While I was in Liberia, I was aware of the paradox of scale. On the one hand I was overwhelmed with the size of the problem, depressed by how much there is to do, and how long it will take …..On the other hand, I realize how easy and inexpensive it is to change the lives of individuals. A single clinic doesn’t change the mortality rates for the nation, but it does change the mortality rate for the village in which it’s located. Because of the clinic, real people live who would otherwise have died. People are healthier and better able to contribute economically and socially to improve their own lives and therefore the lives of everyone in the village.

A newly trained midwife, doesn’t revolutionize the appalling national statistics on infant and maternal mortality, but she does enable mothers in that village to have access to clean and safe deliveries, and their new babies to be born with the likelihood of living longer than 5 years. This can change, at a stroke, the fate of whole families and whole villages.

A new generator doesn’t light up Monrovia, but does make sure that a clinic can be open 24 hours a day and admit emergencies around the clock.

$7 doesn’t eradicate malaria but it can buy a net to protect a child. Nets plus the vaccinations that Merlin provides mean that these kids can have an expectation of growing up in good health and have every chance to take their place and contribute to society.

In the end, it all adds up. Merlin changes the lives of individual people, thereby changing the lot of the villages in which they live, thereby ultimately changing the fate of the nation.

Broken down like this, I no longer feel overwhelmed by the scale of the task, rather I feel motivated to do my bit to change the lives of individuals… and therefore villages ….and therefore the country. And when the plight of all of the fragile countries like Liberia has been improved, then the world will have changed for the better….and that will be because people like us, who I now realize have everything, will have done something.

When my daughter says that she’s thinking of becoming an aid worker after she leaves university I can’t tell you how proud I feel. I don’t mind whether or not this is her eventual career, I’m just proud that it’s even in her mind. When we’re flying out of Ghana and she’s writing down ideas of how to raise money for Merlin at her boarding school, I can see how this trip has changed her perception of the world.

When my son finds himself unable to buy a hoodie, because he says they all seem ridiculously expensive, and when pressed it turns out that they’re considerably less costly than at home in the US, I realize that it’s his understanding of what money can buy that has changed. Later in the same day, when Katy and I are agonizing over whether or not to buy some scarves, Ed reminds us of a Liberian villager called Fromo who we met at a rural Merlin clinic. Fromo bounded over to introduce himself and was clearly delighted to see us. As Ed said, Fromo was at a clinic because he was ill, he possessed nothing but the clothes he was standing up in, and was as happy as could be. Ed asked us if our scarves would really make us happier….

My children have never experienced personal hardship as we now understand it. They have their issues of course, but they’re not the issues of poverty, conflict and aggression. I feel so grateful to Merlin that they enabled Katy and Ed to be exposed to an aspect of the world from which they’ve been sheltered. I suspect it will have changed their lives forever.

We’re now in Cape Town in South Africa and this afternoon we toured Robben Island, which is the prison in which Nelson Mandela was detained for 18 years. As I walked round, I felt ashamed that I hadn’t become more involved with anti-apartheid campaigning when I was younger. Sure I went to the ‘Free Nelson Mandela’ concert at Wembley Stadium in 1988, but if I look into my heart I know that that was more because of the great line up of bands rather than because I had anything more than a passing support for the cause.

Having become involved with Merlin, I’m determined that I won’t walk past this cause. I’ve seen firsthand what’s happening in a fragile state and can’t ignore it any longer. 

If there’s been anything in these blogs that makes you think that you’d like to help Merlin in any way please contact me or Merlin directly. I’m at helen.mumfordsole@hotmail.com  and you can click here for Merlin.

If there’s been anything in these blogs that has made you want to donate, then please go to Merlin’s website at www.merlin-usa.org

And finally, I’d like to thank you for reading this and ask if you could please let me know who you are! Please send me an email at Helen.mumfordsole@hotmail.com with ‘blog’ in the subject field, and I’ll know that you were with us on our journey.

 

Tuesday began with a visit to Monrovia YMCA, a magnet for kids of all ages and a great place for Merlin to reach youngsters for healthcare intervention and education.  We met Vivienne and Dexter who are funded by Merlin to operate a drop-in center at the Y. They also train peer educators who work in the community to raise awareness and improve outcomes around sexually transmitted infections, one of the top 5 healthcare issues in Liberia, general sex education, teenage pregnancy and so forth.

The YMCA’s ancient and occasionally leaky building is absolutely throbbing with kids of all ages, and it’s obvious from the concave steps in the concrete staircase that this place is exposed to a phenomenal amount of traffic. A room full of 7 and 8 year olds cavort around while watching a Michael Jackson video. 3 computer labs hum with 25 workstations each. 150 kids watch or play basketball in the gym. In another room 50 sit at a horseshoe shaped table engaged in a debating class. The library has more people in it than books. I exaggerate only slightly.

Everywhere posters proclaim: Personal Accountability, Teamwork and Collaboration, Tolerance, Openness and Honesty, Leadership and Contribution are what count at the YMCA. This is a very inclusive place, membership is open to everyone at no fee. For kids who don’t have the right clothes, sports shoes and T-shirts are provided so everyone can feel at home regardless of how humble their means.

The National Director, a young man in his early 30s, is inspirational, charismatic, self-assured and wonderfully articulate about the YMCA’s mission and its importance for the development of young people to become the next generation of Liberia’s leadership. From a rural area himself (and you’ll be pleased to know I resisted making a joke about The Village People), he owes much to the YMCA who recognized his leadership potential and provided the necessary support and mentorship to prepare him for his current job. He is an outstanding role model and living proof of what can be accomplished when opportunity and nurture are combined with talent, enthusiasm and a desire to serve.

Apart from the sheer energy that pervades this place and the very tangible atmosphere of fun and fellowship, the most striking thing about the YMCA is the feeling of optimism and hope that it engenders. However bad things are outside, and they are very bad for just about everyone, inside the Y anything seems possible. The raw material for Liberia’s future is being honed, developed and inspired on a daily basis while Merlin is taking care of their health. It’s a perfect partnership.

I left feeling good that we are members of the Greenwich YMCA and in some small way are contributing to the global organization. But I’m appalled and feel embarrassed by the dramatic contrast in facilities. In Greenwich there’s a recently donated $6m Olympic-sized swimming pool. In Monrovia, there isn’t even running water – except when it rains and the roof leaks.

I’m glad that in spite of everything, even in Monrovia, it’s fun to be at the YMCA.

 

Note from Helen

We've taken some dramatic photos that capture our experiences of Liberia. Unfortunately, I can't post them from Africa because there just doesn't seem to be enough bandwidth to load them. If you'd like me to alert you when they're available, please just send me an email with 'Photos please' in the subject line to helen.mumfordsole@hotmail.com and I'll be sure to let you know about them. Helen.

We slowed as we approached a wooden bridge over a small ravine. This is always an alarming moment because it’s very obvious that the bridges are not constructed to withstand the weight of a large 4x4 with 8 people in it. Suddenly at the side of the bridge, 3 figures emerge, who have been at the water’s edge below. One of them is a tall strikingly statuesque young woman who looks ghostly. She’s naked except for a long skirt of brightly colored African cloth. Her body from waist to crown, is covered in thick white dusty paint. Even her hair is whitened. It’s hard to tell how old she is but she’s probably in her mid to late teens.

The scene is startling and dramatic and I ask Torwan the Merlin health coordinator for the area, why she was dressed and painted in that way. He told me that it is traditional for women and girls to wear white paint for three months after they have been genitally mutilated. It is respect and recognition for all to see that they have been through an important rite of passage in rural Liberian culture.

No one knows the statistics for female genital mutilation in this country but it is thought to be widespread, and is commonplace in the clinics where girls and women go to be treated for resulting infection or later childbirth.  Throughout our time in rural Liberia, we had seen many girls daubed with what looked like white powder, although we’d never seen it as thickly applied as today. It was so commonplace, that we hadn’t thought to ask about it as it didn’t seem so strange in such a dusty country. With complete shock, I suddenly realized that all those girls we’d seen had actually been recently genitally mutilated. Lots of them were younger girls of maybe 7 or 8, and the thought of this process being done to their unblemished young bodies with a blunt razor blade, and no anesthetic or pain relief makes me recoil with horror.

I try to reconcile this horrific practice in some way. In general I believe we have to be very careful not to judge other cultures and apply some kind of misguided Western cultural superiority, after all cultural imperialism is still imperialism….. but  it’s impossible for me. I can’t reconcile it at all and I’m really struggling to see this in any way other than barbaric.

However undeveloped Liberia is, this also seems anachronistic in a country that has elected Africa’s first female president, where women are fully emancipated, and where there is a real will to establish female rights and equality.

This experience happened 3 days ago. I’ve seen several girls since then with white dusty markings and I feel a now familiar surge of horror and distress. The image of the statuesque young woman, emerging from the side of the river, her features hidden by the thick paint, remains very strong for me. In fact I can’t get it out of my head. It’s one of my most vivid mental snapshots from Liberia….and it haunts me.

I’ve now seen several medical facilities including a hospital, 4 clinics, a health center and a teenage drop-in place for HIV/AIDS counseling and testing, and the first thing that strikes me over and over again is how basic everything is. 

When I say basic I mean an urban clinic with only 1 tiny room for ante-natal screening, delivery and immediate post natal support. I mean a lab for blood, urine and fecal testing that doesn’t have electricity so samples have to be dried using the heat from candles inside an old tin can. Waiting rooms that are outdoors, covered from the sun by simple roofs, and chairs that are rows of long wooden benches. Treatment rooms that are not as well painted as the inside of our garage at home. A Clinic that is open 24 hours a day for the delivery of babies where the staff on duty at night have to wait in the dark for their patients, because the power generated from the solar panels won’t last all night. Pits where placentas are buried. Bathrooms that are outside and are just holes in the floor. No running water, but water pumped from wells and that has to be boiled and filtered. I mean really, really basic.

The second thing that strikes me is how much can be achieved with so little. This is due to the outstanding skills and dedication of the Merlin staff and country health workers who work the magic that turns so little into so much for so many.  We must have met about 30 or 40 Merlin people while we’ve been here all of whom are deeply impressive. Each has story to tell, and sadly I’m only able to pick out a few of them here.

There’s Jan who runs all the projects here in Liberia. She’s a veteran of aid work and has worked all over the world including Iran, Afghanistan, Tajikistan, Pakistan, Myanmar and other places too. She has two grown up boys and when they were small they travelled with her. Her unflappable demeanor, practical approach and open style inspires confidence right from the start.

Then there’s Dickson, the driver. He’s Liberian and has worked for Merlin for 7 years, long before the conflict finished. He’s currently saving the money for phase 2 of his home improvements. His first house was shelled during the war so he has been building a new home for his 7 children. So far he’s built the walls and he and his family are living in a tent inside the walls until he has enough to build the roof. He’s very proud of his daughter who has just got a degree from the University of Liberia.

There’s Anna, who I met only briefly over dinner because she left the next day to go to Grand Cru, a very remote place in the south of Liberia. She was a fast track civil servant at the British Foreign Office who left to join Merlin. Merlin are not yet in Grand Cru and her project is to open it up and build and staff new clinics in this most difficult of territories. I can’t begin to imagine how incredibly difficult it will be to create this infrastructure from nothing, in such a disconnected place.

There’s Miranda in Buchanan. Buchanan is Liberia’s 2^nd city but has none of Monrovia’s city feel. It can only be reached by 4x4 along a potholed and unforgiving road that shakes your bones and leaves you feeling exhausted. It’s in these remote conditions that Miranda manages Merlin’s 14 clinics and hospital as well as the compound within which her staff work and the security that goes with it. Miranda is focused and completely on top of her game, and you can tell she lives and breathes this post. Having said that she’s tired and is counting the days until her month long vacation when she can see her boyfriend and parents again.

Torwan works with Miranda and oversees several of the Buchanan clinics. Respected by his field staff and extremely knowledgeable about local issues that impact the delivery of healthcare, he gave us a remarkable insight into the silent practice of female genital mutilation that is still commonplace here.

Helene is French, a graduate in business, and has dedicated her career to managing the Finance, HR and legal aspects of NGO field operations. Her boyfriend is a member of the American Bar Association and works on legal and contract issues for charities that specialize in that field. An impressive and inspiring couple who are at once both light and serious and make you ponder the superficiality of our normal lives.

Vivienne and Dexter are Liberian and they work for Merlin in the drop-in center housed in the YMCA in Monrovia. They are passionate about their work educating young people about reproductive health, and counseling and testing for HIV/AIDS. They speak directly and brightly about sex, sexually transmitted infections, and condoms and it’s no surprise that the statistics in their neighborhood are trending in the right direction. We met the head of the YMCA in Monrovia who could not have been more fulsome about their work.

Ginny runs the clinics in Monrovia. This is a difficult job because of the overcrowding and squalor of the inner city areas and shanty towns. Ginny is lively, happy and engaging and very committed to getting her clinics the formal accreditation and recognition they deserve from the Ministry of Health and Clinton Foundation assessors who audit them.

These people, and many more like them that I don’t have the space to introduce here, work in the most difficult of conditions. Many are far from home, where nothing is familiar or reliable and there’s no real time to acclimatize. They have jobs that they can never leave behind at the office. Even on their rest days they are thinking and talking about their tasks. They live in very basic housing with no luxuries and unsurprisingly, they get tired. But in spite of all this, they continue day after day to make things happen that are otherwise impossible.

What they do with donated money is alchemy. Be assured that every dollar they receive is directed efficiently and effectively to the people and projects that will benefit the most.  Giving money is the easy part. These people double, triple maybe even quadruple the value of the funds we give with the priceless effort they put in. It’s like watching miracles.

Today I cried. We were visiting the Liberian Government Hospital in Buchanan which is a large facility with over 170 staff, run by Merlin, funded by IrishAid and staffed by nurses and doctors from all over the world.

As we drove up we saw hundreds of Liberians, mainly women and children sitting in the shade of the covered area that acts as the waiting room for the out patient clinics. The hospital opens at 9 and some of the people arrive at 5am to make sure that they are sufficiently high in the queue that they’re certain to be seen by a doctor or nurse that day.

We were shown the operating theaters by Doctor Andrew, a medic from the Philippines. We had dinner with him last night and heard how he had been working as Merlin’s surgeon at the hospital for the last 18 months. He returns home this weekend although his replacement hasn’t yet arrived. As the only surgeon, Dr Andrew is on call 24 hours every day. We asked him how many people he treats every day. We should have asked him how many lives he saves every day because that is the nature of his work. He operates on at least 8 or 9 patients each weekday.

A touring American surgeon is visiting the hospital for 1 week. His specialty is correcting cleft palettes. This is a heartbreaking affliction in this country as families often reject their babies if they’re born with this defect. Posters were put up over the last month advertising “Project Smile’ and urging people to bring their children. This morning over 300 mothers have asked for their child to be operated on, which is more than can possibly be accommodated.

As we tour the hospital, I keep my tears at bay, through the labor ward, the women’s ward where many were dying of AIDS, and the men’s’ ward where gruesome wounds were being dressed, and even the children’s ward. Here, there are 17 beds and 27 children have been admitted. On the left is a little boy, maybe 2 years old who is convulsing with malaria. The nurses are rushing to him. On my right a mother shows me the body and legs of her 3 year old son, who has been burned so badly that his beautiful black skin now only remains on his lower legs and face. The rest of him is pink. The soup cooking on the open fire, was accidentally spilt all over him as he played close by. Burns are a very common occurrence on the children’s ward.

In the bed next to him is a little girl who can’t be more than 1 or 2 years old. She has a mass growing in her stomach and has a distorted body. Her mother holds her up to stand on the bed and she’s tiny. I ask how old she is and I’m stunned that she’s 4 years old, nearly 5. That’s the same age as my little girl, Lizzie, who is probably twice her size and maybe 3 times her weight.

As we leave the ward, we walk outside where there’s a little hut. The door is ajar and we can see a table inside it. On the table wrapped lovingly and completely in beautiful Africa cloth, tied with string at the neck, hips, knees and ankles, is the unmistakable shape of the body of a small child. It was that that was too much to bear, and brought my tears.

This is the reality of very high infant mortality, where almost a quarter of children die before they reach their 5^th birthday. 2 of my children stand next to me as we realize what we are seeing. At that moment I feel a profound sense of gratitude that they’re with me.

How lucky we are to be born in the Western World.

 

*Pictures of Liberia’s President Ellen Johnson Sirleaf, opening the Merlin hospital in Buchanan http://www.merlin.org.uk/Lists/News-Detail.aspx?id=779

 

Today we were shown round Monrovia by Emmanuel, who was Liberia’s Minister for Information and Tourism from 1970 to 1973. The 70s were his heyday and they were also the rock n’ roll years of Liberia, when Monrovia was a lively bustling city with a healthy tourist industry and was the destination for visitors from all over Africa.

The Hotel Intercontinental Ducor was built at that time and must have been spectacular. It sits on the highest point of Monrovia overlooking the Ocean and has a breathtaking view of the sweeping peninsula far below it. It was abandoned during the civil war, and was looted and stripped bare by the squatters who lived there for 10 years.

Today, children still play in the pool but now it’s empty and they slide from the shallow to the deep end on empty jerry cans. The fantastic views from the old dining room cannot be missed, though the windows have long since blown out. The reception area houses beds for the army and 1 floor up there’s a make shift classroom with a blackboard pinned to the wall run by Mercy Schools. 

This building is far from exceptional.  Road after road in Monrovia is full of the ruined shells of buildings. The looting and stripping that has gone on subsequently is so comprehensive that it’s difficult to determine which buildings are falling down and which buildings are going up. Except that there are many buildings lying derelict and hardly any being built.

And in between all this, the poorest people in the world go about their daily business scavenging a living out of this ruined city.  Running water piped to every home, and widely available electricity are a distant memory as is an adequate food supply and decent sanitation. Shanty dwellings are everywhere and the beautiful beaches are impassable as they have become the bathroom for most of the city’s dwellers.

It’s heart breaking to see what’s become of Monrovia and its people. It makes us ask ourselves what can we do to help. If you were here, I know you’d feel the same.

It takes about an hour to drive from the airport to Monrovia. The road itself is excellent, repaired recently by the Chinese, who have not sent money to Liberia but have supplied labor and plant to rebuild roads, bridges, and buildings. Every renovation and rebuild project seems to be labeled with Chinese characters.

There’s a small amount of traffic on the road. There are aid agency vehicles just like ours, typically white 4x4s with the agency emblem on the top and sides.  The UN is everywhere. There are also small trucks piled high with sacks, then with Liberians perched dangerously on the top. And there are state taxis, just a few, and surprisingly sprayed the same yellow color as those in New York City. 

The first village we drive through after Roberts International Airport is called Smell No Taste. The huts are built of wood and mud, usually with no walls, or else they’re reclaimed from the ruined shells of concrete buildings bombed out in the war. Families sit outside under trees, gathering around fires and cooking pots, and small, maybe too small, children play games and chase each other.

The strange name of Smell No Taste came about after the 2^nd World War when the US built the airfield for their airforce and erected a military camp right opposite to the village. Each day the villagers would be subjected to the most wonderful cooking aromas as the US cooks prepared the food for their soldiers and airmen. Sadly they received only the cooking smells as there was no surplus food for the villagers to eat. The village soon became known as Smell No Taste and the name has stuck so solidly that no one we speak to can remember what it had been called originally.

A few miles and several more villages along, having passed UN army barracks and many churches, the density of the villages increases and we see fewer mud and more brick built dwellings. It’s clear that we’ll soon be in the city. As scrub gives way to city, we come across the last large stretch of sand. It’s a soccer pitch, with white goal posts at either end. Boys are playing soccer and there are lots of people gathered on the sidelines. As we draw closer we can see there’s something not quite right. And then we realize what it is. Every boy on the pitch is on crutches and has only one leg. We don’t like to ask the driver to explain it to us, we just silently acknowledge that we are witnessing what we’ve read about – the brutal amputation of limbs by warring factions.

In this hour’s drive we have a snapshot of Liberia.  We see evidence of the ravages of war on the infrastructure, the economy, but most strikingly of all, on a generation of young men.  

It wasn’t the burnt out and abandoned plane that we passed on the runway as we landed, nor the white helicopters bearing the UN insignia that were the most striking first impression of Liberia. Even more noticeable was the lack of noise and bustle. No other planes were landing, taking off or taxiing. No cars, lorries and people wearing ear protectors were buzzing around the tarmac.  It appeared that it was just our plane that was arriving that afternoon.

It’s not as hot as I was expecting, which is just as well as there’s no air conditioning in the airport building. Liberia is very close to the equator and it’s the rainy season so humidity is extremely high. This accounts for the lush and verdant tropical landscape. It also explains how oppressive the atmosphere feels, although now we’ve been here just a few hours it’s already becoming less noticeable.

It’s not just the weather that’s oppressive. Roberts International airport has repeatedly been the scene of fighting as Liberian factions fought to take control of it during the many phases of the 14 year civil war.  This has left the building half derelict, covered everywhere with barbed wire, and with a potholed and unfinished car park that’s smaller than the one at Old Greenwich elementary school and nowhere near as full.

The airport is in a completely gated and wired compound. The police guard the gate, to check you in and out. A crowd of people stand opposite ,either begging outside the gate, or waiting for the opportunity to come inside and hustle you there. There’s a large sign amongst them saying ‘Do not urinate here’.

I only noticed one other sign while I was there. It said ‘Welcome to Roberts International Airport’ in 1970s style lettering.  There were only two things that felt  welcoming: the first was the white 4x4 marked with the green Merlin logo; and the second was the 5 bars that incongruously appeared on my mobile phone.  

In the last 14 hours I’ve been in 3 countries. I left the one I live in (USA), to visit the one I was born in (UK), before being welcomed into this one (Belgium) which is like the inner sanctum of the country club I’ve belonged to since birth. Tomorrow I’ll be flying to a 4^th which is Liberia and the first of our African destinations.

I’ve never felt so much at liberty to roam the world and this trip has made me become conscious of all the freedoms I take for granted.

By virtue of my passport I’m free to leave the country I live in, and welcomed in most others. My education (and the internet) renders all the information of the world available to me and I’m free to investigate and research any trip I want to take. Courtesy of our economic circumstances in the largest economy in the world, I have the freedom to buy tickets to almost anywhere I might want to go. Access to excellent medical care from the day I was conceived, and a supply of nutritious food to eat, has given me the freedom that only good health bestows, which means I have no physical handicap to impair my ability to move around confidently. Because of the culture to which I belong, I’m free to travel alone without asking for permission and with no fear….and I could of course go on. The list of freedoms is seemingly endless. 

Contrast this with Liberia. This country was formed by freed slaves re-patriated from the US in 1847 and is so-called because it represents a people’s new-found liberty from slavery.  What irony there is in that name. Years of oligarchy, rounded off with vicious 14 year civil war, have left 75% of Liberians living below the poverty line of $1 per day, 80% of them are out of work and over three quarters are illiterate. State expenditure on healthcare is $4 per person, compared with over $6000 per capita in the US, so it’s no wonder that almost 1 in 4 children die before their 5^th birthday, and life expectancy is 42 years. Only 6% of women have access to a modern form of contraception and the birth rate in Liberia is the highest in the world.

In other words, we’re going to a country that shares none of the freedoms that I so unthinkingly take for granted. Merlin is helping to restore some of these basic freedoms by providing healthcare to over 1 million Liberians through the 52 health care clinics and 5 hospitals that they operate having educated and trained local healthworkers to staff them. I’m looking forward to seeing their work and know that it will give us new perspectives.

As we approach Liberia, it’s already changing us. Just last night, when I was delayed for 4 hours, with my 4 year old, at Liberty International Airport, believe me it was escape rather than liberty that was on my mind.

 

 

It’s a strange thing that we only notice what we’re thinking about….

My first car, back in the 80s, was a tiny dark blue Renault 5. As soon as I got it, sales must have increased dramatically because thousands more Renault 5s appeared on the roads overnight.

Likewise, during each of my pregnancies, the popularity of having children must surely have soared, because a disproportionate number of women seemed to be pregnant at the same time. 

Now we’re on our way to Africa it’s clear that Africa and Liberia are dominating the airwaves.  Every time I turn on the TV, read twitter, browse the net, or open a newspaper it seems to me that Africa is a hot topic right now. 

Here’s an example: I know that statistically the most played MJ song over the last few weeks is Thriller; and yet everywhere I go, whether in the car or the shopping mall, the DJ’s favorite is Liberian Girl.

It’s funny how that happens isn’t it?

Of course in my energy world, we believe we attract to ourselves whatever it is that we’re thinking about, so these things should really be no surprise.

Yesterday, when I opened my email I was sent a link to a YouTube video*. It’s lovely to look at and listen to, and opens with a fantastic thunderstorm. Have a look at it and you’ll see why it’s so relevant on the day of our departure to the wettest country in Africa during their rainy season! Click here. 

*My thanks to Alex Kelemen for sending it to me.

At this time of year we usually go on our annual family holiday. You would recognize the format because I’m sure it’s just like yours, and however exotic the destination, we know what to expect because the vacation will be pretty much like the one we had last year…and the year before …and the year before that…

This trip’s completely different though. In fact it seems really inappropriate to use the ‘h’ word at all. The purpose of our trip is to see for ourselves first hand what it is that Merlin does.  We want to learn and understand what happens in the field so that we can speak with conviction about Merlin’s work. Seeing truly is believing.

Not knowing what to expect, however, has lead to some serious crises over what to pack. We’ve decided that we should take only rucksacks. I’m sure there’s no real reason why our wheelie suitcases won’t work perfectly well in Liberia, but somehow it seems important to contain the ‘holidayness’ of the trip and be more, well, real.

Our rucksacks are a modest 65 litre size so whilst they contain a decent amount of stuff, they also contain our excesses.  By the time we’ve put in our vast supply of pharmaceuticals and medications to combat the bacteria, viruses and insects we’re going to meet, there’s not much room left for anything even vaguely resembling a little black dress.

But then again, this is a trip where it’s worth remembering that  ‘The richest person is not the one who has the most but the one who needs the least’. This was a tweet today from Robin Sharma, and it’s become our packing mantra.

It’s pretty good as a mantra for packing – even better as a mantra for living.

We've been to the doctors more times this week than in the previous 12 months. The 3 visits we've made have all been for vaccinations to protect us from some of the terrible and killer diseases that affect Liberia. In our left arm we've had shots for Hep A, Hep B, and yellow fever. In our right arms we've had typhoid and polio. We walked away from the clinic with more than new found antibodies and reassurance. We also left with pills for malaria, heavy duty antibiotics in case of severe diarrhoea, Tamiflu and various chemicals to protect us from the sorts of biting insects that are best avoided. For someone who doesn't even keep Tylenol in the house, I've had many shocks to my system.

The biggest shock came right at the end when I was presented with the bill. All that, for 4 of us, cost almost $4,000. Whilst I'm sure that this was the best $4,000 we've ever spent, I can't help but think of what this could have bought for the people in the country we're about to visit. 

For example, for less than $4,000 Merlin can train a community midwife for 2 years, and then kit her with everything she needs to deliver healthy babies to healthy mothers for about 2 years. In a country where over 80% of babies are delivered by unskilled birth attendants and almost 2 out of every 10 die, this seems a much better bang for buck than 25 shots in a clinic for over-nourished westerners.

So it's started. This is only the beginning of the heart breaking real world inequalities that we're about to witness, and I'm wondering how we'll be changed by the ethical dilemmas we'll be forced to consider.