Last Day in Makeni :(

Well folks, we have reached the final day in Makeni. Tomorrow we will be off to Freetown to meet with the World Health Organization and meet with our other worker for Ukweli, Allieu.

To start off the day, the team finalized the messaging packets that Hassan will use to train community group leaders on how to make their community members more aware of UTIs, Preeclampsia, and the need to get screened for these health issues. After all the edits were made, the squad rolled on over to the print shop in the market for the 17th time to print and laminate (fancy) the packets. Although Naakesh had a nightmare that the lamination would have set the pages and the print shop on fire, everything came out clean and the packets are ready to be presented to the Bombali District.


Upon returning World Hope with 5 cucumbers, 3 bananas, and 5 mangos, we finalized the pre-marketing license employee contract for Hassan and sent it over to Saidu (DC (Director of Country)) and Joseph (In HR (Human Resources)). The two gave the contract the green light and Saidu signed it, so all that is left is for Hassan and Allieu to sign it and we’ll be ready to rock and roll. We will transition to a different contract once we get the marketing license approved.

The next order of business was procuring Hassan’s bike. Rohan crawled out of his darkroom and emerged to help Hassan with his new whip. The licensing process turned out to be exceptionally frustrating because everyone Rohan needed to talk to left the World Hope office at the same time. Don’t worry though, readers, Rohan was able to get Hassan’s bike licensed and even got him a helmet. There are still some questions as to whether Hassan can take the bike home but we are choosing not to worry about it. All you need to know is that a bike is currently in Hassan’s abode.

We had a super productive meeting with Bockarie and Sylvester in the finance controller office and they agreed to store our inventory in Makeni (480 boxes). Naakesh, Rohan, and Zach loaded up our bucket and it fit pretty well.

Hassan then read over the employee contracts and explained to us some interesting anecdotes about traditional medicine. For example, an herbalist can crush up a live chicken with herbs and incorporate that into a cast which will cure a dislocated shoulder. Sierra Leone is wild.

We headed to dinner with the rest of the GSIFs (minus the sickle cell team, who were in Freetown) and had some rice, beans, potatoes, and bread. We had the 1st annual GSIF talent show. Ukweli’s acts were in three parts, but Hassan stole the show and part of Jordan’s trousers. We began with Rohan and Sage performing Bonnie Tyler’s Total Eclipse of the Heart, then the whole Ukweli team joined them onstage to perform Billie Jean a Capella. Then, something incredible happened. The moment we all had been waiting for had finally arrived, when it was time for Hassan to lift a bag of rice with his teeth. Unfortunately, there was no bag of rice to be found and it’s expensive as hell (280,000 SLL per bag!) so we gave him a bag of concrete. He lifted gracefully but still was not mollified. He asked Jordan to come up with him and be the bag of rice. Jordan lay flat on his stomach. Hassan stooped down, a dangerous glare in his eyes. He attached his mouth to Jordan’s belt loop and tried to lift him, using only teeth. As you can imagine, Jordan’s belt loop gave out but he did catch some air. I have seen some wild things in my life, but I have never seen a man try to lift another man by his pants using only teeth. Sierra Leone is wild.

Many people dressed in African clothes today (partially because it was the only clean shirt I had left) and Khanjan ended up #twinning with Jordan. Unfortunately, Khanjan was eating when Jordan asked him for a picture together and we are still bummed that Jordan didn’t get to touch Khanjan’s forehead. There’s always the fall semester — don’t give up on your dreams, Jordan!

We had some tearful goodbyes and took some time to reflect on the genuine human connections we have made in such a short time. We had a fun sing-a-long where Ibrahim danced and Jwara did some freaky stuff with his arms. It was surreal to eat our last meal at Mbinti’s and say goodbye the people that have made our work here possible. We wouldn’t be able to do this without the dedicated translators and drivers on the World Hope staff or Hassan, so this goes out to them.


Signing off, this is Zach. See you tomorrow at 5:15 AM, GMT.

Radio AMZA and a Radio

The team didn’t leave the Makambo until 10:00 AM and that was a true blessing. Hassan called me at 9:22 AM saying he was already at the office so that kind of sucked but we did tell him 10:30 AM, so I accept minimal fault. I have definitely learned that communication is a more involved process in Sierra Leone, where precedent will be honored before a direct order so I have to be clear at least twice. I’ve also noticed that Hassan prides himself in coming to the office on time, which is something good to take note of in the future.

Jessica and Griffin during breakfast.

We started off the morning by running internal training. Jordan acted as the CHO while Rohan, Chris (from malnutrition), Cassidy, and I acted as CHWs. Hassan did well communicating the goals and limitations of the project. Aside from small details on messaging and anatomy, it was a perfect training session and we are excited to roll it out to PHUs once we have government approval. Naakesh accidentally put in a funny phrase in the CHW messaging packet: “frequent unprotected sexual identity”. Please let us know what you think this means in the comments below.

The team set off to answer a big question: what does Hassan do until the marketing license is approved? We decided to divide and conquer for the afternoon.

Naakesh, Zach, and Rohan went to the market with Hassan to procure some disposing bags and a radio. The boys bargained the radio price from the ‘Apato’ rate of 275,000 SLL all the way down to 60,000 SLL and we are proud of them for saving us project money. They also revisited the print shop we went to yesterday because we missed a few pages on the training packet and saw a fun surprise on the desktop. The desktop screensaver on all the laptops is a picture they took of us yesterday with the owner! Guess we are famous now.

Jordan, Cassidy, and I walked down the street from the World Hope compound to Radio AMZA, which involved walking up seven dark flights of stairs. We spoke to Mustapha and Mohammed who helped us set up a meeting with their boss for Monday at 9:00 AM. Hassan also secured a meeting at Kalangba with 4 CHWS at 10:00 AM on Monday, so it will be a busy morning.  Jordan has been spearheading the program for a while now and it is exciting to see progress. We plan to visit Radio Mankeneh, a more community-oriented station, next week.

Left: Staff at Radio AMZA. Right: the simulated training session with Hassan.

The team spent the rest of the afternoon discussing strategies for grant procurement and engagement. I did not realize how higher-level foundations rarely had a website listing so we found a helpful database called Foundation Directory Online. (Any organizations reading this: donate 20 dollars to Ukweli!)

We wrapped up the night with a Khanjan meeting about CSR initiatives in Sierra Leone and logistics. Good news, Khanjan talked to World Hope’s country director, Saidu, who said he can sign off on a bike! There are these unused bikes from UNICEF just sitting at the Makeni office and he is willing to let us get one fixed up for Hassan.

The absolute highlight of my day, however, was that the president of Lehigh University, John D. Simon, emailed me back. Ukweli plays a card game that involves joker cards, and when you play one you get to dare someone to do a stupid task. I was dared to email President Simon about his day and he replied. Correspondence below:

With less than a week left in the trip, I’d like to note some observations on Sierra Leone.

  1. Everyone gives you exact change even if it puts their life in danger. We have had street vendors chase us down because they owe us 500 leones, which is 5 cents with the current exchange rate. People are incredibly honest with money here even in such small quantities and have never short-changed us even if it was easy. This level of honesty is interesting to see in such an impoverished setting.
  2. Makeni is the heart and soul of the APC (All People’s Congress) and the party infrastructure is still in place even though the SLPP is currently in power. Red and White colors are everywhere and there seems to be a dilapidated party office on every street corner with a detailed painting of E. B. Koroma, the former president.
  3. NGO posters are everywhere but you rarely see the NGO workers themselves. I’ve seen Toyota land cruisers everywhere with logos and most street corners seem to have some public health announcement or other. It makes you wonder how long these signs have been up and what happened after they were erected.
  4. Makeni has a poor waste management system. It is clear how much plastic waste affects the quality of life here and how the storm drains get clogged with single-use plastics. It shows how hard it is to make impoverished communities more eco-friendly when wasteful products are the cheapest. It makes me think about how we always come from a privileged standpoint whenever we tout the value of green products without first addressing socioeconomic barriers.

Me by an APC building right by Radio AMZA.

Cassidy by our favorite UN poster in Makeni. Not me, not now!


8/10/19 – Wisdom of the Warrior: Hassan’s Journey

Our team trained Hassan today and finished some employee contracts, giving us time to go to the market. Khanjan gave us a weekend gift today and let us sleep in. We woke up and watched Marc completely butcher a can of tuna because he never learned how to use a manual can opener. Don’t worry, he eventually got it, but it was an embarrassing experience.

Picture 1. Marc with his mangled can of tuna and bread.

There are some big soccer games happening and several hotel guests were watching in the kitchen. As someone who has no idea what sports are (or even why they are), I really liked the team that wore yellow.

I also messed up this morning and told Hassan the wrong time to be at the World Hope office. Swallu, one of our drivers, played some fun dancehall music on the way over. We told him we liked it and he immediately turned it off, so that was my second communication error and it was only 11:00 AM.

Jordan and Cassidy finalized our operations document while Zach and Naakesh edited the training materials. I finished our employee contract for Hassan so we can onboard him. Rohan worked on quality control in the mushroom production system house, which is 110 degrees Fahrenheit and 94% humidity.

Picture 2. Rohan and Naakesh smiling. 

Hassan came in the afternoon and was interviewed by Steph, our university videographer and full-time trip mom. He shared his experience as a community mobilizer during the Ebola epidemic. During training, he brought up several good points that we had not thought about. He addressed how to take corrective action for CHWs who do not correctly take data, how to avoid double-screening patients, cultural barriers, and men screening positive for protein. Hassan also told us he preferred a cost-recovery model, which was helpful feedback.

Picture 3. Hassan being trained by Naakesh.

After training, we went to the market and looked around. We got some tasty street food and fabric. Marc and Rohan got fake Gucci slides and they are super proud. ***Edit***Apparently, Marc actually got versace slides and that is somehow different from Gucci slides, but I fail to see the significance.

Picture 4. some GSIFs with their goods from the market.

We saw a man who used to drive for World Hope but was let go because the project ended. I hope that we will not have a similar situation where we have to let Hassan go after funds run out. It hit me that I also saw a man on a bike with a bomber jacket that said “Albuquerque International Balloon Fiesta”, which is something specific to my hometown in New Mexico. It is interesting to see how the shipping of secondhand clothes affects fashion in Africa. I couldn’t find a single thing in the market that was not imported, even the skeins of fabric. The amount of cheap counterfeit goods was interesting and spoke to the influence of bigger markets in rapidly industrializing countries like Sierra Leone.

I’ve also been garnering some observations about working in Sierra Leone. Something that became clear this week is that vocabulary is a huge class indicator. All the educated people we spoke to used words that we would deem unnecessary in the United States for conversation, but it is used to indicate respectability. I’ve also been personally struggling with how we can communicate clearly with Hassan without being patronizing.

This weekend is an exciting national holiday for Sierra Leone. The celebration of Eid Al-Adha will start tonight and continue through Sunday evening. It is known as “Big Eid” or the “Feast of Sacrifice”, where Muslims celebrate the willingness of Ibrahim to sacrifice his son as Allah ordered. It also coincides with Hajj, the annual pilgrimage to Mecca. It is interesting to be in a country where Muslim and Christian holidays are given equal weight in work schedules. Boxing Day is also celebrated here! Pretty cool.

Picture 5. Cassidy and Jordan smiling at Rokulan clinic earlier in the week.

Eid Mubarak! Tune in next time for what the Ukweli team is up to in SaLone.

Gearing Up for Sierra Leone

The Ukweli team is starting our international journey today! Naakesh, Zach, and Rohan are flying into Brussels a couple of days early to see the sights and enjoy Europe. Cassidy also left for Paris today to see France. Sage and Jordan are staying on the east coast until Saturday to prepare everything for our trip. We all will reunite in the Brussels airport this Sunday and head down to Freetown, Sierra Leone. It’s unclear what Khanjan is up to but we are sure he has it covered.

We have one main priority in Sierra Leone this year: launch. Ukweli plans to secure our marketing license, onboard two employees, launch a radio and sensitization program, train CHWs to screen pregnant women, and build relationships with clinics in other districts. Ukweli currently has a strong foothold in the Bombali district but we want to expand to other districts in the north like Tonkolili.

We will face challenges in achieving these goals so we’ve prepared hard this summer. Zach has completed our training modules, certification process, ID cards, sensitization posters, messaging strategies, and everything is ready to print and take to Sierra Leone. We will be bringing two detailed binders detailing our concept of operations for both of our employees. Mr. Bangura will be serving as our quality control manager and we have yet to determine the distribution manager. Naakesh has been checking all these documents for accuracy and clarity and Jordan has been leading the radio programs. Cassidy has been spearheading the marketing license and been instrumental in getting the correct approvals.

We’ve also engaged in other clinical research this summer. Sage and Gabi have been writing up a journal article about distribution strategies for Ukweli. We have 14 locations with 6 months of clinical data and need to find patterns, such as distance vs. willingness to pay or free vs. charged scenarios. This research has involved setting up a MySQL database and completing the multivariate regressions in R Studio. Sage is also working on finishing an older journal article about technological innovations in maternal health and the paths they take to scale.

On a domestic level, our team submitted two final manuscripts to the Global Humanitarian and Technology Conference (GHTC) yesterday. We are excited to attend this IEEE conference in October of 2019. Jordan is the first author on “A case study on implementing a technological medical device into the health care system of Sierra Leone“, which deals with Ukweli’s concept of operations and how they were developed. Rohan is the first author on “Analysis of Failure Modes: a case study of ruggedizing a low-cost screening technology in sub-Saharan Africa” which focuses in on the quality control aspect of our three-parameter test strip. It is exciting to see two new team members spearhead their first papers. Being the first author isn’t easy, and we are all proud of Rohan and Jordan for completing final manuscripts!

We are excited to travel with all 6 team members this year! Sierra Leone will be interesting this year because a huge group is traveling, so we will definitely never be bored. Let’s secure this bag and get Ukweli off the ground.