautiful horizon.

I still get homesick whenever I see mountains in the distance – I realised that it is not the mountain itself that makes me homesick, but seeing them from afar, as this is how I grew up – seeing the outline of mountains behind every corner and from every hill.

It was all of the above that made me send a question to my trilateral friends back in Salone – Why am I in Sierra Leone? Remind me again. Life is so easy and beautiful in Europe. And I understand I only see it when I am on vacation, but surprisesurprise – I have lived and worked there before, for the majority of my life, actually.

My smart and wise friend answered, half as a question and half as a statement – “You know the answer to that.

And I do. It is more a gut feeling, than a rational answer. And that gut feeling is passionate enough to draw me back to Salone and keep me here, through good times and bad times. I am on a mission. I am living out my biggest passion, and I am privileged to be able to do so.

Make the world a more equal place, a more just place and a place where people have opportunities.

I studied the theory, I tasted what the classical path to a nice life would feel like in Switzerland, and I left, to find a place where I feel alive. And aye, have I felt alive, have I felt despair, excitement and sadness, heartbreak and jubilation, a whole rollercoaster of emotions.

One of my greatest strengths and weakness at the same time is that my memory blanks out negative experiences – I remember good things much more and better than bad things, to a point where my friend had to remind me that I was burgled twice, robbed twice, as well as sexually assaulted, when I told someone else that nothing has ever happened to me in Sierra Leone. I honestly meant my statement and it only dawned on me after she reminded me, that actually quite a few things have happened to me.

I have no regrets – and not just because I never liked the sentiment of regret, as I find it pointless – you can’t change what happened, just live with it. I have no regrets because I feel alive, with every fibre of my body and inch of my brain. Admittedly, sometimes I am tired, or suffer from insomnia (like now) but generally Salone makes me use all my senses, all my talents and all my risk-appetite, a very satisfying feeling.

My passion is that others can experience this thrilling feeling of existence too – whatever this entails for you. I am thankful for Mama Salone, for making me feel alive, and I am thrilled to be working towards making others feel alive too.

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…

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.

Smiling-stories from the Lion Mountains


It is as if I told enough stories at the African story telling evening in May 2016 (thanks so much for coming, it was glorious!) in Switzerland that I had to hold on for a while… That is not the only reason though, I have also started working in a new position, managing a team working on improving the health worker situation within the Ministry of Health, which has proven to be a LOT of work and not much time for anything else! However, that doesn’t mean I didn’t collect stories in the last few months, they just had to wait a bit longer than usual to appear in written form. Forgive me!

I have recently celebrated recently celebrated my three year anniversary in Salone – who would have thought I would be enchanted so much by this country to keep staying. My impression over the first few months (before Ebola) was that generally everyone thought things are getting better. Then Ebola came and it was crazy for nearly two years and now, after Ebola, the general atmosphere feels negative – people think things are just going to get worse. The president has announced “austerity” measures, a word that is now mocked everywhere on the streets. No wonder, given that the president still goes to work everyday with his 15 cars caravan, stopping all traffic and burning enough fuel to keep someone’s house electrified for a month. The Leone, the local currency, has lost nearly half its value since I came, which is horrifying to watch. In 2013, I received 4000 Leones for every dollar, now they are giving me 7500 Leones for my dollar. Terrifying, if the whole economy depends largely on imports, which just get more and more expensive. It is horrifying personally, and interesting for me as an economist to experience such high inflation. I guess my English friends understand this feeling a bit, now that the Pound is giving in so much… Sorry oh!

Nevertheless, there is always something to smile about in Salone, read for yourself.


One of my favourite things about Sierra Leone is the life on the street, which you see best when walking from and to places. It is rare that I don’t meet someone I know, or at least make a new friend, while walking outside. It makes me feel like I am living in a village smaller than my hometown – Weinfelden has about 10,000 inhabitants, Freetown has 2 millions. Out of some unexplainable reason, everyone always seems to be out and about and therefore the street is the hotspot!

The other thing I love is the constant feeling that I am watching a fashion show. Sierra Leonean have an incredible sense of fashion and no shame to wear crazy things, that look absolutely fantastic. One of those habits is to wear socks to the beach, which we now copied and turned into a regular socks on the beach outing.

Street fashion in Freetown

Socks on the beach!

Human beings are not the only ones out and about – I also have a bird paradise in front of my balcony, everyday. Pretty small shiny blue birds, big ones with yellow beaks, some of them living in my electricity pole (they picked a nice hole into it), it is absolutely gorgeous to watch them. Sierra Leone boasts of over 2000 different birds and bird watchers come specifically to Salone for that purpose. They know where the party is playing!


It absolutely amazing, how much some knowledge of the local lingua franca, Krio, helps. I arrived back in Salone in June with full bags and was dreading customs – who knows what laws they would come up with! I started talking with the customs officer assigned to me in Krio, smiling my best smile, which he returned positively surprised. It went like this:

Noemi: “Hello sir, aw yu dey do? Aw di bodi?” / Hello sir, how is it going? How are you?

Customs officer: “Eee Ma, di Krio sound na yu mot. Udat lan yu di Krio so?” / Wow, your Krio is great. Who taught you?

Noemi: “Ar dey get mi padi dem. Dem bin lan mi smallsmall.” / Well, I have some friends, they taught me some.

Customs officer: “Wow, ok, fo di sake of mi brother, go go. Yu na mi sista now.” / Wow, ok! For the sake of my brother, you can go. You are my sister now!

Noemi: “No wahala, tenki sir!” / No problem, thanks a lot!

We both left smiling, without having had any conversation around my full bags…


In a recent verification of a performance-based-financing scheme we have been administering to all health clinics in the country, we asked nurses how they are promoting family planning, as only 16% of women use any modern family planning methods. The best answer came from Nurse Isatu: “Well, we usually tell the women when they are in labour that they need to take family planning in the future, to avoid such pains. That usually works quite well.” No doubts, very effective sensitization strategy! “You are sick and tired of labour pains? No problem, just take a condom next time!” 🙂

Nurse Isatu at her clinic