the purple elephant: twenty one days

Becoming fearless isn’t the point. That’s impossible. It’s learning how to control your fear. And how to be free from it.”

There’s a purple elephant in the room. One that I promised I would address. The twenty one days are up.

Though there was anticipation in the Canadian customs line…

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We were welcomed back to Canada with only a few curious questions and a raise of the eyebrow. “So what were you doing in West Africa? You were volunteering in a hospital?

There was no forced isolation. It was Ghana, not Liberia, Sierra Leone, or Guinea. We were about the distance between Vancouver and northern Saskatchewan. When there was a SARS outbreak, did we leave Canada? Vacate Saskatchewan because we were ‘near’ Vancouver?

A friend shared that her preschool son was praying we wouldn’t get Ebolum. Cute. Whatever you call it, it’s nasty. I will tell you all now that I wasn’t the face of courage.

I know you all were worried, or ‘wondering’ at our choice. It was the looks on the faces, the questions, or the ‘discussions’ in the OR and hospital wards. If you don’t know me, then I’ll tell you, I’m not the picture of fearlessness. I might appear confident, but it’s learned–because like more than enough people, I’ve fought a planeful of fears. The words, West Africa, caused a few mini-meltdowns for me, no matter how close or distant it was.

I’ve been watching this epidemic unfold since last winter, before most people knew it existed. It was all over the news. I knew I was going to WEST AFRICA. I didn’t think bringing my family of six into Ebola territory was such a clever idea, even if we were relieving pressure of some seriously busy third world medical staff. Even if we made a commitment over a year and a half ago. Even if our lives were meant to be spent living, and sharing, and not whiling away in luxury. I’m not an extremist looking for a suicide mission. I hoped, and expected, the Ebola epidemic would decline–not spiral internationally. (And I might have been quoted to say that it wouldn’t land in the US. I politely clear my throat…I was wrong).

I might not have let on that I was ‘concerned’. A small handful knew. It wasn’t just a discussion with my husband. I think I can confidently suggest I’ve had an argument with my husband that most haven’t. I did more than argue it out with him a handful of times. Mini-meltdowns that he had to accept–I didn’t instinctively think that heading closer to the flame was a great idea. Not everyone is as instinctively brave, and rationally-minded, or as confident in gloves, masks and handwashing techniques, or calm, cool and collected under pressure as he is.

We prayed a lot, occasionally for perspective, definitely for courage. Coded prayers with kids, and many prayers without. We didn’t tell them much about Ebola. We told them too much about cholera and malaria, since we were definitely heading into a cholera outbreak, and heavily-saturated malaria zone. I thought it would be useful to show them a couple animated YouTube videos, get them serious about not walking outdoors without long sleeves and a full-body cover of DEET. We hadn’t left Calgary before our five year old was requesting long sleeves for bedtime. Later, the long sleeves in plus 40 slippery sweaty heat was a bit much to handle. The bedtime mosquito nets were suffocating for some.

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And the super high DEET concentrations I now own cannot be purchased in Canada. My oldest declared this bottle to be her African best friend…

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World Health Organization expected first spread transmission to enter Ghana, not Spain, not Mali, not the States, primarily because it is the regional airport hub in West Africa–Accra, Ghana’s capital city. I wondered if I would see an empty airport waiting room–the six of us on a plane by ourselves. Nope, not so.

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Did I take a few deep breaths as I walked through the extra KLM security check? Yes.

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Hesitated before I stepped over the plane’s threshold? Uh huh.

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Seven hours later, we landed, blasted by the heat as I stepped over the threshold again. I expected to see the signs when we first arrived at the Accra airport. But when I actually saw them, I had to take a deep breath, (illegally photograph them), and move into the temperature scanning line-up.

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There might be talk of Ebola on North American television, but we weren’t in North American hype-ville anymore–the land of CNN, MSN, and tweeting feeds; instead, there were signs for handwashing, bottles of hand sanitizer, and people in medical uniforms and masks welcoming us (no it’s not airborne–this is more a statement of the country’s public health training).

We landed in West Africa’s destination airport–a travel artery that collects folks from all over that zone and sends them on to other international destinations. And this Airport was doing what it could to prevent it from entering their country. If you think eye temperature checks are a useful prevention strategy (it really isn’t), well, each of us patiently waited to be checked.

There’ll be no bathroom breaks in this Airport, no bottles of water purchased, no snacks at the snack bar, no stopping to touch anything. Keep your hands in your pockets. Don’t breathe heavily. Don’t brush past people’s jacket sleeves. Dorothy, we are not in Kansas anymore. Okay, I exaggerate, mildly. I’m sure you’ve been told that the disease is transmitted by visibly sick people, not healthy, handsomely dressed travelers toting a piece of Ralph Lauren luggage.

Oh, you say, but what about that fellow who flew to Dallas? Yep, there’s that exception. That one out of two million Monrovia, Liberia residents exception that found his way onto North American soil. The many thousands of others infected couldn’t imagine purchasing a taxi ride, let alone a plane ticket. At a buck a day income for much of African slum citizens, a plane flight is an unobtainable purchase.

I won’t say that I’m thankful that Ebola found its way to the States. That wouldn’t really be what I think. Affecting and infecting many people on American soil isn’t a good thing. Affecting and infecting and killing thousands of West African people isn’t a good thing either. But now that it’s in the States, you can guarantee that whatever can be done will be done to change the tsunami wave of Ebola infection.

Jim was worried that our family couldn’t handle the seven hour flight from Amsterdam to Accra, then only sleep a few hours and take another hour flight to travel three hours to Nalerigu. I was just happy to get out of that West African hub.

Bye bye Accra.

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Despite driving three hours north from the center of the country in the hospital’s Land Rover, I felt awfully safe wandering into the nether regions of Ghana. I felt relieved when we drove past farms and farms and farms and small towns and more small towns. It made you realize how VERY far away we felt from the potential of Accra, and the difficulty it would be to travel that far north for almost everyone.

So when we settled into our three week location, it unnerved me to hear a discussion about potential Ebola transmission travelling through the northern border Burkina Faso, despite Cote d’Ivoire’s closed border, to this well-known, reliable hospital.

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It also unnerved me to hear that earlier in the summer a threat of hemorrhagic fever, query Ebola, created panic and induced volunteers to leave suddenly. It definitely unnerved me to hear that only weeks before we arrived, another threat of hemorrhagic fever forced one of the doctor’s and his wife, baby and toddler, into isolation in the capital city. Query, Ebola? It wasn’t Ebola. The mother of those two kids questioned whether the hospital would be equipped to deal with Ebola if, or when, it came. I know what I think. A resounding no. Two American doctors can’t maintain sterile procedure for the entire hospital. It did not help my frame of mind to see the state of the hospital. That hospital wasn’t clean, smears of different colours covering the walls, sterile fields optional, gloves optional.

Jim performing a lumbar puncture, gloves brought from home…

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It unnerved me when we were told the recently visiting American doctors were on isolation for three weeks from their work back at home, just in case, despite not being exposed to Ebola. It unnerved me when a nighttime knock on the door, two nights before we were to fly home, we were told that our flight was grounded. Were we even going home?

Need I say that I wouldn’t share that information with family and friends when I was there? Why let them know that we felt threatened, recognizing that the potential was larger than originally expected?

So despite my being there, feeling awfully close, there’s still that discussion: Should African borders be closed? My response: Do people know how large Africa is? It isn’t a country. It’s a continent, with presently fifty five countries. A continent that swallows North and South America easily. Should we close the borders to North America now that Ebola is in Texas? We wouldn’t just be preventing the illness from travelling, but not bringing any essential protective gear, food, medical assistance from the western-able world? Shutting down already faltering, fragile African economies? It would be like a cruel military strategy to starve it out. Cruel.

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In the end, you could call it crazy or risky. You could call it worthwhile and helpful. We wanted to follow through with our commitment we’d made over a year earlier, especially as we were one of the last volunteers in that area willing to still go despite the Ebola threat.

I’m certain it was helpful. I’m certain it was an adventure. And I’m certain that by looking into the face of my fear, sometimes it’s the fear itself that I’m most afraid of.

I learned that courage was not the absence of fear. But the triumph over it“. NM

 

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reverse culture shock?

If I’m honest (and when am I not honest?) I haven’t gone through reverse culture shock. Instead, reverse culture relief!

Within an hour of landing in Canada, we were at McDs. We almost never hang out here, but the kids requested, and we were eager to please and return pounds to their tinier frames.

The look of love is in their eyes…

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When I tell people that this was a most challenging experience, not the vacation-like experience many might think we should have had, some are disappointed. Yup, I hear ya! In our part of the world, everywhere we intentionally set to go should be a fantastic, exhilarating experience.

I did have a pretty good sense what I was heading into, since I have been third world before. I wasn’t naïve. We went to share, and where better to share than a place that actually has needs? One doc to ten thousand, instead of one to one thousand here. We didn’t head to Africa to soothe ourselves in leisure and comforts. But I also wasn’t prepared to see a harsher reality of this part of the third world (and yet I’m certain there are much, much harsher realities still).

I quickly missed stuff from home…

1. Luxury items: clean, running tap water and public safe sanitation. I can turn on my tap and fill my glass, or swish my toothbrush, without fear of intestinal cramping or potential death.

And if you think three and a half weeks is really not that long away from these things, well, I dare you to try;)

2. My cappuccino maker…the gal living in our Canadian home during our trip told me she was sipping on a cappuccino while she read I was missing my machine…I thought of her in Ghana. Even the touch of the coffee beans grinding under my hand that first afternoon back was thrilling. Yes, thrilling.

3. North American climate. My Caucasian, four season-trained exterior didn’t know what to do with that tropical humidity. I like being outdoors. But not outside in plus forty degrees, with a sweat-slicked body,  no thanks! I was still sweating like a pig an hour into my air conditioned flight home.

4. Coffeeshops…and my favourite second-home, John Ward…

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5. Food variety and availability. The only truly surprising aspect of our culture is the incredible variety, and really, excessive variety. I stared in amazement at the eight dollar flavoured toothpicks at a gift shop last week. Obscene. Though I won’t judge you for your purchase (I’m sure some of mine might look excessive to you); just don’t offer me those toothpicks for the next month. This time I didn’t have a manic moment in Superstore, but I did slump over in overwhelm and then gushed in tears when I saw my ‘bare pantry’. Before I left, I thought that I’d ‘cleaned it out’–now I saw its abundance.

Whether one is ‘western wealthy’ or not, availability is ubiquitous.

Have you seen the fruit options?

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Those fifteen dollar, make your laundry smell good, but not wash them, beads? Seriously?

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Nutella snack packages…they should pay me for this…

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I said it before, but ‘eating in season’ is a North American modern notion. The rest of the world does it by default.

6. No sense of food scarcity. Packaged meat was a twelve hour drive away. Powdered milk was as challenging to find as saffron here. There was no whole grain anything, except rice if that qualifies. No pasta. No cheese. No stuff in cans. We had what we needed. I don’t want to suggest otherwise. There were the basics. But we were very aware that our options just become seriously limited.

Really, do we need to stock our pantries for a month? Do we really think that our bean and rice availability will dry up if the end was near? We might miss citrus, or feta cheese, or fresh pasta, but we’ll always have an abundance of food.

7. Premium Healthcare. I wasn’t personally missing it. Though I wasn’t eager to be treated in-hospital when dealing with malaria. Yikes, the uncleanliness.

No one here is worried about babies dying in our doctor’s waiting rooms. That would make the news, an inquiry, a College investigation. No one is worried about our hospitals running out of narcotics. Or that the OR would forget to call for a burn patient dressing change. Or concerned that sterile fields and sterile gloves wouldn’t be available for a lumbar puncture. Or that you couldn’t  afford a dollar a day hospital admission, or a ride to the specialist two hours away for your typhoid-induced abdominal perforation.

And I can be certain that many would come to our rescue if the city of Vancouver (similar size of Monrovia, Liberia) were overrun by a freakish nightmare like Ebola…they wouldn’t consider shutting down borders and isolating millions to end their existence in a horror-like state.

I am now keenly aware of things that I should be thankful for.

The ordinary is extraordinary. You want to really see what you have? I recommend taking it away temporarily. Don’t know why the human spirit is trained under unpleasant circumstances, but I am certain it is.

I am thankful that our government, imperfect as it is and always will be, doesn’t concern itself with potential military coups, like Ghana’s neighbouring country of Burkina Faso, an hour away from where we were at the beginning of November.

What we are probably missing within our western culture…

…a keen awareness of who we really are minus our entertaining distractions and perpetual comforts.

…and subsequently, understanding what’s really important in life. Call me opinionated, but insisting that we stand apart as individuals, distinct, competitively asserting that we are better, more important, popular, have people acknowledge our greatness….a waste of our life. We’re all important. And call me loudmouthed, but aspiring to wealth and fortune is a waste of energy. Comforts are good. Oh yeah, baby! But teaching our spirits to enjoy the little things, being content with simple, that is the greatest luxury.

…a deeper awareness of communal community…yeah, I know those words have the same root. But community is an exponential experience where community is required. Perpetual handshakes and personal involvement are part of the African culture for a reason. They need each other more often. Our western independence is a sign of our privilege. But is it always a privilege?

Yes, I know this was an adventure of a lifetime. And I am deeply grateful for the life transitions it has pushed me toward. I was delighted to encounter so many interesting Ghanaian people, privileged to share our gifts and skills. But I am really, REALLY thankful to be home.

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Gearing up for our redeye tonight, I didn’t sleep last night. That wasn’t as planned. Thankfully, three out of three of us have had an afternoon nap (not me).

On our last day of Africa, we spent it unconventionally. With availability of resources, we bought ourselves twelve dollar pedicures, scrubbing that terracotta muck off our toes, threw away our shoes and stopped at the gelateria for lunch. Not how you see Africa? Ya, me neither.

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Some of us found the pedicure tickly…

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I’ve never had a more effective foot scrub. I can recommend a pedicurist if you’re ever in these parts.

Zach bounced on the lonely bouncy castle. Not a lot of people in this modern mini-mall.

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 I debated suggesting elongating our morning out by driving by the Gulf of Guinea. I like to collect the sand from waterways around the world, the Arctic, the Pacific, the Atlantic, the Adriatic, the Mediterranean and the Caribbean, are checked off my list. I didn’t make it to the Indian Ocean on our way through Kenya last time either. But I hear this oceanfront is sewage-filled so I’m not missing much more than a garbage-beached view.

Cappuccino is tasting closer to home, possibly Tassimo inspired. Milk coming from South Africa, a long ways away. No dairies in these parts.

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The FroYo was delightful. White pineapples from Tamale. Bounty chocolate bars, yum, my fav. Dark chocolate syrup. Papayas and other tropical fruits.

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I’ve taken my final African tepid shower, avoiding water running into my mouth. I imagine the cold of the Netherlands will whip me into shock, but I will be so thankful for the bug-killing temps. It’ll take me a while to not ‘swat away’ bugs, aka falling hairs from my heads or people that brush past me.

We’ll get to put away the Steripen and stop buying water everywhere we go, drink from public taps, not squatting over toilets, not worry about being run over by traffic (not even in European cities), and not have to dodge public defecators, animals and humans alike. I’m even going to wear jeans and sneakers to the airport.

I am super grateful for the opportunity we’ve had for the month in Ghana. As I have written, it has taught us much, and we came to share, and we did indeed do that. But I am thankful that we’re just four hours from being out of Africa.