Off to Sierra Leone soon…

Many of you are likely to know that I’m off to Africa again in February.

Mercy Ships, the NGO I worked for in Togo last year have asked to take me on again for 8-10 weeks in Freetown, Sierra Leone this year. However this time, instead of photographing a variety of requests from the many offices across the globe I will be photographing with the aim of producing a book and exhibition for them to use for fundraising across the USA and the UK. That creative process will start after my third field service with them at some point towards the end of 2012. I will of course not be profiting off of this.

Meanwhile, despite this privileged position I am still a volunteer and am fundraising for Sierra Leone to pay for my flights and basic board and lodgings. This total is $3000 and I’m just over half way there. If you would like to hep in any way do please donate here. If you are not sure about donating to this direct link online then get in touch with me for another way: info@tom-bradley.com.

To remind you of some of the work that Mercy Ships did in Togo here are a small selection of pictures that I took there.

Gafar, an 11 year old boy with a large benign tumour. As Dr Gary Parker the chief surgeon points out this is almost worse than malignant tumours because it is a much slower, painful death that leads to all sorts of stigmas and social exclusion. Some tumours on the neck and mouth are even worse because they result in very slow starvation. Gafar was practically a mute before his surgery. His eyebrows didn’t so much furrow from worry as weigh heavy at the sides from the past few years of misery.

Gafar lies under anaesthetic, post-operation. His tumour has been removed, and he now has two weeks of recovery in the ships’ wards to look forward to.

Gafar and Tani play in the hallway of the hospital floor. Gafar is a strikingly different human being, mischievous and fun. Tani, a young patient who is undergoing several long-term operations suffered severe burns to her face. Neither show any sign of concern of the physical changes they’ve gone through, but are simply basking in the wake of the slow deaths they escaped.

In 2010 the Africa Mercy was docked in the Lome, the capital of Togo. The ship has a number of 4x4s for getting around the city which are regularly used by medical staff during the day to ferry patients to and from the ship and the hospitality centre in town.

The hospitality centre in town was a building that Mercy Ships used to let patients stay in care and recover a bit longer without crowding up wards on the ship. It also served for most of the eye patients that needed tests and correctional treatment.

Many of the Africa Mercy’s 450 crew don’t get to meet patients of help with Mercy Ships’ prime mission on a regular basis (they are busy in the keeping of the ship). So day trips are organised for them to spend time with the locals that Mercy Ships sets out to help. Here a young boy from a special needs school for the mentally disabled plays with a carpenter and a shop assistant from the ship.

The orthopaedics team often deal with the younger patients, whose deformed legs or feet are usually easier to mend than older ones. A child born with club foot is caught early and the large remainder of their physical development continues like any normal person. Here a particularly young boy does not like his correctional shoes put on to ensure the correct growth of his bones after the club foot operation.

Vision trips are made up of a team of people from developed countries, often generous donors that wish to see the cause they are supporting from afar. One such team from a church in Texas brought bags of cuddly toys for the patients. This lucky recipient being held by a nurse doesn’t seem to be quite as pleased as her mother on the ward bed behind her.

Sassou was born with a growth behind his right eye. As it grew, pushing against and slowly killing his eye, his father spent most of the families money on doctors to cure him, but to no avail. His teacher suggested Mercy Ships when they arrived, who quickly agreed to operate. To Sassou life is no different now to how it was before. He still can’t see out his left eye, but he no longer has a time limit of a few years on his life.

Mercy Ships cannot operate on everyone that comes to them. There are so many patients wanting care that priority must be given to those that are sure to recover successfully. So cancerous patients are not offered operations. However for a few nearby terminal patients they provide a palliative care team. In this case Ayabavi, an old lady with very late stages of cancer that started with the enormous tumour on the side of her head receives a wound change from Harriet. The team also provide painkillers, social care and advice on how to look after themselves once Mercy Ships have gone.

Lucie Amedji is also a palliative care patient, with a malignant tumour on her right eye that has spread through her body. It has been extremely painful and the painkillers that Mercy Ships provided have alone made her life bearable once again. The supply of drugs that the palliative care team provides will run out a couple of months after their last visit (which was the beginning of August 2010). The cocktail of painkillers she requires costs in the region of $60 a month. Her church community who provided much support throughout Mercy Ships’ Togo field service cannot help her financially. She earns an average of about $1 a day.

Kossi was a patient near the start of the Togo field service. Surgeons removed a large benign tumour from the side of his mouth, which was slowly suffocating him to death. His father was so grateful that he invited us to one of his services, where he is the Pastor (front figure). It was outdoors in the evening, and at just an hour very short for an African Christian service. He breathed fire and brimstone in the sermon, and the congregation, all seated in a circle got very animated towards the end of it. Kossi is the boy seated on the right in the light blue and white shirt.

Mercy Ships teamed with Bethesda of Benin, a fellow NGO, to create the Food for Life Agriculture Program. This photo is of the second graduating class so far celebrating the end of the course with traditional song and dance. They underwent a 16 week course where they learnt about biological agriculture and how to manage and market a farm. Now they not only have agricultural knowledge, tools and skills, but they can pass on their knowledge to fellow Africans to improve farming practice in their local areas.

Markets, Sleeping on Streets and African Dancing

Well it’s been another varied week or so here in Lomé. Like I finished in my last post, I’ve continued rolling with the punches and taking the daily frustrations as part of life and so learned to accept them. That doesn’t mean they’re not there though, and I don’t feel I’ve got coherent photo essay, let alone a complete set of photos for Raymond’s street children organisation. I’ve been photographing around the area in part, but I haven’t yet accomplished anything special image-wise – something that is naturally very important to me in progressing as a photographer.

Raymond still feels peaky from the malaria – we just had a sprite together at “Obama Bar” at the end of his road, which he promptly filled with salt to help with his fever. Having tasted salt water before, I had no real inclining to ruin the cool sweetness on my panting tongue, surprisingly dry in the humidity. It sounded like a useful hangover cure or something to down just before you go to bed after a night out – a hangover preventative by purging the system perhaps? But when in Africa… it tasted like sprite with a strong aftertaste of salt. Don’t bother.

Raymond has been disappearing every now and then, trying to organise anything from UNICODES meetings to baby Robin’s naming ceremony. Meanwhile when I’ve not been out photographing I’ve been passing my time reading the last few books I brought with me (I must admit, I never actually thought I’d be reading ‘Ships of Mercy’ by Don Stephens), watching Prison Break in French over Vivienne’s shoulder, and answering emails from home and friends; some bringing upsetting news, some asking for photographic services on my return, even some wanting advice about belief in God (God help them if they’re asking me).

I’ve found that in keeping those western elements in my life I sadly haven’t been able to truly get to know Lomé. I can’t seem to let go of them for more than a day at a time. But it’s those times when they’re not present – visiting Raymond’s sister for lunch, playing goalvi football (4-a-side teams using miniature goals) with Dodzi (one of the day volunteers, currently a law student), popping out to the woman on the corner to get water sachets (because of my yovo stomach) while chatting with Raymond about his childhood on the streets, eating fresh pineapple skilfully diced up into a black plastic bag by a woman ambling along the street with them on her head, walking along the beach and through Adidogome and various market places, chatting to Dodzi’s brother before realising he’s deaf and the other elements of life here where I don’t feel the need to compensate with American TV programmes, or facebook, or even this blog. Here’s a few of those moments taken with my western camera…

Fisherman preparing to fold their nets.

A baby clings on to his mother who as a single parent is the bread winner, bringing in 500CFA a day ($1.00).

A young mechanic takes the seats out of a car.

Kids in Adidogome

A roadside butchers in Adidogome

If anyone wants to move to Togo...

A graveyard near the Ghana border

Brother and sister at Adidogome coal market

Mother and child at Adidogome coal market

Dodzi's deaf brother (far right) at his cobblers workshop

So these last few days have been a last ditch attempt to get photographs for Raymond’s street children project. Part of the problem has been getting natural shots. People are very suspicious of cameras – perhaps more so than back home – and I found out yesterday that in Togo you are in fact not allowed to photograph anyone in public without their permission. Oops. I’m still not sure how I can verify this. Anyone know? This is very different from UK laws; which is how the paparazzi get away with everything. It’s always helpful to find this out at the end of a project about the life on the city streets…

Monday night was an odd one. Plenty of times in the past three or so months I have been to the big market that stretches towards the port from the Palm Beach hotel. However I have never been there after dark, and the transformation from the bright, bustling bodies and businesses of the day time is a stark contrast to the eerie (yet unempty) shadows, filled by the occasional argument, sleeping bodies in doorways, young girls crouching in the nearest puddle to relieve themselves etc.

The plan was to photograph some street children at 5pm that a journalist friend of Raymond’s had agreed to take us too, but his phone ran out of battery, so at 6.15 so to cut a long story short we found ourselves wandering back through the market, as dusk began to steal away the beautiful golden African sun. A short, mama selling fresh, silver foot-long fish called out to me: “Yovo, o fon yureah?” (excuse the spelling if you speak Ewe). “Eee, mefon dadanye. Ocho o fon yureah?” I replied, widening the beaming smile underneath the childhood-etched voodoo scores on her cheeks. She shouted out to the other women in the stalls next to her, revelling in this white man that responded in her native tongue. I stopped. “Donna vegbe vidividi” – “I speak a little Ewe”.

Raymond immediately saw this as an opportunity, taking over from my limited lingual abilities to explain who I was, that I had worked for Mercy Ships, and that I was now working for/with him to photograph children that live on the streets. I have met very few people in Lomé that don’t know of the Africa Mercy, and one of the women’s sister-in-law had had both of her eyes successfully operated on a few months ago.

Raymond talked excitedly with them. They were very helpful, explaining the problem of children sleeping on the streets in the evening. Of course it’s not just the children; many of the adult street vendors come to the city on Sunday night, sell their produce throughout the week until Friday, then go back home at the weekend. Unable to afford the daily commute, they sleep on the streets, occasionally under mosquito nets if they have one. Their children help during the holidays, and some are too valuable on the stall to afford school after holidays are over… mainly the girls.

We were told to come back around 9ish that evening, when people would start settling down to sleep. Raymond arranged for a policeman friend of his to meet us in town, for a bit of extra security, and we munched on spicy bean, tomato, avocado, onion and potato salad sandwiches made freshly (trying not to look at everything been stuffed in the baguette by bare hands) to order on the street.

So at around 8pm I stood on the same street looking at a very different scene. Rubbish was strewn everywhere, the last few vendors packing up under the orange cast from the concrete lamps parked sparsely at long intervals. Raymond went round the corner to ‘prepare the field’. By this time I had given up questioning his method, it only prolonged the inevitable. So I waited with Martin the policeman, attempting to try out my French and Ewe. In trying to search for the word ‘flag’ he showed me a photo on his phone of a flag – I noticed with amusement that he had to skip past about 10 photos of naked white women and a photo of Christ on the cross to get to it.

I was very much aware of the eyes of those passing being planted on this yovo with a £3000 camera in the bag he gripped tightly to his chest. A nearby boy was cleaning out the dust from a pile of handbags. “Madeo photoa?” I asked. He stared at me, unresponsive (so much for my vegbe pronunciation). A group of passing youths stopped at the sight of my camera. They asked me something in French I could only guess at. Then “you take his photo, you dash him something” they said. “Ah no, I don’t give money” I tried to explain. Five minutes of poor communication ensued where I learned that they were in fact Nigerian. Mentioning that I travelled through Niger, Kwara and Kogi state there for 5 weeks last year did the world of good, and suddenly I was their best friend. For the next half hour or so we talked about Nigeria, football (well we listed clubs) and taking them back to England with me. It’s never entirely a joke when they mention the latter to you.

The market streets late in the evening

Myself and the Nigerian guys

Meanwhile Raymond had come back and was chatting to a security guard who was looking after the surrounding area. At first he wasn’t too pleased at me photographing so I stopped, but Raymond once again turned the situation round to his favour, and he was soon showing us the areas where people slept. It wasn’t hard to find. Walking down the street perpendicular to ours for about 100 metres I must have passed 50 or so people sleeping outdoors. Maybe 5 or so were lucky enough to have mosquito nets.

Vendors sleeping on Lomé's streets

Vendors sleeping on Lomé's streets

Vendors sleeping on Lomé's streets

'Vendors sleeping on Lomé's streets

Walking around the block I was glad for the protection of Jules the security guard and Martin the policeman. Without them I would almost have certainly got mugged, quite possibly worse. When you walk through the market during the day you don’t really look at the buildings behind the stalls, but now they rose out of the loom, creating darkness below the faint glow of the clouds.

Lomé at night

Lomé at night

Lomé at night

The woozy whiff of weed ran in ribbons across the air, creeping out of some dark corner. We approached the distant glow of a meth lamp lighting up a street vendor’s delicacy of meats. The night ended nibbling on a bit of slow-cooked pepper-dusted beef. I declined (unusually for me and food) the stuffed large intestines.

A vendor slow cooking beef and intestines

Yesterday was not quite so surreal. We had planned to photograph at a street children’s charity at 9am, at 2pm meet up with Jules again to photograph the same places we saw last night in day time, and at 4pm meet with the girls from the beach.

Not one of those things actually happened.

Well we went to the charity – Terre des Hommes – run by a helpful Frenchman called Gerôme, who did point out that as well not knowing we were coming, there are of course many child-protection policies in place, so photographing the children – only a few of whom stay at their facility – at a moment’s notice is not really possible, and they weren’t in fact street children anyway, but abused children in need of mental healthcare. So that didn’t quite go to plan. However he did put us in contact with a man called Souleman who works with former street kids, and is running a rehearsal (of some sort) at 5pm that we could go to.

Jules wasn’t at the home number he’d given Raymond, and when we went to meet the beach girls by the independence building, they weren’t there. So a good few more hours of the day were taken up migrating through the streets with Raymond.

Children playing by the Independence building with the largest hotel in Lomé in the background

Luckily Gerôme had come up trumps and at Nyekonakpoe, I gave my index finger a good exercise photographing (mainly former) street children rehearsing their traditional African drumming and dancing performance set. The breakneck rhythm and sheer volume of the percussive sounds was enough to energise even the weariest of souls. The exhilarating dancing was gone about with certain menace and fierce pride in what they were doing, every part of their bodies streaming with sweat and throats hardened to the hoarseness from years of experience.

The Amagan drumming crew

Amagan dancers

Amagan dancers and their founder Souleman (far left)

Souleman, who is now 28 started living on the streets at the age of 10 after his father died. He befriended mainly wood carvers, his father having been one, who helped him find money by giving wood carvings to him to sell. He soon became skilled himself, and over 10 years the money he earned from selling these crafts helped him get off the streets. With the money he’d saved up he wanted to go travelling to Europe, but was swindled by men claiming to sell visas. So he moved in with his grandmother. Feeling empathy for many of the street children, he employed a few at his workshop and let them eat at his grandmothers, soon letting them sleep on the floor there as well. Soon 15 children were staying there.

The children were allowed to come and go as they pleased. Unfortunately this meant that often they would stay out all night and sleep at work the next morning. Souleman decided to encourage drumming sessions in the evening. This way they would be tired, sleep all night and be awake for work the next morning. Except many of the children turned out to be very talented at drumming and dancing, so Souleman sent them to get properly trained by a professional. Soon they were performing at events and functions all over Lomé allowing Souleman to build up various shops and workshops in different places. The money collated from them and the performances was shared with all the kids and youths involved.

Amagan dancers

Amagan dancers

Amagan Dancers

About 100 people have been through his organisation Amagan, and about 30 youths are currently employed by him. They no longer have a place to shelter, but many of them can afford to rent, and the few that can’t sleep in the workshop/bar/training area where these photos were taken. Amagan has never had any financial sponsorship. In all honesty I’m quite in awe of Souleman, having built up his organisation pretty much from scratch without outside help in a city where he found himself living on the streets at the age of 10. It’s a dog-eat-dog world on the streets, and it is only the smartest that survive.

A group of street children in Lomé

I’ve got less than a week until I leave now. I’m off to Sokode tomorrow morning – a town up towards northern Togo where there’s a leprosy settlement run by catholic sisters. I haven’t been able to contact them, but hopefully I’ll have two days there to continue my ongoing leprosy project. No doubt I’ll see; it will be nice to be able to get out of the city at least.

Living in Lomé

On Sunday 15^th the Africa Mercy left port for the sail to South Africa where it will spend the rest of the year in dock suffering ship repairs of one sort or another. I had originally planned on going to Liberia or Niger to photograph more leprosy in these next three weeks. However, I wasn’t able to get a response from the contacts I had in Liberia, and the TLM (Leprosy Mission) reps I knew of in Niger were all going on leave from the 16^th. Naturally.

So I had a choice – pay an extra $500 plus £300 for three weeks additional ship fees and a flight home from Durban which lets me spend extra time to work on various photo projects in the office I’ve called home while crossing the equator on a Danish ferry-turned-hospital ship designed for journeys of no more than a few hours. Or stay in Lomé as a guest at the house of one of the day volunteers who I’d only just met, but who runs a charity that aims to help the street children of Lomé which I could photograph for. As much as I was burning to sail for three weeks and spend that little extra time with friends I know I may not see for a long time, I decided the opportunity to get to know Lomé as well as photograph for a local charity was too much to pass up.

One of the Mercy Ships longest serving volunteers waves goodbye for the last time.

The gangway is lifted up – the point of no return (for me at least).

So I waved goodbye to the Africa Mercy. It was a strange moment waving goodbye to 100 beaming, colourful, familiar faces, some of whom it was very painful to say goodbye to.  The port seemed bleak and empty without the blue and white branded hulk. I didn’t feel as though I was saying hello to a new adventure, just saying goodbye to the last one. It was like a huge vacuum had just been created in my life, ripping away all sense of comfort and routine that I had settled into over the past three months.

However I told myself I’d soon be experiencing what it is really like to live in an African capital city, away from luxuries like air conditioning and a dining hall with boiling water on tap. It would do me good.

There were about 12 or so of us left behind, many of whom were staying at the Team House (a rented complex where inland MS volunteers had been staying), one staying at a hotel for a week and myself who was meeting up with Raymond the day volunteer to go and stay with him, his wife, his puppy, and as it turned out his baby girl who was born the night before. I couldn’t help but wonder if I’d come at the wrong time. As I write this I unfortunately still have that feeling…

However, Raymond had insisted I stay with him. I believe it’s quite a nice house for this area of Lomé. Raymond has a spare room and his wife had already made my bed the week before the boat left by all accounts. He’s provided a mosquito net and curtain-come-sheet, but it’s so hot and humid that I need no more. The bathroom is two tiny cubicles – one with a toilet (I’ll spare details of cleanliness), and the other a tap with a bucket. It’s very cramped, and I don’t even mind that I’m washing out of a bucket. Trouble is I’m the only that uses toilet paper, the soap smells dodgy (I foolishly left my shower gel on the ship) and it doesn’t let in light, or have a working bulb.

My room.

For the first two nights his wife Vivienne and the baby stayed in hospital. His puppy, Joli was a month and old and very cute. It was nice to have a timid and totally clueless ball of dusty African fur to scratch and pay a bit of attention to for the first day. It stopped after that because the dog disappeared right before a day of solid rain. I’m guessing there’s 10 inches of lifeless pup-meat lying somewhere in the sewer ditch that runs past the back of the house, right outside my bedroom window. On top of this, calls from the hospital kept coming through that Raymond had to go and buy drugs for his wife and the baby, who had a fever for the first few days – a worrying time for any child in the developing world.

I made friends with quite a few day volunteers in my time with Mercy Ships. These are men and women from Togo who are paid expenses and a small (but not bad for Togo) wage to work on board the Africa Mercy in various positions in various departments, mainly as translators, but also as deck hands, cleaners, galley crew etc.

I will eventually post a blog about the day volunteers leaving party. It was a sombre time for most of them, who are going back to a life with no jobs. The same is for Raymond. He has his charity, UNICODES which was set up in 1999, but got all the official paperwork done in 2007. I’ll explain more about it in a few weeks, hopefully after I’ve taken some photos that describe what they do – essentially they are aiming to combat the problem of youth on the streets, many of whom have no home and are forced to resort to illegal activities like stealing and prostitution. He is hoping that UNICEF will fund the work the charity is doing and will allow him, as president, a small wage. He has a program written up, along with a number of staff that are willing to be trained and a comprehensive (apparently) budget. This will start next year if he gets funding.

Meanwhile, I went to and fro on Monday, Tuesday and Wednesday trying to get a visa extension sorted (successfully thank goodness), having to get a new charger for my laptop to replace the one that didn’t work except for the occasions when it sent off sparks, and trying to figure out what it is that Raymond actually wants me to do for the charity.

I’d already offered to cover expenses for my stay, Raymond asked for some money up front to cover the next two weeks at least. This would cover all travel by zimi-jean (motorbike) as well as my portion of the food that I’d be eating with the family.

On the first night when it was just myself and Raymond, he showed me how to cook a gumbo (okra) and fish soup with Akumé (the pap similar in consistency to fufu, but with flour added as well). That lasted a few days until his wife and mother-in-law returned. The mother-in-law (which she was introduced to me as – I call her grandma) is a very sweet old lady, and between her and Vivienne, the food has been absolutely delicious. They haven’t so far cooked me anything that I haven’t loved. No ‘problems’ yet either (famous last words).

Looking out of my room one evening.

 

Grandma.

The baby under her mosquito net.

The baby, who has been named Robin (after Robin Harper if you’re reading this!) has hardly made a sound, except for when grandma was throwing her up in the air and catching her. Upside down.

Raymond at a UNICODES meeting in his house.

Those first few days were incredibly frustrating, but that gets easier once you realise Africa requires endless patience (I thought I’d vaguely learned this over the past three months when going off ship with Mercy Ships). I can safely say now that Mercy Ships perform miracles with what they are able to coordinate and achieve with the countries they work in. It’s still frustrating, but I’ve since learned just to roll with it.

I have been out on only two trips to photograph around town since I’ve been here, which has been disheartening, I must admit. I’d got the impression from Raymond on the ship that he’d already organised all the different places and people to photograph. However, this is Africa, and it’s never that simple. It seems that in these next few weeks we should work to build up a relationship with children to gain their trust before photographing them. I couldn’t agree more – I’d just assumed that Raymond had already done that with some of the children. In all fairness, it’s been hard to gauge all the facts about what the charity has done without appearing to be an interrogator. Raymond seems to have a lot of last minute meetings (political, church, family, anything…) that either overrun, or don’t start on time (usually both), that coincide with when we were supposed to go out and photograph, so I’ve been out twice to photograph street children. Once with Joseph, a friend of Raymond’s who is quite timid, and submissive (as Raymond put it), but who owns a zimi. Unfortunately, he didn’t seem to understand at all what I was supposed to be photographing (a general mystery it seems…) so I did my old bit of street photography through the market.

A naked mad man who some Mercy Shippers maybe recognize from the streets.

Selling pepper’s.

Muslim’s wash their feet before worship.

I went out the next day with Raymond, and got talking to a few street kids on the beach, finally getting one or two decent photos that could possible relevant to this project (whatever it turns out to be!). I won’t post them now, but here’s a few along the beach…

I was hoping to meet them again today to get to know them a bit better and gather some information as to the sort of lives they lead. They were for the most part very friendly and eager to be photographed. I will say one thing for Raymond, as I’m sure anyone who knew him on the Africa Mercy could vouch for: he is an excellent talker and gets along extremely well with children. If I knew that we could go out for 5 hours a day to meet and photograph children (as I had naively thought it might be) each day for two weeks, I’d be confident of creating a coherent and interesting photo essay about the street life of a child in Lomé. Maybe coming events will surprise me. I’m sure I will get an interesting series of photos that show life in Lomé, but it would be nice to make sure I go beyond that and actually get photos that a struggling local charity like UNICODES could use to improve its image – make it look that little bit more professional.

In all honesty, I do love it when we hop on a zimi and zip through town; the wind dusting my beard and blowing my hair into a jedwardesque hairstyle. I’ve travelled on zimi’s quite a lot in Lomé and I’ve only ever come across one that had working dials on the dashboard. It was also spotlessly clean. However that same guy had also angled both of his mirrors so he could see his face from both sides, and not behind him. Maybe that doesn’t matter too much, as most of the others didn’t seem to have mirrors on their zimis anyway. There’s something very liberating about hopping on the back of a motorbike and zipping in and out of traffic, experiencing the sights and smells of Togo. It is one thing I know I’ll miss about Togo.

It is exciting going out when the African rain hits. You wade through miniature street rapids and after the downfall the mud roads have changed; the meandering grooves that plague the taxi drivers and make life more fun for the zimi drivers deepen and form little ox-bows in the street. And in some areas the stench of human waste thickens in your nostrils until you simply accept that you can’t do anything about it. It helps squeeze the squeamish out of you.

I’m ashamed to say I have not made nearly as much effort with getting to grips with French as I should have. Having translators around has spoilt me. However I’m trying to learn as much Ewe (the local language) as I can – Raymond’s teaching me but I’m not the best learner. Bizarrely though he’s been taking me to a free Chinese language course in town for two hours day. I asked why we are going, to which Raymond grinned ‘because it is what I want very much to learn!’. Obviously.

So myself, Raymond, and two others can count (extremely slowly) to nine hundred and ninety nine million, nine hundred and ninety nine thousand, nine hundred and ninety nine in Chinese, as well as say the basics; how are you, I’m fine/have a body with no health etc.

Vivienne speaks a little bit of English, but Raymond is really the only person around that can translate for me and I can have a decent discussion with. He has a lot of energy and a good heart. Unfortunately on Saturday, when he was supposed to be at a political party meeting we got a call from him saying that the mild malaria he thought he’d had for the past two days had got much worse and he was in hospital.

Vivienne and I left straight away, leaving grandma and the baby behind. When we got there, Raymond was on a dirty table-bed, with no doctor in sight. He had tears in his eyes and was no longer able to talk or even open his mouth, and he kept pointing at his heart. What really makes me angry, and is the icing on the cake of why I’ve written this post is that his wife was given a prescription and told to go and buy the prescribed drugs for him, as well as glass slides and a tube to take a blood sample. If his wife had not been around, or if they didn’t live in Lomé there would be no one who could have got him any pain killers, or medication or anything.

Everything here is just so bloody inefficient.

I have given my last bit of cash on me (about $20 worth of CFA) to his wife that will hopefully cover the drugs. I did not hesitate in lending/giving money for his medication (as I’m sure any person in my position would have), but at the same time part of me didn’t want to – because what would happen if I wasn’t in Togo staying with Raymond? Would his wife have stood and watched him suffer pain until it went away, or perhaps it is not worth thinking about. I am thankful that I’m privileged to be in the tiny top percentile of the world that has as much money as I do, even if it does not seem that much to me. I am a white westerner. And the fact is that I am in Togo, I am staying with Raymond and I will do what I can to help without being too foolish.

Even speaking to those from the states on board the Africa Mercy I realise how lucky the UK is to have the NHS. I’ve had a number of operations in my time, and I’m sure if my parents had had to pay for them life wouldn’t have quite been the same. I don’t think I’m being overdramatic.

It turned out that it was malaria, and the IV medication, thankfully did help. He’s still resting, but feeling much better. I’m sure if it was me that got malaria I would not have recovered so quickly.

I’m experiencing the real Togo, and in this past week family life has been as colourful and chaotic as i could have imagined it. I am learning that the life of a local in Lomé is about enduring constant frustration, pain and crises, while learning that the best way is to just roll with it, trying to enjoy the occasional carefree feelings of freedom, and balance a careful mix of not planning ahead with planning too many things at the same time (not planning ahead seems to work better I think). And I am extremely thankful for where I come from, and where I will be returning to in 17 days. I am glad though that I chose to stay in Lomé and not sail. I’m sure I would be enjoying the sail thoroughly, but my desire is to live Africa, not the 51^st state of America.

Meanwhile I can only hope things improve while I’m here, for Raymond, his family, myself and this slowly evolving project.

If you could spare any thoughts or prayers for Raymond and his family it would be greatly appreciated by them. Thanks, Tom

A Mental Health Workshop

Unfortunately towards the end of the field service you discover that there are aspects of the work that Mercy Ships does that are seldom reported and that you haven’t had time to cover properly. I was asked to photograph the last day of a Mental Health Workshop and in researching what the Mental Health Program was about found the summary of the objectives of the team from 6 months ago.

I think it’s a very interesting aspect of healthcare contrasting with the very obvious removals of benign tumours and other physical operations that Mercy Ships is primarily there for.

Here is the executive summary:

“Togo is listed among the world’s poorest countries, but continues to improve developmentally.The country of six million people currently ranks 159 out of 182 countries, according to the 2009 UN Human Development Index. Poverty remains a problem as almost 70% of the population lives on less than $2 a day. Access to quality health care is still limited for most citizens. There are only 225 physicians in the country, or less than one per 10,000 people. Comparatively, in the U.S., there are 26 doctors for every 10,000 people. Specialty care, such as mental health, is even more limited.

Togo is currently striving to improve the mental health care capacity. Mercy Ships intends to assist in this improvement through partnerships with the National Mental Health Coordinator and two Togolese neuropsychiatrists. The mental health team plans to utilize existing primary health care services and community organizations to increase capacity to assist the mental health needs of adults, children, and families.

In collaboration with Professor Grunitzky, Dr. Gaba, and Dr. Dassa, Mercy Ships will provide a mental health nurse/trainer and an interpreter during its service in Togo from February through August 2010. The Mercy Ships trainer will train 30 health care workers during the six-month field service. The primary training will occur over ten days of training, one day a week for ten weeks. Mercy Ships will also train a total of 60 health care professionals from hospitals and clinics in Lome and the surrounding provinces in two separate three-day seminars. The goal is to increase awareness of mental health diseases, and improve diagnosis and treatment of mental illness and counselling skills. Additional activities will include patient assessment and referrals for severe cases.

These cases include those patients requiring more than basic counselling, changes in life skills or social support, and/or medication. Training for a total of 60 church leaders will take place in two separate workshops (30 participants each). The sessions will take place two days a week over a period of two months (18 days) to increase proficiency at recognition, support, and proper patient referral. The sessions also include instruction in training of trainers so that the indigenous leaders can multiply the model.

Additionally, the mental health team will offer two distinct workshops for 50 teachers and 50 social workers. During each three-day event, the goal will be to improve awareness and identification of, and counselling/treatment for mental health diseases and problems. These participants will also learn how to refer severe cases to appropriate medical facilities. Counselling and training for 50 corrections officers and prison workers and 50 military leaders will take place during two three-day workshops.

The goal is to increase awareness of mental health and illness, and anger and stress management training. The workshops will help participants better understand, identify, and be sensitive towards mental health sufferers. In addition, due to high levels of stress accompanying these positions, the mental health team is prepared to provide training for prison workers and corrections officers in partnership with Pastor Martin Anani, the President of Prison Fellowship, Togo.

The training for military leaders is being developed at the request of Dr. Dassa, a well-qualified, critical incident stress management provider, and in collaboration with Colonel Baton Bineh. Many children can benefit from trauma healing; not just children impacted by war.

Mercy Ships mental health team will offer a five-day children’s camp to provide counselling for 50 children and training for childcare workers. This camp lays the groundwork for children to know how to express and heal their emotions in a safe environment, and to educate them on basic abuse and neglect.”

These photographs are the children on the last day of the camp. Many come from broken homes and have suffered abuse in one form or another.

If I ever come back to work with Mercy Ships in the future, then I think this is something I’d like to explore more. I have no doubt many of these children have interesting and probably disturbing stories to tell…

CMS Adidogome – a Togolese hospital.

I got the chance to visit a local hospital – CMS Adidogome. A couple of nurses went to meet the Director there and we got a tour of the facilities. I don’t have a huge amount of information about it – Mercy Ships did a screening there at the start of the field service, but as to how many people it deals with I have no idea. Unlike the UK, but like most of the rest of the world health care in Togo is not free. That could explain why there were only a few patients there.

Coming in through the entrance.

A patient waiting to be seen.

This is a poster that informs of the different ways HIV/Aids can and cannot be transmitted. Click on it to view the details – some of the captions may amuse you – bluntness is a key to the poster. Some of the captions are questionable in their reliability too; I am not an expert in Aids, but I know that some of the ”nul risque’ captions aren’t entirely accurate.

The hospital director gave us a tour.

The above price list refers to the cost of different echographs and examinations. The price is in CFA – of which there are 513 to the US dollar. The average wage is just over 1000CFA per day.

A young girl is examined in a room also used for minor surgery and wound care.

A boy stands under the checkout where patients pay for the medical services and supplies they’ve received.

The Maternity ward notice board.

A mother with her newly-born child.

The hospital director and two nurses.

Blackout day and teaching an African how to swim…

Well I do have some more serious and informative posts coming up, but since I’m still gathering information on these things here’s a few more snaps taken on the blackout day. A few times a year the ship needs to cut the electricity in order to perform maintenance checks and repairs. So this time they got everybody off ship to a local sports facility.

We brought along a few of the day volunteers – one of whom didn’t know how to swim. This piece of information accounts for perhaps one of the dodgy photos of nurses holding up Togolese men in the water.

As for the rest – you’ll have to take my word for it that it is innocent fun.

After a good afternoon burning under the West African sun in the pool, four of us decided to head out with the day volunteers for some local grub on the Boulevard.

Black and white photos of life on the Africa Mercy

This is a rather general blog; I thought I’d share some of the individual photos that don’t usually get made into stories. These were taken at a variety of times, usually when reporting on another story, or while I’m down on the wards taking medical photos. However the first photo is of myself and Claire (Bufe – the writer who pretty much gets all the information that I put in these posts) in our little office.

(Left to right) Missie, Dick and Marina inside the admissions tent (on the dock by the ship).

A toddler wandering around one of the wards where their mother’s bed is.

A cargo ship from Thailand on the dock next to us.

Painting the bow of the Africa Mercy.

A mother sits with her child while day volunteers and nurses sing and dance in ward devotions.

Mary, a ward nurse, takes stitches out of a patient post-operation.

Day volunteers singing during a VVF dress ceremony.

This is Kossi, a 5 day old baby sleeping next to his mother. He was born with a large tongue lesion that almost prevented him from breathing, and became one of Mercy Ships’ quickest admission patients (most are screened many months in advance).

Members of the fire team put on their gear at the start of a fire drill. There are two alarms, a first for the fire team, and a second for everyone else to assemble at the their muster stations on the dock. This ensures that the fire team aren’t blacked from getting to the fire by crowds of staff trying to get off the ship.

Having already been the first group in to fight the (simulated) fire Elliot (centre) and the rest of his fire team changes their oxygen supplies while another team goes in to continue fighting it.

Deck hands help secure a new tyre to the side of the dock. These help cushion the ship when hitting the dock as it sways in the water. New tyres creek very noisily, keeping many of the people in the cabins next to it awake during the following few nights.

Christina, a charge nurse, cheerily looking after an infant (that’s not so cheery).

Day volunteers and staff spontaneously form a band in the corner of Starbucks, keeping everyone entertained after the church meeting on Sunday evening.

(Centre to right) Theo, James and Cael entertain in the corner of the Strabucks cafe in Midship.

In the orthopaedics tent a mother breastfeeds her child while a day volunteer takes off the babies correcting shoes (for club foot) ready for a post-op photograph. Nick, the physical therapist makes notes in the background.

Anama (left), Nick (out of sight) and another day volunteer put the babies correcting shoes back on. They’re not particularly comfortable.

Eye patients sit outside the admissions tent on the dock.

Tracy (Ship Security Officer – centre) and the Gurkhas, who guard the ship: (left to right) Lok, Pradip, Tek, (Tracy,) Ganesh (head of security), Chitra and Min.

A VVF lady listens to a speech during her dress ceremony.

A day volunteer drums during a VVF dress ceremony.

Americans celebrate their independence on the fouth of July with a barbecue on the dock.

Amanda and Anouchka enjoy the dock barbecue on the fourth of July.

Above and below: Crew and members of the Academy throw an American football around on the dock.

Maaike, a charge nurse, tickles Irene, a patient, on a bed in a recently emptied ward.

Josee (centre) plays a card game with Claire and a couple of visitors.

Dr. Leo Cheng explains to Kakou the details of the operation he will perform on him later that day.

Dr. Cheng operating on Kakou later that day.

The port of Lomé from the Bridge.

A member of a vision trip from Texas pulls along a patient on a buggy.

Patients resting in the ward.

Deck workers take a moment to look out over the port of Lomé.

A nurse pushes a patient along on a tricycle.

How to brush your teeth…

So far, since February the Africa Mercy Dental team has attended over 4000 dental patients. Oral and dental hygiene is, like most healthcare back home, taken for granted. The amount of sugar we consume in fast food and fizzy drinks is balanced out with easy and cheap (relatively to what we earn) access to electric toothbrushes, new and improved dental toothpaste formulae, and dentists that can fix pretty much any problem we throw at them.

Here it’s not just a case of preserving teeth, or even relieving pain, but tooth infections – left as many are – can eventually be fatal.

Last Friday a small troop from the comms team tagged along with the Mercy Ships Dental Team while they taught in one of Lomé’s public elementary schools, Ecole Primaire Publique de Be-Klikame.

Donna Bartholomew, one of the dental hygienists stood in front of a classroom packed with children and asked how many own a toothbrush. Roughly half the class put their hands – shortly followed by much of the rest, who thought they probably should too.

Amused, Donna asked how many had brushed their teeth that morning. Less than a quarter raised their hand.

Gini Porter, the Mercy Ships Dental Coordinator is filmed by Joanne, a visiting videographer: “Dental health is very important. Learning to take care of their teeth now, as children, can prevent large cavities in the future. Our team performs many extractions every day in the dental clinic. We hope education at a young age will help,”.

Many of the houses these kids come from are classed under the poverty line, and families struggle to feed and clothe them. They have never been taught how to brush their teeth.

9-year-old Rodrique volunteers to show other children in the class how to brush their teeth, demonstrating with an oversized set of teeth and a toothbrush. The kids clearly understand, and Donna asks them to teach their family too. She explains the importance of a healthy diet in maintaining their teeth, and holds up charts with fruit and veg.

Mercy Ships have provided a brand new toothbrush for each of the children in the school, and in a typical African filing system (I’m not racist – just British about queueing) they clamber to get one.

Slowly the kids file outside to chat, and look at their toothbrushes. While we were there, they were awaiting exam results. The Mercy Ships team had coordinated their arrival with this, as the kids were otherwise on their summer holidays.

Meanwhile Donna and her team move onto the next classroom, addressing the need that will always keep her busy.

African church in the evening

On Sunday the communications/PR team were invited by Kossi, a former Mercy Ships patient to hear his father (whom is simply referred to as “Pastor”) preach at church. We weren’t sure what to expect. We’d all been to an African church of one sort of another and were expecting a long (2+ hour) service in a small room. In fact it wasn’t long at all, just over an hour. However it wasn’t indoors either and with just a small tungsten lamp to the side, the videographer found filming quite difficult.

I see these lighting conditions as an opportunity for a bit of experimentation and capturing life a bit differently. In dark light our eyes don’t pick up detail very well…and neither does the camera (relative to bright light using a low ISO setting – for you camera lovers I use a Canon 5d mkII and this time was shooting almost everything between ISO 3200 and 6400). So using long shutter speeds I was able to get bright enough images while capturing some of the atmosphere during worship and intensity in the Kossi’s father’s face.

On a side note in case anyone got the wrong idea, this is not the sort of Christianity that Mercy Ships practises. Though it is a Christian based organisation it’s core value is not to convert or evangelise, but simply to love as Christ asked us to. I happen to be Christian myself, but I’d feel comfortable doing what I do on the ship if I was an Atheist or a Hindu.

Afterwards Lewis and Meheza (our translator) interviewed Kossi and Pastor.

Pastor waits while his son is interviewed. He was interviewed himself shortly after and his genuine gratefulness to Mercy Ships, not only for curing his son of his tumour but to Joy, Lewis and the rest of us for keeping a promise to come and visit him at his church was obvious.

From left to right: Meza Kpakpabia (translator), Claire Bufe (writer), Lewis Swann (administrator), Joanne Besse (videographer), Joy Clary (assistant administrator), Kossi Delou, and Pastor, his father.

The Hospitality Centre

Every now and then I visit the hospitality centre, a Mercy Ships-run compound in Lome about 15 minutes drive from the ship. Here many patients rest and recover after surgery, as well as getting eyes tested and engaging in physiotherapy.

Here are a few shots I took there from a day visit the other week.

The tent where many patients hang out during the day.

Elaine (one of our writers) looks into a dormitory in search of one of the patients she’s writing about.

This is one of our patients, Abel. Here, after a few months of physiotherapy at the Hospitality Centre he can finally walk again. He looked like this before.

Patients have their eyes tested here both before and after surgery. Dozens of eye patients get seen each day and cataract removal and straightening crossed eyes are two of the Mercy Ships most common operations.

This is Sassou, a boy who a tumour behind his eye. I visited his village and school near the Benin border on Monday, and will put up his story in the next couple of days.

This is a Dela Aboudou, who suffered from burns all the way up his arm when he was very young, ‘freezing’ his arm so that he could not bend it.