Princeton sent four students interning at the Amputee Clinic with GAF (Global Action Fund, goact.org) this summer working with Dr. Bailor Barri from SL and Dr. Dan kelly from US. Dan was here the last two weeks of June and Bailor is in Koidu with he interns.
Kulani, the only female intern, is everyone's favorite. Staff and town's people all know her and love her, their eyes light up when they see Kulani and they shout with delight or chase her down to say hello. When they dont see her they ask "where is Kulani". Kulani's parents were from Ethiopia but this is Kulani's first trip to Africa. She gets constant unwanted attention on the streets so she got a ring to wear, except the jeweler added a heart to the band and it now signals "searching for love". So she has to go back and get rid of the heart.
Kulani works with community health workers on HIV patients in the home care program. Part of her project is to create a stigma index about HIV. Her interviews take her all over the villages day and night, and she hears a lot of difficult life stories and very personal feelings. It is now the raining season when people are busy with planting, plus people forget or just no show. She often has to schedule several times for one interview. Some days she is just drained after a full day's work.
Raphi works with a Medical Anthropology postdoc Peter whom I met for a few hours before I left Freetown for Koidu. They study PTSD-Post Traumatic Stress Disorder among the amputees. Currently they have some difficulties with their questionnaires due to "lost in translation" type problems, but Raphi continues to gather data on chronic pains. He hopes to write grants this fall to bring funding for physical therapy, counseling, and prosthesis to the amputees. Raphi hits the "gym" after work to train with an ex RUF rebel to get ready for his wrestling career at Princeton. He often finds amazing papayas. Being popular at the camp he is often given oranges and ears of corn, which he hopes were not taken from other people's trees.
BJ is gathering data on blood pressure and diabetes, two common diseases in SL. After the initial drive of 1500 people, he now follows up with everyone taking new data on BP and blood sugar. For instance one day he held down the fort at a local tea shop most of the day so people in his group could come and get their BP and blood sugar checked, and have some tea or Turkish coffee. BJ is funny, outgoing, and friendly with a quick smile, drawing wanted and unwanted attention.
BJ and Raphi also has a pilot project they are excited about--to buy two goats for an amputee camp and see if they can raise the goats to produce milk as a source of income. If the campers do not lose, eat, or sell the goats, and can show responsibility about running the goat milk business, then the next thing maybe to get them two cows to raise and produce income for the camp. Bailor thought this might be a no return high risk investment but he is okay with it. Raphi and BJ have to front the cost of the goats and hope to get reimbursed back at school.
As BJ does the health servery, Michael is doing a wealth (well, poverty really ) survey trying to figure out average household income in the general population vs the amputee population. From that data, they hope to construct an income-based fee schedule for the services provided at the clinic to non-amputee patients. Michael is about to survey the general population. He also takes BP for people because otherwise who would want to sit around and answer a bunch of sensitive questions. Michael was hooked up with a local soccer team made up mostly of seemingly unemployed men, but he said anyone of them could be a super star on the Princeton Varsity soccer team. He has many friends through his translators and community health workers.
Bailor directly works with the interns while Dan works with them via email and phone. I have talked to Dan a few times on the phone about my trip and I hope to meet him some day. Both Dan and Bailor, founders of GAF(Global Action Foundation) and NOW(National Organization of Wellbody), are just 30 years old. With his young family living in Freetown Bailor commutes between Koidu and Freetown most weeks, not an easy task considering the bad road conditions. He sees patients at the clinic, runs all the projects with Dan and the interns, lectures in the US on global health, travels on GAF businesses--. I dont know how he does it. He certainly can move overseas and be part of the SL brain drain, or he can practice in Freetown and make big bucks, but he chooses to stay in war torn Koidu to work with the amputee community.
After the Sunday dinner, Bailor stayed to talk. Kulani was very worried with one of her HIV patients Molai who was in the hospital for transfusion, She has been visiting daily to check up on Molai. Raphi wanted to give blood but Bailor did not want Raphi's hemoglobin to get too low in case he should get malaria, which is still possible even though everyone takes a Malarone pill daily. Next Bailor talked to Michael about what questions should be on his survey to determine wealth, such as, do you use milk with your tea ( fresh milk is rare and expensive), how often do you buy meat, how often do you need to beg for good etc.
Bailor stressed that any questionnaire should not take more than 30 minutes to do. There were discussions on how best to ask people about the violence they had seen or suffered personally during the war. BJ thought amputees had been forthcoming with such emotional information while Kulani thought it could be hard to press them back to those painful memories. Bailor suggested that perhaps crying could bring healing and talking things out could be therapeutic. Bailor will work with each intern on their field work or routes this week, starting with Michael and his translators on Monday to start the surveys in town. To make it a random sample they should pick every third person to interview.
Bailor and I talked a bit about the radio interview on Monday to promote dental health. After all the talk on HIV, TB, high BP, malaria, malnutrition, amputees' hard life---, brushing teeth seemed trivial. But everyone insisted it was important business.
The nasty road to Koidu was the cause of an accident in 08 involving a GAF vehicle and 5 passengers including Bailor. One SL medical student died from brain injuries. Bailor recounted how he did the first roadside EMT work even though he himself was in the accident. I don't know how this came up but it affected me deeply. The interns pointed out that such accidents could happen on any US roads any day. I pointed out that emergency brain surgeries would have been much more available in the US.
There is plenty of hard work to go around here for sure, and this group is pressing ahead with dedication and compassion.
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