Koidu, Sierra Leone
Koidu, Sierra Leone is the least developed place I have visited in my short life, but I have constantly questioned why. What every woman aspires to have on her hand comes from the ground right below where I am sitting. Twice a week, Koidu Holdings blast deeper into the mine to extract more diamonds. This industry has had little to no effect on the wellbeing of individuals living in the area. I constantly question how one of the most expensive natural resources is being extracted from an area with no improvement to the community or living conditions of individuals in the Kono Distract.
Koidu Town, which is an hour walk from the clinic, is the most urbanized location. The strip of stores and restaurants still cook food outside over open fires by using coal and wood. This was the signal to me that development has been slow to non-existent in Koidu. Moving from outdoor cooking to indoor cooking can show better access to running water, sanitation, gas lines, ability to allow smoke to exit amongst very many other simple things. Even within Koidu Town the water is brought to locations by carrying 5-gallon paint jugs of water over 500 meters to each individual location. This is a sign of poor sanitation because of a lack of access to water to properly clean silverware and dishes. When walking down the street there are also limitations to what types of food can be offered. The market for different types of food is very low as a result of levels of income. The Kono District is a place where disposable income is so low that individuals are forced into producing low cost crops such as rice, beans, cassava, plantain, banana and groundnuts. On the day-to-day, these crops seem to be peoples entire diet, with very limited other options. The largest income earners are individuals with businesses on the strip, NGO workers, government workers and employees from Koidu Holdings. Subsistence farmers are yielding different crops but do not seem to be making large enough profits to expand their farms to increase returns. Many of the business owners are also foreign workers who have brought their own funds to start a business. These foreign workers are good for economic growth but also create divisions because they live better than the local population.
Infrastructure here in Koidu is very poor. The few paved roads are littered with potholes and most areas are only regularly accessible by motorbike, making the transportation of HIV and TB patients very difficult. The light from the Koidu Holdings site is the brightest thing in Dorma Village. Other than the lights at our house, it is a kilometer before finding someone with light produced by something other than batteries. The city has recently committed to installing 10,000 solar panel streetlights. This will allow children to exit their homes to get vital time to study underneath the street light.
The education within the district is only supported until 6th grade. This leaves children at the ages of 11 or 12 with no access to education unless their parents can pay approximately $20 to attend high school. The $20 fee covers the tuition but not a $2 dollar notebook or $3 uniform. After accounting for all of this, a parent must be spending over 15% of their annual income just so their child can move beyond the sixth grade. When raising a family on less than one dollar a day, sending one child to school means that a parent will not be able to feed their family for 20 days.
The general budgetary restraints do not account for any of the other barriers that prevent children from accessing education. It does not account for 10-year-old child taking care of his 8-year-old brother, while his mother is struggling with paralysis in the hospital. It does not account for a child’s aunt raising him and 6 other children because two of her sisters died from HIV. It does not show the maturity and strength of an 8-year-old girl who struggled to take care of her mother instead of attending school. It does not depict the struggle of working while eating nothing but dry rice for weeks at a time. The financial gap quickly goes from a challenge to the largest barrier between learning the most basic skills such as counting to ten, recognizing letters and a destitute life of poverty.
The United Nations is planning to leave the Koidu and centralize their efforts in Freetown, the capital of the country, ten hours away. When walking down the street you can also see abandoned facilities with missing windows where the UN troops used to stay during the conflict. It seems as though funding for this population has rapidly declined during the post conflict era, leaving the population living in a poverty trap to fend for themselves. I do not believe this is the United Nations fault, but funding for places like the Kono District often fade over time as other international tragedies call for immediate funding. It is the classic example of putting a huge band-aid over an open wound rather than the longer process of cleaning the wound, inserting stitches, applying antibiotics, and finally the large band aid. This is not a result of incompetence by the United Nations, but a reality of funding and the low success rate of long-term development projects.
The thing that stresses me most about the Kono area is the lack of structure for children Children have little to no structure or anything to play with. The children from the house next door play with a deck of 26 cards everyday. The only other three things I have seen to occupy children are old tires, soda caps nailed to a stick and the occasional soccer ball. This signals a challenge for the next generation that will need to be fixed in order for real development to be made in this area. I have not seen one child with a book, even the adults here struggle to find anything to read or stimulate their minds.
The most positive signal for development around Dorma Village, where I live, is that people have moved from thatch roofs to tin. Tin roofs will last a much longer amount of time and also save individuals money, but are also more expensive to install. There are huge segments of people surrounding Dorma Village that do no have the ability to save enough or make enough in a year to cover the costs of a tin roof. The Engineers Without Borders from Princeton are improving the access to safe water, which will reduce water born illness. This will also make Dorma a more attractive place to live in the area because safe water and access to medical attention are close by.
Every person here has welcomed me with open arms. Individuals have asked to go to their homes for dinner, asked me to come to their churches. When I enter the home of an HIV patient, they always offer me the only seat the own to take care of me as a guest in their home. Every patient I meant thanks me for coming and thanks me when I leave. There is no deed left forgotten by the people in Kono.
My coworkers have been more than willing to sit down with me and explain everything. They have welcomed me with cheerful excitement every morning. My coworkers are a pretty young crowd and I enjoy their young and lively demeanors. Joining them to watch European fútbol matches with 75 other people on a single TV was an amazing bonding experience.
Everywhere I turn I see little children yelling “Whiteman, Whiteman!” Many of the children become afraid of me when I come to say hello, but other times I turn to look behind me and one is stretching out to hold my hand. The children here may have very little, but it does not prevent them from smiling and laughing. The looks on their faces when they discovered that hopscotch was something they could draw in the sand clearly depicted how easily they could be occupied and excited about something so simple. I hope that I can continue to show them new games so that they can interact with different children to improve their social skills and connections within the village.
The majority of individuals are Muslim or Christian, approximately split right down the middle. The religious groups are integrated together; it is not as though they are divided. Throughout the day you can find yourself hearing the speakers projecting daily prayer from the Mosque. There is a strong trust in religion here and a competitive atmosphere to get Westerners to come to their Christian church.
The Wellbody Clinic seems to be the most trusted clinic in Kono. People come to the Wellbody Clinic because it is more affordable and feel that they are treated better here than at the government hospital. The first two weeks I was here I went out with different individuals in the TB Reach program and the HIV program. This week I have spent in the office helping with the data collection that is done by the field workers I had spent time with during the first two weeks. I am starting to finally understand the entire organizations programs, day-to-day functions and the clinical functions (as a result of feeling under the weather already).
The HIV program functions as an arm of the ‘human right to health’ that Wellbody Alliance truly represents. The HIV supervisor and I went to many different villages to personally check up on HIV positive patients. Patients range from an array of categories. Wellbody actively treats patients and their spouses, mothers and their child, single men/woman as well as orphaned children. Each individual has a different story but all of them have a similar issue- nutrition and food. The HIV drugs have shown strong results. The drugs allow people to live normal lives, but when they are waiting for harvest or income they no longer can fund food to eat. The medications although effective, can make individuals who are taking the pills without food very sick. As a result people are forced to make a decision take the medication and become sick or not take the medication and allow their immune system fail. These individuals are not only stuck in a poverty trap but also become too sick to even have a chance at making ends meet. The living conditions for many of these individuals also consist of dirt floors and mud walls creating a very strong chance that they may become more ill from other issues as a result.
The clinic plans on having over 20,000 people come through their doors for medical attention. This is a critical location where the average life expectancy is 47. Sierra Leone is also a place where 1 in 8 woman die during childbirth and 1 in 4 children die before reaching the age of 5. This clinic serves ensures that mothers can care for their children and children have the opportunity to survive. Everyday I come to the clinic I see countless infants that are sick and need medical attention. I can’t imagine what this population would do without Wellbody.
There is also the TB Reach program has screened over 50,000 people. TB is passed through cough and within living quarters where a whole family may share one bed it is easily transferred. They have found 6,000 subjects and constantly working with limited supplies to ensure each one of those individuals gets tested and treated. The grant that Wellbody received has enabled them to extend their outreach but also made their name well known throughout the district.
This clinic has a very great reputation amongst the surrounding population and I my hope that I can uphold and help improve the clinic for the next 8 months. I am excited to be a part of this organization and their goals. I wake up everyday feeling that I can help others accomplish great things everyday. I feel that individuals here have truly dedicated their lives to making a difference.