Washing Feet

 I am in the throws of "ortho season" right now. 48 kids in casts who were previously bowed legged or knock kneed are coming to rehab to see a PT. It's controlled chaos! There is a team of 8 of us seeing all of them (soon to be 6 as 2 of my colleagues return to the US and Belgium). After 12 weeks in a cast, they have their "healing check day". We take off the cast, go to radiology for x-rays and then wait for the surgeon to say yes they can stay out of casts or no they have to go back into cast for 2-3 weeks then try again. Of course we are all hoping and praying they get out of casts and we can start that next phase of rehab. 

Part of the process of taking off the cast is using a cast saw to cut the cast off. This is a new skill I have acquired here, something I have never had the need to do back in California. But after the cast is off, we take a few minutes to clean off the leg before going to radiology. After being in that cast for 12 weeks, there is dead skin, small wounds, you name it. While friends here have asked "isn't the small awful?" or "isn't that gross?" it is the absolute pleasure of my life to clean those legs.

It is a sacred thing to me. A moment of servanthood. A time to slow down and show these kids how much I love them. I will clean your feet. It's a vulnerable thing for them that I do not take lightly. 

I have no pictures of these moments and never will as I wouldn't want someone with a camera ruining the moment. But believe me, this is one of hundreds of unexpected blessings I have been a part of since coming to Sierra Leone. 

Banking in Africa

It is quite difficult to have the same level of banking as the Global North (or "the West").

Even for me, the Mercy Ships Finance Director,  to just to log into the local African bank's website will often take 3-5 tries. Or I may try in the morning and then have to wait until the afternoon because of error messages. The site is up; it loads. Mind you, I use a password manager so I'm not mistyping. When I log off, I'll often get an error just trying to safely log out of the system! 

A colleague from a different Africa nation was completely locked out of his bank. He contacted customer support to no avail. Thankfully, he knew someone in IT so he reached out to that person. I think (hope?) he now has access to his personal money now!

What about wiring money? Between North America and Europe it is pretty quick at just 2-3 days, or even less. In Africa? Could be a week. Often with fees. 

Last year, we had nine crew members who had to pay exorbitant fees to simply wire the equivalent of $1,000 to their home. Sometimes it would be $60 or all the way to $170. And this is usually without explanation. While we eventually resolved it by setting up US dollar accounts in their home country, it took many months to get to that point, lots of fees, and the constant reminder that it is not equal. This was just one country. Multiply that by dozens of countries and trying to work through those regulations and what is and isn't possible...it's not just the weekly time investment, but the inequality simply because I'm from the USA and another person is from somewhere else. 

I'm accustomed to "free banking" in America where the bank makes money on the float (the cash I have in my account) but here you pay a monthly fee for that privilege of having a bank account. If you have a commercial account, you may even have to pay taxes on owning an account and some of your transfers!

This is often the reality of banking. I knew it was hard to live here, but I didn't understand the micro-frustrations of daily living. So when we have grand ideas of micro-finance loans, creating jobs, or whatever it may be to build up economies within sub-Saharan Africa, those are worthy ideas and we should pursue them. However, we must also remember there is a huge amount of infrastructure required to get to that point. It's like that kitchen project: we just want to replace this one thing to make it prettier, but then when we peel off some paint, we discover dry rot. From there, we find other problems. Before we realize it, we've ripped off half the wall, are redoing plumbing or electrical, and upgrading a few other things — all because of that small, nice-to-have project that we started with. However, here the stakes are different. They're often harder for us to see, or imagine, or to rally enthusiasm around to fix the ten things before we can get to the one that initially lit our passion.

Oh, and that's if you're lucky enough to have a bank account.

Life Lately

 Not sure what else to call this except "Life Lately". A little of this and a little of that. Going with the old quote "A picture is worth a thousand words", here is a few thousand words :)

Sam's class made this for Jeffs finance team. Everything here overlaps in amazing ways, even the school and the bank. 

My patients continue to be the highlight of my days. About 55 cute kids in casts are coming to the rehab department, and very soon there will be more and more without casts! Then we make those beautiful straight legs strong before sending them home. Forever privileged to be part of their story. 

This is the current rehab team. They are from New Zealand, Australia, the UK, Belgium, the US, Netherlands, Spain and Sierra Leone. Beautiful people with servants hearts. 

These are our daycrew. They all live in Sierra Leone but travel everyday to the ship to work for Mercy Ships. They do translation, sure, but so much more. Exercises with patients, helping us understand the culture, etc etc etc. Most of these I have known for both years, a few from just this year, but all sweet friends of mine I will miss dearly when we sail away. 

We recently had an event called "African Praise Night". It was a beautiful night of people from around the world singing in many languages. Felt like heaven. 

Life in Sierra Leone is interesting. There is always something to see when walking/driving around. We were trying to figure out how many people were in this KayKay!

These are a few fun this things from the hospital. The first is all the feet are the orthopedic patients, and every hand is someone who has cared for them. Beautiful. Another is puzzle pieces patients colored, and finally a note written by a patient. Although a hospital and very clean (thank you housekeeping!) I love that it is also colorful and vibrant! 

Do you want to know more? Have questions? Reach out to us anytime! We love texts from home. 

Love,

J^2, L, S^2

Other Forms of "Taxes"

Last time I talked about the Black Tax, but there are other "taxes", too. These aren't what I actually owe a government or society. These are what we may call "headwinds" or "obstacles" toward progress. At least in Sierra Leone, we see:

• Limited clean drinking water. Many broken water pipes exhaust an already small and old architecture. During dry season, you often get water only three days a week and often have to pay someone to deliver 5-gallon jugs to you.

• Lack of mechanization. A lot of work is done by hand, rather than by machine. Wages are lower and more back-breaking work (literal ditch digging).

• Poor banking access. Bank accounts are hard to get. Even when you get one, the distrust is so high, online access is intermittent, and inflation is bad. Even for me, I usually have to attempt 3-5 logins before I finally get in (yes, even with a password manager using the exact same username and password. Imagine that happening in your world. That would never happen.). 

• Unyielding inflation. We may complain about inflation in the West, but five years of inflation in the USA is often felt in one- or two-years here. How can you save money if it constantly becomes devalued and you don't trust the bank? Or they don't pay interest?

• Lack of tracking/experience. Good training requires someone with good — or great — experience. This is severely lacking here. While the resourcefulness and ingenuity are exceptional, countries in West Africa could be so much more advanced with better training. Examples include: poor or inexperienced electrical wiring, plumbing of pipes where the sewage or water get stuck or brittle pipes may break. Many pipes are laid on the ground instead of buried and protected by a covering — this causes numerous pipe bursts. 

• Very old machines and vehicles. Many of the trucks, vans, sewing machines, and other construction tools are old. Some of the semi-trucks (lorries) are from the 1960s through 1980s. Quite impressive, but also means breakdowns happen significantly more than what the West sees. Again, the ingenuity of mechanics to take a barely-functioning vehicle and somehow get it to keep going is simply admirable. Imagine trying to get the necessary and high-quality parts for all those various machines!

I've included pictures below. They don't show the broken pipes, banking, or inflation, but I want you get the idea. Hopefully this gives you a small glimpse into life in this community, into this nation. While there are plenty of hardships, I'm daily amazed at how resilient, compassionate, ingenious, and creative people are here. They don't let a broken down car the lack of water stop them. They keep going, albeit slowly — like a tax.

A number of vehicles are broken down blocking one lane of traffic. This has been the case for over a year.

Blue-tented semi-truck: this truck was broken down in the middle of the roundabout, partly blocking traffic. I saw this during a morning run coming back to the ship.

At the gas station in Makeni, two men were chipping away for a shallow trench to run pipes or lines to the gas tanks underneath. All done by hand.

Freetown has a terrible water shortage in the dry season (Nov-Apr) and water leaks are very prevalent so there are constant patches and repairs. The Guma Valley company is hard at work to repair pipes all over town.

This ship, while creating beautiful sunset photos, has been derelict for years or decades.

It is very common to see cars broken down on the road. Vehicles are overloaded with passengers and supplies, putting further pressure on vehicles. Coupled with dirty diesel or petrol fuel, inadequate maintenance, and often poor washed-out roads, and you get an increase in breakdowns.

Quite the overloaded vehicle driving from Guinea. Look at the right-rear tire. Trucks are expensive and harder to come by.

The rear axle came completely off. You should have seen the picture from the rear.

The door handle...needs some help.

Thankfully, there were two toilets and the other one had a seat. It just wasn't attached so you need to remember to sit down slowly and softly.

If you look closely, all the boards bow down. The roof will likely hold up, but you should appreciate the ingenuity and relentless determination.

I really do like the lightbulb covered by a cut-off plastic water bottle and other plastic shrink-wrapped (melted?) over the base of the light socket.

We can see all this and feel defeated or sad. We go through the cycle of optimism, wishful thinking, defeat, "why even bother?", seeing glimmers of hope, and hopefully and finally seeing progress and opportunity. It's taken me awhile, but despite the challenges, I see hope and growth in this country. I see great work. But these detrimental "taxes" slow down much of the opportunity.

Orthopedic Surgery

 Many different kinds of surgery happen on the Global Mercy. If you look at their website or social media you will see tumor on faces, hands stuck in a fist from a burn scar, people who have hernias, and then my favorite orthopedic. This is kids ages 4-10 who have bowed legs or knocked knees. This is in general from one of two different diagnosis's: Blount's disease or Ricketts. Blount's means they were born with weak bones that can more easily bow. Ricketts means it is a dietary deficiency, especially in the first few years of life. These hallow bones bend more and more as they get older, under the weight of their upper body. Whichever is the mechanism for injury, Sierra Leone has a lot of kids with bent legs. We are able to do surgery on approximently 60 each year we have come and every time there is a waitlist. 

These kids are outcasts of society. Mercy Ships sends people into villages and shows them pictures of bent legs and often the answer is no, they don't know anyone like that, because they are hidden away. I have met so many children who have never stepped foot into a school. They don't know how to count, write their name, know their colors. Some are slightly better off and help with chores around the house, but never to be seen by anyone who is not part of the family. Stories of fathers who have left families because they think the child is cursed. 

I'm always amazed by how functional from a physical therapy perspective they are when I meet them. They can stand on one leg, go up and down stairs, do squats, etc because they have to to survive and keep up. When I ask about goals (what is rehab without goals??) the #1 is always "to not be mocked by neighbors" and #2 is "to go to school". 

Both last year and this year I feel like my heart grows by 50 kids. I no longer have just my 3, I now have 53. :) Their triumphs are everyones triumph. Their frustration is mine too. They scream in pain and in fear. So much fear... how would you feel being stood up with two legs in casts all the way from foot to mid-thigh? We blow bubbles, sing songs, and show love and attention to them in all the best ways. My heart wants to burst every time I am at work. I am exhausted at days end, but in the best way possible. I truly believe this is what I am called and equipped to do, and living in that space brings so much joy. 

Doris

Aminata

Please be praying for me as I not only help legs get straight and strong, but more importantly love these kids and their parents and hopefully point them toward Jesus in the process. 

Let me know if you have any questions. As always, we are so thankful for you support 

Black Tax

I was sitting across the coffee table from Sophia as I was learning about her life in Nigeria. "Black tax" she said, was what held many Africans back but also was the social security net for families.

"Black tax" is the common term used for when African expats who have moved abroad are obliged to send a portion of their income to their families back in Africa. Especially the oldest, usually son, must do this. 

This is a tax on that person's ability to save, build up wealth, buy a home, or otherwise move up, ecomically speaking. It's similar to when parents pour all their time, attention, and money into their kids' education hoping and praying that they can one day go to college. 

As I (Jeff) oversee the finances of the ship and lead our crew bank (where crew can receive donations, save money, withdraw local currency, and use it for basic supplies like a toothbrush or a soda), I see the way money is handled. Africans and those from the Global North act, treat, and use money very, very differently. 

It is not a tax from the government. It is a societal and familial tax. Because if you have even the slightest amount of money, you're expected to share that when someone asks. You must say "yes". 

This is why it is common that, when you get paid or somehow get a windfall of money, you immediately go out and buy bricks for your house or some other physical asset. You've converted your cash (an asset) into another asset — bricks, wood, fuel, roof material, etc. Then, you have no money and, thus, you can say "Sorry, I don't have any cash".

So while we in the West may feel the squeeze as we need to take care of our children and also our aging parents, it is still quite a bit different here where there is no governmental social security income, medicare, or other safety nets — you are that safety net.

Helped by George in the dark

When the weather is not terrible (i.e., the smoke, pollution, and Sahara dust) I enjoy a morning jog up into Freetown — usually 5-8km. This morning a Sierra Leonean was also running, caught up to me and began a conversation. Jeff is not a common name here, but it is still easier than many other Western names.

I was running solo which is rare, and so when a Sierra Leonean came up alongside me, I was a bit apprehensive but I knew the route, it was well lit, and there were other runners behind us. So we started talking, as strangers around here do. Being white, you are automatically popular. People want to know a white person, say hello, and practice their English. Also, Sierra Leoneans are also very friendly. So we jogged and in basic English and Krio over the next two kilometers we got to know each other. He runs Monday-Saturday and does not run on Sundays (I didn't understand if he is a Muslim or Christian). He is at college and plays football (soccer, in America).

While jogging back to the ship, I kept thinking "I was looking forward to a solo run and to enjoy the semi-peace of the morning with all the honking from kekes, cars, and large diesel-powered trucks chugging up the hill blowing out plumes of dirty diesel exhaust out their sawn-off tailpipes." Nope. Not today. He wanted a conversation. So then I thought, "God, why did you place this person next to me?" and then I remembered the proverb "a cord of three strands is not easily broken." I pondered that for the next kilometer.

Then I suddenly tripped on the concrete and while I likely would not have fallen, George instantly grabbed my arm to stabilize me with his lightning-quick reflexes. "Tenki ya, George!"

I had my headlamp on, my florescent green/yellow shirt, and while I was not concerned about getting hit by cars, I misjudged jumping off the 18 inch curb and did not see the lip of the concrete in the morning twilight. Sierra Leone is in the Northern Hemisphere, so it is still winter here — if you can call 79º Fahreinheit at 6am "winter". The sun had not yet risen at 6:40am.

I guess my lesson and takeaway is that sometimes there is goodness that comes from strangers in the dark. We're taught to always be on our guard and to not talk to strangers, and while that is still a very good and important approach — especially in raising up our kids! — it may happen just to prove that there can be goodness and beauty in this broken, impoverished, and needy world in which we live. 

I later looked up the full passage for the proverb in Ecclesiastes 4:9-12 and smiled.

Two are better than one,
    because they have a good return for their labor:
10 If either of them falls down,
    one can help the other up.
But pity anyone who falls
    and has no one to help them up.
11 Also, if two lie down together, they will keep warm.
    But how can one keep warm alone?
12 Though one may be overpowered,
    two can defend themselves.
A cord of three strands is not quickly broken.

Lines 3-6. Ironic for my morning. Right?

While not this morning, here is what my typical route looks like in the afternoon:

Usually about 80-84º F and 80-85% humidity.