Thursday, August 6, 2009
Peace Out Liberia!
Note: Pictures to follow. The internet is just too slow right now :(
I did not do as much with the clinic as I had hoped. Monday I went to see what I could do- they told me to come back tomorrow when the Boss-Lady was there. I came back Tuesday and I was supposed to do a nutrition education session later in the day, but when I got there all the mothers had already left for the farm. So, I helped with a children’s worship/ arts and crafts event that was going on through Hope for the Nations. Wednesday, I didn’t bother to go back to the clinic because they told me I would not be able to do anything with nutrition. FINALLY, Thursday I was able to do a nutrition education session with the mothers of the malnourished children staying at the center and some volunteers. We talked about the food groups, the types of malnutrition, breastfeeding and some other topics that came up during the Q&A portion. I was able to use the nutrition cards I made for the PD Hearth sessions and I think it went well. I also was able to finally give out the clothes that Valley View sent as a donation, along with some of my clothes that I was donating. They were very grateful, thanks Valley View! I posted a picture before of the bracelets that Carla’s children made for me to send before I left. Here is another group of children who received the prayer bracelets! They were so excited to get them!
The woman I was working with, Mary Ann Newah, is a wonderful woman that works with the Child’s Recovery Center. She grows Moringa trees in her yard to use to supplement the children’s meals. Moringa is an extremely nutrient dense tree that “happens” to grow in areas of the world with the highest malnutrition rates and extreme poverty. More information on the Moringa tree can be found here through an organization called Trees for Life International.
http://www.treesforlife.org/our-work/our-initiatives/moringa/introduction/the-moringa-tree
The center is not adequately funded and they have no proper supplementary feeding products for severely malnourished children. Moringa is a great substitute for the pre-packaged foods and formulas often used in feeding centers, but it is only really supposed to be used for mild to moderate malnutrition, not severe malnutrition. The leaves are mixed with prepared foods such as porridge or a rice dish. These dishes are not appropriate for severe acute malnutrition. Anyway, this woman is doing the best she can to care for the children at the center. I gave her a small personal donation but I would love to do more. If anyone is interested in donating to her cause, I have her contact information. Please let me know if this is something you would like to join me in supporting. I would like to be able to buy a couple of more trees for her to grow in her yard or help with funds for harvesting the trees. I wish I got involved in this earlier, but….C’est la vie!
Tomorrow, I head back to Monrovia for the weekend. I will get some time to be with Danielle and Caitlin (the new one) and enjoy a weekend of running water, the beach and get to go out to eat at least once. I fly out on Monday morning (really Sunday night) at 3:30 am. I then fly to Casablanca, Morocco where I have a five hour layover. They have a barber there and I am really hoping that I can get my hair cut! This summer has wrecked havoc on my hair, body, spirit, you name it. At least I can feel better about my hair for my Italia vaca! After Casablanca I fly to Brussels where I have an 11 hour layover. I am grateful for my parents- they got me a hotel for the night at the airport so that I didn’t have to sleep on benches. I can’t wait to have a nice hot bath when I get there and sleep in a real bed!!! I am really looking forward to a nice salad and a glass of wine also J. After that, I finally fly to Rome. I leave at 6:30 am and finally arrive in Roma 2 short hours later! Bill’s flight gets in about 20 minutes after mine! I can’t wait to see him! It will have been 77 days (11 weeks) since we saw each other last. VERY excited!
As this may be my last entry from Liberia, I would like to say thanks to everyone for reading this and supporting me over the summer! I know not everyone comments on the entries and that no everyone who reads this is a “follower,” so I would love to know who has been following along. If you get the chance, please send me a brief message at Nicolecbrewer@hotmail.com and let me know who you are! Thanks for everything again! Love you all
Saturday, August 1, 2009
Wrapping things up
Some pictures from my birthday...
My Cake made from layers of homemade crepes, bananas, pineapples, coconut, Nutella, and jam. So creative and so nice of Nathan, Danielle and Caitlin to make it for me!
Carefully cutting into the creation
An update: I am in Ganta right now and I have completely moved out of my Gbarnga house. I will be here until Friday at the latest and then I will head down to Monrovia to spend the weekend at Amy’s beach house before getting on a plane at 3:25 am Monday (next Monday). I will be observing at the “Child’s Recovery Center” this week. It is a step down clinic from the hospital before the children go home. Malnutrition is one of the reasons the children are there, among other reasons. Audrey, one of the program directors has noticed that there have been some unexplained deaths at this clinic and so I am going to observe for the week to see if I have any suggestions for improving care. This clinic has not professional staff and is purely women who volunteer their time. So, we’ll see how that goes. I can’t do much in 4 days.
So, since my time here is wrapping up I thought I would make a little list of things that I have gotten used to, things I will never get used to, things I have missed from home and things I am looking forward to doing at home.
Things I have gotten used to:
Cold bucket showers- I would still prefer a nice hot shower or bath, but it wasn’t too bad
Feeling like I am constantly in a parade- people yelling “white woman!” and me having to wave and shake hands when I walk anywhere
Only having electricity for part of the day and having to work around the generator schedule
Being forced to be creative with meals
Sleeping with a bed net
Nothing running as planned or on schedule
Lighting burners with a match
Filtering all my water
Things I will never get used to:
Feeling bloated all the time from the heat and dehydration- seriously I feel about 50 pounds heavier than I am from the bloating. I have also totally gained weight in Liberia. Not happy about that since I gained weight before I left because I assumed that I would loose weight here. My meals are heavily carbohydrate based. I don’t like the food here, but the bread is fresh baked and good. Therefore, I eat a lot of bread. And a lot of canned foods. I have been eating eggs although I do not prefer to because it creeps me out a bit. They are shipped from other countries, despite there being lots of chickens around, and are not refrigerated. I have had a couple of bad ones, but they have been pretty much ok for the most part. As the rainy season, the “hungry season” has been picking up, the food availability in the market has decreased substantially and there are almost no fresh foods available. The things that are available include pineapples, bananas, plantains, tomatoes sometimes (not in Ganta), cucumbers, potatoes, rice, peanuts.… not too much else. SO the fruit I do get is high sugar, starchy fruits, and the vegetables are starchy veggies. A standard meal that we make when the items are available is a pasta salad with cucumbers, tomatoes, and chickpeas with garlic and onion and a dressing made of oil and vinegar. Sounds incredibly simple, but it is one of the only things that tastes fresh here. I can’t wait for a nice crisp, cold salad!!! So, back to the start of this little rant- I can’t believe I gained weight. Lots of yoga when I get back and lots of fresh food. Mom, for the short time I am home after Italy, lets keep the refrigerator stocked with all fresh ingredients, K? I can’t wait to go grocery shopping and have options!!
On the topic of food- the stages of eating food with bugs in it. Specifically ants. There are stages of acceptance. 1- throw out the food if you see ants. 2- Pick out the ants/ eat around the ants. 3- eat the food, ants and all. I don't think I will ever get to 3, but I do consider myself at stage 2 1/2- I will pick out the ants, but I will also eat food without even looking for them because I assume that they are in there. Ignorance is bliss!!
Spiders- I have been protected from really massive ones, but there are still some sort of spiders everywhere. I am not as “scared” of the little ones, but I definitely still don’t like them.
Toilets- or lack there of.
Feeling dirty all the time
Things I really miss from home:
Being able to curl up on the couch
Being able to call people easily
My comfy bed
Being able to walk around without flip flops or some sort of foot protection at all times
Going out to a restaurant
Being able to go for a walk without being harassed for money or being shouted at
Yoga studio- I have been able to do it on my own, but so not the same
Being able to work out the way I do at home
An oven
Grocery stores
Running water to wash your hands
Hot baths
My family and friends
William
Things on the agenda to do when I get home/ Europe:
My parents got me a hotel for my overnight layover in Brussels. Thanks mom and dad!!! Things I will do there include a hot bath, nice shower, have a salad for dinner at the restaurant, watch TV in bed, have a cup of tea without sweating.
Things in Italy. See Bill!!!! Have a cappuccino, have more salads, gelato, wine, walking around without people yelling at me, air conditioning, more running water, brushing my teeth without having to use bottled water, the clothes that William is bringing with him- I am sick of wearing the same stuff over and over and over- going swimming on a hot day, relaxing!!!
Home: going grocery shopping and having options for food, hopefully loosing some of this extra weight I packed on, sleeping in, hanging around in my pajamas and enjoying the mornings, seeing friends and family, getting back to a routine.
Things that were good about Liberia:
The people that were here to support me through the hard times
Every day being an adventure- good or bad
Being creative with things to do for fun
Lots of time to read
What I feel that I accomplished here:
Finishing the nutrition cards- visual aids to help with education
Developed good friendships
Brought severely malnourished children to the hospital and got to see some success stories
Learned a bit more about myself
Learned to be very flexible and adaptable
Strengthened relationships with people back home
Helped with some logistical issues in Gbarnga
So there ya go, some wrap up thoughts for Liberia. I will write from here probably one more time, but thanks again to everyone who supported me through this. I think that the first month here was the hardest month of my life, with little exaggeration. I could not have done it without your prayers, support, emails, phone calls, packages and well wishes. Thanks also to all of those who financially contributed to my work here. I was blessed to have to pay very little out of pocket. People from my church, friends, family, Renee and Jon, thank you so much for your contributions. I love you all very much and I can’t wait to see all of you. I will be back in America in 25 days! First though I have to make a stop over in Italy to spend 15 wonderful days with the greatest person in the world. We are planning on traveling all over Italy and I could not be more excited. 10 days until I am in Roma!!!
68 days down, 9 to go!
Monday, July 27, 2009
Some Before and Afters
Before 1: Kwashiorkor
After 1
After 2:
After 3
The other before/after was a child with anemia and I posted those pictures on the last blog. There are more before pictures that I took and they are available on my public web albums, I recently put new pictures in albums Liberia, and Liberia 3 and 4:
http://picasaweb.google.com/Nicolechristinebrewer
This weekend was Liberia’s independence day, so we headed up to Ganta to celebrate with some friends and to celebrate a new volunteer’s birthday. We went up Saturday night and made dinner, had birthday cake that we managed to make in Gbarnga, and then went out dancing. So fun. The dance clubs are hilarious. There are mirrors all around and people love to check themselves out while dancing. They will stand directly in front of the mirror and look at themselves- pretty much dancing with themselves. The African ladies said I was a good dancer and were teaching me how to shake it. I’ll take that as an extreme complement. They said I had the African rhythm. I may be very white, but at least I can move like an African!
Sunday we just relaxed and enjoyed the day. Today is the celebration of their independence day so everything is shut down. We are heading back to Gbarnga tomorrow and I will stay there until Sunday then head back here to work at the clinic until Friday. Next Friday I head to Monrovia and then I fly out Monday the 10th! 2 weeks left in Liberia and I can’t wait for vacation! See you all in a little less than 1 month!
Sunday, July 19, 2009
Some pictures...
Here are some pictures... the first before and after for children sent to the hospital (child with anemia), a child with severe malnutrition (Marasmus), me teaching through pictures in a village, me and Danielle before a dinner with expats.
Enjoy!

I leave Liberia 3 weeks from Monday! Thanks for your support. Love you all!
Monday, July 13, 2009
Gumby string bean meets the US ambassador
Hello- sorry it has been a little while since I have written, but I have not had much Internet access for about a week and a half. Just an FYI, I will not have as much access as I did at the beginning of my trip for the rest of the time here in Liberia.
A quick note about the title of the blog... Every time we go into the field we get native names. Mine have meaning ranged from long neck, flexible, long, thin woman.... they might as well name me long string bean. And the second half of the title, I will have to write more about later, but I got to have brunch at the ambassador's house yesterday. She made blueberry pancakes and eggs! Sweet lady and very very interesting! I will write about it more and post pictures. I have about 5 minutes to post this message that I wrote a while ago. So here it is:
Since I last wrote… I had been working in the office finishing up work here from Monday-Thursday. On Thursday, a girl came to stay with me! Her name is Danielle and she is great. We get along wonderfully and we have become instant friends. She is 24 from Canada and she is in Chiropractic school. She has already given me several adjustments and done pressure point work for my rib! Yay! She will be here with me probably until the end of my stay. Which is 5 weeks as of Monday. We have been talking a lot and getting to know each other and she has already been here for me when I have gotten discouraged and down about my work here. Good to have some one to talk to and I am sure that the work will go by so much quicker with her here. Very grateful for the addition to the Gbarnga house.
On Saturday, we got picked up by Dave, and Daniel, stopped by Ganta to get Caitlin and Christopher, and headed to do some hiking on Mount Nimba. This mountain range connects Liberia to Guinea and The Ivory Coast. So technically, I went to 3 countries that weekend. We hiked on Saturday and stayed in a wonderful house at night. The president of ABC (African Bible College) allowed us to stay at his house for the night. Luxury! They had a refrigerator, couches, fans, and even cereal with cold milk! I can’t believe I think these things are luxuries, by the way. But we did get to watch a movie on an actual TV. That was the first TV that I saw since I have been here. We went to a good service on Sunday and headed back to Ganta for a senior staff meeting. After that we had dinner, made from ingredients in the market. We have been able to get pretty creative. The menu: Potato greens (very bitter) sauteed in Garlic and onions and curried squash, and bread.
Monday was a brutally long, all county, end of the month staff meeting. And it was only day 1 out of 2. Everyone there had problems to be resolved and nothing was being done to actually resolve them. It was a frustrating meeting to sit in on. Plus, it turns out that I might not be able to do the clinical work I had hoped to do in Ganta at the end of my stay. I might be here in Gbarnga for the rest of my time. I am saddened by this, but Danielle and I are going to figure out a way that we can volunteer at the local hospital on our own time; just so we can get some more experience. But anyway, by the end of the day I was seriously thinking that I would like to get on a plane and head back to the US because I was so frustrated, but I overcame that and brushed it off. Some of us left a bit early and headed to the market to get more things for dinner. I will be so happy to go to a grocery store when I get back. Seriously, there are only 4-5 ingredients available at the market on any given day. We wanted to make sweet potato fries and a cucumber salad and some lentils, but guess what? No lentils, sweet potatoes or cucumber that day, despite the fact that it was there the previous day. So, again with potato greens and this time we just cubed the squash and cooked it with the greens. Not too exciting. But Ganta does have the best bread in Liberia, so we each had pretty much a Baguette to ourselves. Hey, it is delicious and filling. I thought the rest of the meal was fine, but other people thought it was gross. Vegetables are scarce in Liberia… sad vegetarian and RD.
Tuesday, Danielle and I worked on the pilot nutrition component of the PD hearth sessions that we will be implementing this week. A refresher: we are creating cards with food items pictured on them. Participants of the training sessions will be asked to identify which food are a protein “body building” food, a “protective food” aka fruits and veggies, and an energy food, aka starches and fat. Then, they will be asked to create a complete “mixed” food with the pictures. A complete food involves a protein, energy and protective food. We had taken pictures of foods at the market earlier and printed them on card stock, then laminated them. I am amazed about how much you can do in the middle of nowhere with the proper technology! Tomorrow we will be writing scripts for the back of the cards explaining the answers and at least one key fact of why that particular food is important to the diet (ex: greens à a protective food à high in vitamin A à good for the eyes). That is as complicated as we can get. So hopefully having a bit of activity in the sessions will be good for the learning process. But we’ll see in the next 2 weeks.
Wednesday, Danielle and I went out into the field to pick up some of the severely malnourished children to take them to the major hospital in Bong County, Phoebe Hospital. Oh, what an ordeal. There is a severe lack of communication in the field because cell phone coverage is horrible, plus people just don’t inform others the way they need to. We went about an hour into the field to pick up one child that ended up not being there. On our way back we had to cross a bridge that was just a couple of logs stuck next to each other- not tied together. So, we ended up not making it across this “bridge.” The tire slipped and went in between 2 of the logs. It was a bit scary because the jeep started to tip towards the side that I was on. We quickly jumped out of the car, but then it took an hour for us to get un-stuck. Another hour back. But we did end up bringing one child back.
She had Kwashiorkor and Marasmus. We took her and her mom to the hospital and we will be taking them back to their village in 3-4 weeks. Hopefully I will have a good “after” picture to post before I leave. The rest of the week was pretty much the same. Each day we went out and picked up another child and brought them to the hospital. 4 children in total. I am really praying for their recoveries.
Saturday was a good day. We went to Kristen and Tate’s for dinner and to celebrate the 4th of July. We had fried plantains, wine, macaroni and cheese, and the largest papaya ever seen for dessert. I will post a pic when able.
Happy Birthday Mom and Michelle! Glad I got to talk to you both. I also got to talk to Renee, Nolan, Mia, my mom and dad and Mr. K. Nolan was so cute on Saturday. He said, “I am at Grammy’s, you are in Africa!” So sweet. I miss the nugget and squishy so much!
This week was pretty frustrating. Danielle and I were supposed to be out in the field Monday and Wednesday, but the vehicle for the Gbarnga office was is in Monrovia with Dr. George. We have the nutrition intervention designed, yet we cannot get out and implement it. So frustrating. Monday we had a meeting with some staff members to clear up some discrepancies and that was frustrating as well. I find the one man difficult to work with because he is right and everyone else is wrong. It is very difficult to get things done with that attitude, as you can surely imagine. We did get out to one community Wednesday and the test run was a success. Some kinks to work out, but overall, pretty good. Thursday is another office day. Danielle and I have become the people that everyone comes to complain to. So, we have become logistical people in the office and we are trying to resolve a lot of issues. Not what I expected to do here, but hopefully we can help prevent further issues for future workers and volunteers.
Other fun things this week- on Tuesday we went to dinner at some Peace Corps volunteers’ house. Here is a picture of all of us. Kristen and Maya are heading back to the States for a couple of months and I wont see them again here L Tate will be around still, so the rest of us expats need to keep him company while his girls are away.
The expats...
This weekend, Danielle, Caitlin and I are going to Monrovia. Amy, a director for equip, is having a house warming party at her place right on the beach. Should be a good time, plus we have to stop and get Pizza! Bruce, where was that good place again? We can also do some grocery shopping and stock up for the next month or so. There are no restaurants or stores out here, so we have been a bit depleted on food items. Living on canned and packaged food and whatever fresh things we can get our hands on like squash, cabbage, lentils, sometimes tomatoes, and bananas. Not to diverse of a diet and severely lacking in green leafy vegetables! Lack of infrastructure. As always though, it was good to hear from the peace corps volunteers that this was the hardest place they have ever been to and the most underdeveloped. It makes me feel better that I am not the only one that feels like the situation in the bush is rough.
So, that is kind of that. We are pretty bored here without Internet. Sorry if this entry is long and boring. Thanks for all the emails and support and prayers! Again, please accept my apology if I have not gotten back to you via email. I am now sharing 1 Internet “stick” with 4 people, and it doesn’t even work right now because EQUIP forgot to pay the bill. But I ill respond soon, I promise. I am over halfway done now! 5 weeks left! Still need the prayers to finish up this experience strong with a positive attitude…
I will post the pictures when I can.
Love you!
-Nicole
Wednesday, June 24, 2009
I got all the shampoo out of my hair today!
Other things I am grateful for: My mom sending good smelling deodorant and body spray (the travel Dr. told me not to bring anything scented because it attracts bugs, so I brought unscented deodorant, unscented... everything!) Having the good smelling things makes me feel like a girl.
I am also thankful for the baby wipes she sent- the bucket bath really doesn't leave you feeling 100% clean.
Keeping up with cleanliness, I have thankful for the new toothbrushes and mouth wash that my mom sent- I didn't write about this before but the other day when I was getting ready to brush my teeth I saw something really really disgusting on the brush. It was... wait for it... ready...make sure your not eating... LARVA! Ewww! I kept my toothbrush in a plastic travel toothbrush container too. I feel like my teeth and finally clean now.
Also- for the earrings that Mrs. Coglianese bought me for my birthday last year. They are light weight and a good size and perfect to wear on days when I want to feel a little more like a girl and normal- you know, like days I find Larva on my toothbrush.
Thanks also to everyone at Valley View- my church took a collection for baby clothes and toys. EQUIP makes them into "baby kits" designed to encourage mothers to give birth in the clinics rather than in the bush where the infant and maternal mortality rate is much higher. I will present them to the clinic when I arrive in a couple of weeks.
Today was just an office day, nothing too exciting to report. But, I can tell you that after several days of organizing data I can finally now write in my report that the baseline data for the PD Hearth intervention is as follows: There are 35 targeted communities, and in these communities the total number of children ages 6-36 months is 1080. Of those 1080, 46% are malnourished. Of that 46%, 8% are severely malnourished. Seriously... took all day and some of yesterday to be able to come to that. Data was everywhere! But hey, at least now we know and we can set some good goals towards lowering the malnutrition rate. Tomorrow I will write up my report and include what the target reduction rates should be. Another office day. But the new girl, Danielle, should be coming up soon and we will begin to implement an idea that Caitlin and I came up with for improving understanding (an interactive activity involving local foods).
Hope everyone enjoyed the pictures. Carla, did you see the pictures with the little girl with the bracelet on that your kids made? Kids from my church made a whole bunch of bracelets with different colored beads on them. Each bead tells about the story of Jesus: Black- for our sin, Red- for the blood Jesus shed for us, White- to represent that our sins were forgiven and washed white as snow when Jesus died on the cross, Green- for our growth and walk with Jesus through going to church and reading the bible, and Yellow- for the streets of Gold in heaven. It makes sharing the message very clear and easy even though communication here is sometimes a challenge. The adults liked them too and I saw some of them wearing the bracelets themselves. Thanks so much for making them!
Have a great week!
Love,
Nicole
Tuesday, June 23, 2009
A night of few words....
First of all, new pictures
http://picasaweb.google.com/Nicolechristinebr
These are pictures of my time in Ganta, BBQ from 2 weekends ago, trips to the field and the clinic and my weekend in Robertsport (a beach). I had a nice weekend away after feeling frustrated during the week. A nice little beach escape.
I also talked to Audry, one of the directors this weekend and talked over my plans for the coming weeks. We decided that I would spend 3-4 weeks here (hopefully 3) working on the PD Hearth nutrition intervention, and then going to Ganta to work at the clinic there for the rest of the time. I feel more useful at the clinic and I really need the hands on time, rather than all the time spent here in the office. The new girl, Danielle, will come up here this week, so it will be nice to have a buddy finally!
In other news.... poor little Daniele, the really sad case from the last post, didn't make it. I am very saddened by this, but hope to make a difference in the fututre at the clinic and through my work with prevention here. Thanks for your prayers, the little guy is free from pain and home with God now.
Love you all, and I promise I will write more next time!
-Nicole
Tuesday, June 16, 2009
The good... the sad
Okay- now the sad...
On Tuesday I went to the local hospital, Phebe Hospital, where the area acute nutrition center is. I went to observe a friend Kyla (another one of those Peace Corps people) at the clinic and helped with the weighing/ measuring the children. It was an emotional day for me. I have seen pictures in books regarding severe acute malnutrition, but being there in person is quite different. It was interesting to see some of the "textbook" malnutrition cases. When I first got there, the nurse's aid showed me a case of Kwashiorkor and a case of Marasmus. Kwashiorkor is a form protein energy malnutrition where the child exhibits the characteristics of swollen bellies, lethargy and flaky, peeling skin with sores, and Marasmus is also known as wasting where the child has an "old man" face, saggy loose skin, and discoloration of hair- it turns red.
We then went to the outpatient clinic where they were doing growth monitoring and looking for new cases that needed to be admitted into the nutrition clinic for an extended period. 2 children were identified as being malnourished- one severe and one moderate but borderline. The severe child had Kwashiorkor and was severely stunted. He was about Nolan's (my nephew who is 3 years 9 months) height but was 8 years old. He was very lethargic and had sores on his body (with Kwashiorkor the skin stretches from edema, gets flaky and can break open). The other child was 1 1/2 years old and was very skinny, stunted and only had 2 teeth. He was 75% weight for age, but it was not enough to admit him right away because the UNICEF cut off that they use is less than 70%. His grandmother had brought him because the child's mother was sick and could not breastfeed and she could not feed him properly. We had to advocate a bit to have him admitted because even though he was considered moderate at this time, it was likely that his condition would soon deteriorate because he wasn't eating.
Here is the 8 year old...
It is difficult to tell how severe this child's case is in the picture- except the fact that he is 8 years old and about the size of a 3-4 year old. FYI I am testing his Mid-Upper Arm Circumference (MUAC) in this picture. He had all the signs of Kwashiorkor - swollen belly, legs, arms and face, skin lesions, and lethargy. We tested for edema by pushing down on the feet with our thumbs. If it leaves an imprint on both feet it is called bi-lateral pitting edema, which he had, and it is considered severe. His tummy was swollen but not too bad, but his legs, feet and face were all swollen, and his skin had lesions and was flaky and cracked. The Kwashiorkor is severe acute malnutrition and the stunting is evidence of chronic, or long term, malnutrition. It was sad to see the clinic's response to the stunting. I asked what they would do for him and they said, "it is poverty." Very matter of fact. They had plans to address his acute symptoms of edema, but not the chronic condition which will affect/ has affected his mental capacity and ability to thrive as a child. It really hit me how stunted this child was when I thought about how an 8 year old is a child in approximately 3rd grade in the United States.
The worst case- which I do not have a picture of because it was just too sad- was an 18 month old child who was such bad shape that I had to stop and pray for him with his mother. I don't get that sudden urge like that often, seeing him just hit me really hard emotionally. He was- I would guess- about the size of a 4 month old. His little body was covered with blisters and sores because he originally had edema. The swelling had gone down but the sores had gotten infected and he developed septic shock. He was "awake" but looked almost unconscious. His eyes were rolled back into his head and his breathing was very labored. For any doctors or nurses out there, this country is in severe need of properly trained medical staff. The nurses had not contacted the Dr. yet because they said they would do it when his condition got worse. Worse? If he got any worse he would be dead! Some of the staff said he was eating, some said he wasn't. It did not appear that anyone was monitoring his breathing or heart (something they should definitely be doing with septic shock). He should have also been placed on an IV drip of dextrose and water (sugar water), but had not as of yet. Also, protocol for septic shock according to UNICEF is to place a naso gastric feeding tube for feedings rather than rely on oral intake. They promised they would call the doctor, but just in case Kyla and I decided to alert the Dr. ourselves. The child's name is Daniele. Please pray for him.
One more comment about this countries need for trained, educated medical staff. The nurse told Kyla that the swelling of Kwashiorkor was due to too much sodium in the blood. No! Any medical professional knows that Kwashiorkor is a protein- energy form of malnutrition. It is fluid build up as a result of the child not getting adequate nutrition. Uh! I had to bight my tongue. Kyla said she would write about it in her review of the program. The children in the clinic also had no toys and really nothing to do all day. The children just sat in their beds and stared. Kyla might start a program there for arts and crafts with the children and the mothers to make toys. A possible problem identified with these mothers with malnourished children is that they do not seem to spend enough time with them. Hopefully Kyla can create something to give the children something fun to do while also promoting material- child bonding for love, support and development.
I can't leave this all sad...
Today I was supposed to go out into the field, however, there was a problem with logistics yesterday and they are a day behind (which is really 2 days behind at this point). Also, the driver's child was convulsing last night and they had to take her to the hospital. So, first, pray for her, but this means we have no vehicle to get around. So, office day for me, which is fine, I have work to do. Hopefully tomorrow I will be out in the field for the rest of the week assisting with Village Health Educator training and also observation of meal preparation in the community so I can determine serving sizes and portion distribution to accurately conduct a nutrient analysis on typical Liberian dishes.
Thanks for all your support and nice comments. Adam- thanks for the words of encouragement and sharing your story. Carla, thanks for praying away the spiders! I saw a bunch in my room a couple days in a row, but now I have not seen one for several days. So, thanks!
Love you all lots! Please keep me updated with your lives in the States!
-Nicole
Friday, June 12, 2009
I've got to admit it's getting better... a little better all the time
That said, I am still happy that the countdown is now in the 50's. Less than 2 months. Although I am happy to be here and happy to be doing work and happy to have the opportunity to learn... I am not happy about the bugs, spiders, bucket showers, lack of electricity, practically living alone etc. I probably will never be used to those things, but I can suck it up for the next 59 days :) Eyes on the prize... I already have a hostel booked for the end with a real shower and everything! Very much looking forward to my 2 week vacation after I leave and before school starts up again. Focus Nicole! First Liberia.
My week has gotten better every day and I have started to feel happier and more like myself. Overview of the week:
Monday- met the staff. Great people- very nice and welcoming. Worked on some assignments. Some that I was given, some that I took the liberty to complete to pass the time.
Tuesday- Kept working... all day in the office. It's hot in here! Crappy ventilation.
Wednesday- Finished up most of my assignments. I have been working on a nutrition database of commonly consumed foods in Liberia, nutritional guidelines for children 0-6 months, 6-9 months, 9-12 months, 12-24 months and 2-5 years and sample menus for each age group. It was a little difficult because they eat a lot of different foods than I am used to working with (cassava, fufu, bugs-seriously) and they call things different names (mangoes- German plums, eggplant-bitterball, fish with bones- boni, sesame seeds- Benny seed, avocado- butter pear, etc, etc), but I got it done. I have some adjustments to make, but on the right track. With that info I am going to go out into the field and observe some meals being prepared in various villages. I will weigh and measure the food and then be able to do a full workup and nutrient analysis of the main dishes eaten in Bong County. The whole process will probably take all summer.
At night I went over to the American couple's house that I met last weekend. It was nice to have a nice home cooked meal and good company! Thanks again Kristen and Tate and little mya!
Thursday- THE DR IS FINALLY HERE! And he brought with him a fan sent from the Monrovia office! My room is much cooler now, at least while the generator is on. 3-4 hours a day is better than nothing! Dr. George helped me download some software I will need on my computer and introduced me to the program. He pointed me in the right direction and I have been reading up on all the past data from the project. It is still in the pilot phase, so it is interesting to see all of the trials and errors.
Friday- Same stuff as yesterday. Lots of reading, but at least I have a purpose. I will hear summaries from the staff regarding their Positive Deviance inquiry on Monday and they will give a brief presentation about the community members they selected to be community health ambassadors and village health educators. Then Tuesday- Saturday (hopefully) I will go out into the villages with them to assist/ observe the training of the CHAs and VHE. I am also hoping to use this opportunity to go into people's homes and observe meal preparation and begin that part of my the one project. After next week, hopefully I will know enough about the program start heading up the clinical nutrition portion of it a bit more. Another thing I am hoping to do soon is go to the main hospital here and observe the treatment of the sever acute malnutrition cases. I met a Peace Corps worker and she is working in the hospital's acute care nutrition center. Hopefully I will get to shadow her sometime soon. It will be very sad, but a necessary part of my training and education.
Another answer to prayer... there is another person coming up here later in the month! A 25 year old Canadian girl! It will be nice to have the company. The Dr. is here now, but he pretty much keeps to himself. Another person to converse with will definitely make the time here more bearable.
So- thats my week. Tomorrow I still have some more reading and work to do here, and if I have time I want to go to the tailor to get some skirts made. I bought pretty fabric (they call them lappas here- big pieces of fabric that women use as skirts, dresses, and to sling their babies on their back), and to get a skirt made it is only about 5-8 USD. Good deal! Sunday I am going to a BBQ/ potluck with about 10 expats from the area. Looking forward to something normal.
One more thing. I would like to thank everyone who contributed towards the financial costs of my work in Liberia. After Tufts only gave me $800 rather than the $2000 they originally quoted, I thought I would have to pay a lot out of pocket. As of right now, I am only about $600 short of my projected costs ( including living expenses for the next 2 months- it could be less) and my current costs are almost covered. $600 out of pocket is MUCH better than I was expecting and I am truly grateful for all of the support! An extra special thanks to Renee and Jon! Wouldn't have come close without your help! I will do my best to do good work here and prove to be a good investment! And big thank yous again to the wonderful William, my parents and all my great friends for their support and words of encouragement these past two rough weeks!
Well goodnight, the generator is shut off now- which pretty much indicates time for bed! Hope you enjoyed the pictures from the last post!
-Nicole
Wednesday, June 10, 2009
PICTURES!!!!
http://picasaweb.google.com/Nicolechristinebrewer/Liberia#5345732061619861234
A bit discouraged…but OK
Here is a pic of my beautiful staff and my current work environment. The people are very sweet and are always re-assuring me that they are here if I need anything.
One more thing…. I met an American couple the other day (via this blog) and they are having me over for dinner tonight. That will be a nice break. On Sunday I met them and they drove me all around the area and introduced me to some other expats. Good people! Grateful for the western community out here- makes things feel a little more like home.
Hope all is well!
Love,
Nicole
Saturday, June 6, 2009
Welcome to the Jungle then back in Bong

Market. Big pile of chili peppers.



My room complete with bed net. I'll pretend its a princess bed.
Hello! Back in Gbargna. It has been a pretty intense couple of days. Last time I wrote- really wrote, besides the poll- I said I was going to Monrovia to help write a proposal. Well that didn't happen. It turned out that it was going to be too much and too rushed to get the proposal in on time. So... I ended up going to a town called Ganta instead. It is a town in the next county over called Nimba. The first day we rushed to try to get started and then we came to the conclusion that we would wait until a better time. So we decided to explore Ganta. I was with Caitlin, Caleb, Dave (the director) and Mark, who works at the office in Ganta. We went grocery shopping in the market and then went to look at a village who had received bed nets near by.
-EQUIP has been distributing bed nets that were donated from USAID as part of the President's initiative against malaria. They have distributed thousands of nets so far all over Liberia and are continuing to distribute more-
We checked the houses to see if they had their nets hung properly, answered questions, played with the kids, and prayed with the families. We then found some awesome bread from a clay oven baker and went back to the house. Caitlin and I cooked up a meal using the ingredients we bought at the market that day. It was an interesting concoction, but it was good- stir fry of cassava leaves, onion, garlic, coconut milk right out of the coconut, peanuts, eggplant and okra- like I said, quite the combo of foods! We ate it with lentils and had a fresh mango and coconut for dessert. Who says you can't be a vegetarian in Liberia (although to be honest, it is quite difficult- I miss veggies! More on that later). After 10 the generator shuts off there and we sat around talking for a bit over candlelight.
The next day, Thursday, was a totally different day. Caitlin and I went for a walk to the local school and introduced ourselves. The situation there was sad, but it turns out Caitlin will be able to help. There are only several teachers there because they cannot afford to hire more. Each teacher is only paid about 400 LD a month, which is about $6-7 a month. Also, many Liberian children cannot afford to go to school, yet school fees are only about 800 LD a year, less than $12 a year. Evidence of a very poor country. Then, the whirlwind set in. Dave decided he wanted to drive us way into the bush, into the jungle, to check out more of the bed net distribution and to distribute bed nets ourselves. We drove to a remote village called Tappita. That night we slept in a mud hut in the jungle... literally. Caitlin and I shared a local women's bed (no she was not sharing the bed also) and neither of us really slept at all. I saw a big hand sized spider earlier that day and it freaked me out. I started crying on the spot. I was exhausted and it was pretty much the last straw for the very long day. Not to mention that my Fibromyalgia was in full flare up mode, so I felt pretty sick. Definitely a moment that I had to question why I came to Liberia.
The next day, we "woke up" at 6 and got dressed and went and had bread and tea (first tea since home!) for breakfast. We then loaded up about 2,000 bed nets in the van and we were off. We visited a town and met a wonderful family, checked to see if they had bed nets and then drove to another town to hand them out. Everyone in the village came out and was cheering and were so happy that we were there. We instructed them on how to hang and take care of the nets and played with the kids. There was a funny moment where we asked the kids to sing something and one little girl started singing a western pop song- Akon. We also scared some little kids when we went to say hello. They had never seen a white person before. We then drove for a while to a lovely little town where the people were friendly, but we did make kids cry again. They have a special name they yell for white people in their tribal language, but I can't remember how to say it. Checked the bed nets, shook hands, played with kids, prayed with families. The last 2 villages were very remote and picturesque. Sandy ground, palm trees, huts with a grass roof. Same pattern here- made kids cry- checked nets, talked, shook hands. I also got beat at a game of checkers by a fine Liberian adversary. I think he made up some new rules though. They expressed graditute that we were there. It was a good last village to stop at. We had one final stop at a clinic and headed home. Finally getting back to Ganta around 9. We were exhausted because we had not slept the night before and we had not eaten a real meal all day, just snacks and juice. I was getting kind of delirious by the time I went to bed.
Today we woke up, took a long walk, got a little burned (the African sun is not meant for people as pale as me), shopped in the market, stopped by the leprosy clinic and bought some things they had made to support their rehab center and went back for lunch. All I seem to eat here is peanut butter, bread and mangoes. Oatmeal for breakfast and some other concoction for dinner (tonight it was a can of corn, peanut butter and crackers and a mango- hey it is weird, but its all I can cook in my place and its 5 food groups!) Standard eating for a veggie here in Liberia. The veggies they do eat, as far as I have seen are sweet potatoes, cassava (a potato like root), okra and the leaves of the cassava and the potatoes. Sometimes squash. I miss fresh summer veggies that you don't have to boil and serve in a heavy soup!
Finally back in Gbargna. A family sent me a message on an earlier blog and said they are from the US working over here and they live right by me! I called them tonight and they said they would meet up tomorrow and maybe get the chance to introduce me to some other expats from all over! Thanks Kate and Tate! It is coming at a good time because I have been feeling down about being alone here. Oh, I forgot to mention, for now I live alone at the office. I have also been going through periods of wondering if I made the right decision to come here. I actually get to my nutrition work this week which will be great because I have been feeling without a purpose here. Need to get to work! Still not used to the little things like the bugs in food when I cook, no running water, washing with dirty looking well water, lack of vegetarian food and the fact that it is 90 + degrees plus humidity and I don't have a fan or anything. Sweaty! The heat is getting to me. Sorry, I don't mean to complain. Just some things I will have to get used to.
I'll work on the other picture requests. Hopefully this will do. It took a long time to upload. I didn't have my camera for the cute town visits because I thought I was going to be doing nothing by writing a proposal when I packed. Caitlin took some thought, so I will steel some off of her next time I head out to Ganta or she visits here.
Love you! Miss you!
Picture Poll
But for now- I have determined that it takes forever to upload- literally like 1/2 hour to an hour per picture. So... I am turning it over to the people. If you could see one picture of my time here so far, what would you want to see?
Some choices- but not all inclusive:
1. My house
2. My room
3. The town
4. A village
5. ME! haha
I will post soon about my week when I get back to Bong.
Love you!
Tuesday, June 2, 2009
Life in Gbarnga
Anyways... I drove up to Gbargna last night. Part of the drive was in the light and part was after nightfall. What I saw during the day was breathtaking. When the night came I got a little nervous because I realized how much I was truly in the bush in the middle of nowhere! Honestly, had a little cry when I got here because I was so overwhelmed and felt so out of my comfort zone. But I am okay now.
About my new home...
I live in a compound and my room is in the same building as the field office for Gbargna. The only other person who lives here is Dr. George, whom I have not met yet because he is in Kenya. Right now the director's nephew, Kaleb, is staying with me so I am not alone. On Wednesday, this girl Catiline who I met yesterday is coming to keep me company. She is very cool and we hit it off right away, so we should have fun here for a couple of days.
My room is simple: bed with bed net, desk and chair
Bathroom is interesting. no running water, and to wash you have to take a pitcher and dip it in this big barrel of well water (that does not look clean at all and smells) and stand in a tube and dump the water over you. I still don't feel very clean after that. My mom is sending a package of more baby wipes, so that's good! Thanks Mom! When you have to go to the bathroom, you have to take that pitcher and dump water down the toilet to flush. Might take a bit to get used to, but that's okay.
The kitchen is a camp-sized burner and water that the cook boils everyday. Everything pretty much has to be out of a box because their is no refrigerator. But... bugs are everywhere in the kitchen! Last night Kaleb and I made Mac and Cheese and we had to boil the noodles and wait for the bugs to rise to the top to scoop them out. The suckers chew right through plastic and boxes! Eww.
This morning was nice. Kaleb and I explored the town because I really can't do much here until the Dr. gets back into town because I will be taking some portions of the nutrition program from him, so I need him to help with that. We walked around the market and people were so friendly. We explained what we were doing here and the people shook our hands and thanked us for being there and said we were most welcome. It was very nice. We certainly drew a crowd because we were the only white people around. People kept yelling, "white man," or "white woman" and one person said "hey white meat." Interesting. But they they said we are friends and the ladies tell me that we are now sisters. I can't wait to get to work with these wonderful people. Just on the drive into town I saw several swollen bellies and other signs of malnutrition. I also noticed that some of the men here are very short. That's not a regional thing, but most likely a sign of chronic malnutrition- stunting.
As for food, we bough 4 mangos (they call them German plums) and 3 HUGE plantains for about $0.25. We had the bananas with peanut butter and that was our lunch. Awesome fruit.
The cleanliness thing is definitely something I will have to get used to. It is so hot here and I just sweat all the time! Then with the shower situation... ew. So I have to get used to that, but hopefully I will adjust a bit.
I tried to put pictures right on the blog but the Internet is very slow here so it wasn't loading- I am on a satellite connection in the middle of nowhere so I really wasn't expecting too much. So grateful for any connection at all! I am researching nutrition information for local foods so the internet is essential.
OK, thats a lot. Love you all and miss you!
-I literally jsut got a phone call that I need to be back in Monrovia until Saturday because I need to help write a proposal for funding that is due Friday. I really am getting thwon into the humanitarian world! You need funding to do work- so off I go, back to Monrovia!
No time for pics now- ill do in Monrovia!