My health survey: 180 days in rural Liberia shunning SPF, DEET, anti-bacterial products and other items marketed toward the paranoid person

You know, back in the day, when all good science was done by some guy with an idea who did experiments using himself as the sample?  Sadly, that DIY scientific research is being replaced by this complicated, federally funded, human subjects compliant bureaucracy.  I decided to go the old fashioned route - and assess three products I dislike (okay, now my survey is flawed for being biased) - SPF, DEET, and anti-bactierial hand sanitizer.  Answering the question:  Is this stuff really necessary? 
 
Background:  For years I have had few nice things to say about SPF products, DEET, and anti-bacterial hand sanitizer.  I shun them all.  Why?

SPF:  Why should I put some chemically product all over the largest, pourous organ of my body?  There might be certain occassions, like a day of direct sun on the beach, but daily?  As part of a daily routine?  No.

DEET:  What are you trying to do - detract the mosquitoes or poison me?

Anti-bacterial hand sanitizer:  Geez, I hate that stuff.  Killing most germ, leaving the strongest ones to thrive.  When you could do the same job with this little innovation called soap.

But, I thought "There's a time an a place for everything.  Maybe rural Liberia is an occassion to use such products?  Can I do without them in a poor, rural country?"  So I did my own little study.   

So, let's assess my use, or lack of use, of these products over a 6-month period in a malaria region, with no piped water, in Liberia, a country with sub-par infrastructure, ranked among the poorest countries in the world, and, tied with North Korea when Foreign Policy magazine did its 2013 ranking of failed states. 

Purpose:  Determine the effect of severely limited to no use of these products while living in rural Liberia.

Methodology:  Don't use the products unless other methods are ineffective, resulting in clear health problems. Instead, use common sense, avoid the sun, use basic soap, don't sit outside at dusk, don't touch the little kids (kids are filthy), and don't buy food from kids. And eat like a local. 

Results:

Total number of days of time in region:  180 days

SPF:
Number of days I applied SPF:  1 (Trader Joe SPF 50 spray, used during one beach day at Fishtown Beach, near Harper)
Number of days I thought "Geez!  You got too much sun today!":  2 days out of 180
Alternative strategy:  Didn't lie in the sun, wore a sun hat and/or used a shawl, stayed in the shade if possible

DEET: 
Number of days I used DEET mosquito repellant:  0 days
Number of days I thought "Geez!  You've been eaten alive.  You should have used DEET.":  0 days
Alternative strategy:  I periodically (maybe 10 times) used one of two types of anti-mosquito products - both are natural products.  I stayed inside at dusk, the time when mosquitoes are most likely to bite. 
Number of evenings I slept under a (treated) mosquito net:  1 (because there was a rat in my house and I didn't want the rat climbing into bed with me) (there were essentially no mosquitoes in my house - why use the net?)

Anti-bacterial hand sanitizer (and any other anti-bacterial product, such as special soap):  
Number of days I used anti-bacterial hand sanitizer:  6 days (days I was traveling with no access to soap and water - after relieving myself in ditches on the side of the road, or prior to eating if I hadn't washed my hands for many hours)
Number of days I was sick:  1 day (feeling achy)
Number of colds I had:  2 mild colds, one after an exhausting trip in Ghana

Consuming food and water in local establishments or at home:  
Number of days I ate in local restaurants with "questionable" sanitary conditions and/or no access to piped water (or hand-washing facilities for customers):  at least 150/180
Number of days I ate street food:  plenty (number unknown - maybe 40?)
Number of days I used bottled or other specially filtered water to brush my teeth: 1  (Instead, I used my regular hand-pump water, or rain water collected off the roof into an open basin.) 
Number of days I used bleach to wash my food:  0
Number of times I used warm or hot (as opposed to cold) water to wash my dishes:  0 (I did use soap; I never cooked meat)
Number of days I drank my filtered water out of a water bottle with an external straw (not very sanitary):  180
Number of days I had serious stomach issues associated with dirty water, food, etc.:  0
Number of Imodium tablets used during the 180 day period:  6 tablets

Anti-bacterial gels for cuts:
Number of days I used anti-bacterial gels for cuts:  4-5 (used on feet)
Number of infections I had associated with cuts:  0
Percentage of times I wore sandals (as opposed to sneakers):  nearly 100% (wore sneakers 3 times in 6 months)

Passing germs from hand-to-hand:
Number of days I shook hands with multiple people:  180 (in Liberia, one shakes hands constantly)
Number of times I was able to wash my hands after shaking hands:  very infrequently (and I used hand sanitizers as a substitute only once - when I had a cut on my hand)
Number of associated infections:  0

Analysis:

My "SPF, DEET, and anti-bacterial products are a bunch of BS." theory holds up in rural Liberia.  These products are unnecessary and therefore a poor use of packing space.  Moreover, no one living in the developed world who is in moderately good health needs to be using these products on a regular basis.

In addition, the "don't eat the street food and brush your teeth with bottled water only" warning is unnecessary in my region of Liberia. 

Summary:  In short, my assessment that people in developed world are unnecessarily paranoid and needs to chill has been supported by the fact that I didn't die (or get much more than a cold) during my 180 day study. 

Starting a Library

They call it a "reading room", I call it a "library".  Regardless, it is a success.  At the end of the day, there is now a place that students can go into to read, study, and do research.

When I arrived at Barclayville Central High School in February, 2013, there was no such place.  There was no such resource in the school, and there was no such resource in the "city".  Which means, there was no such place in the entire county.  And to clarify, there also was/is no place to purchase books.  No dictionaries, no Bibles, no textbooks, and certainly no novels.  Also, there are no newspapers and no magazines - unless you read French - which most people do not.  Finally, there is no internet cafe. 

But there was, I learned, after speaking to a member of the Ministry of Education decentralization team, an empty room to be used for such a purpose.

I tend to believe that most basic projects can be done with little to no funding.  And I was looking for a tangible project that I could complete during my short time in Barclayville.

So, instead of spending my time thinking about funding and proposals, I started asking questions:  "So, there are books in storage.  On a bookshelf.  Can we move them in here?" "Are there other books?  Can we move them?  When?  Let me know if I can carry anything.  I am happy to carry books."  (A good way to get manual tasks done is to express interest in doing it myself - the response is often for someone to do that task before I can hike up my skirt and start hauling stuff.)

In the end, in less than a month, we went from an empty, locked room to a room with bookshelves, additional shelves on their way, books on the shelves, and students crowded on benches to use the resources.  Yes, we had to wait a few additional weeks for the additional shelves and table and benches.  Yes, I spent a couple of Saturdays with a damp dust rag and broom.  But by the end of the semester, I was helping students find materials for their math and science classes, I had students doing research for English assignments, and teachers were coming into the room to consult textbooks.   

                   

                    

Reference shelf:  Old encyclopedias, one dictionary, and two atlases. 

The books are old, sometimes in poor condition, and limited.  There is one dictionary in poor condition.  The encyclopedias are a decade old.  And the Liberian history section desperately needs materials.  But there is now something to build upon.



Thanks to the generosity of friends and acquaintances, magazines were sent to diversify the reading materials in the library.  And thanks to the existence of the facility, the principal was able to contact authorities in Monrovia to say "Now we have a reading room.  Please send us the staff person you promised us, because now he will have a job - staffing the room during school days."  He arrived several weeks later.

The man brought from Monrovia to serve as Coordinator of the Reading Room. 

I think it is natural for people to want something to point to and say "I did that."  That's why we hang degrees on our walls, take and post photos of ourselves online, and show people things.  "Look!  I did that."  We also want to be remembered.  "Be my online friend, take my business card, let's get a photo of us together - remember me."  And finally, we like to be acknowledged.  

In addition to the satisfaction I got from being able to say "Look!  The resource is there now." was the feedback I got from students, administrators, and others in the community.  On the street, a student came up to me and said "It wasn't until you came that we got a reading room.  Thank you."  At my farewell ceremony, it was mentioned by both students and administrators.

I was in Barclayville for a mere six months.  It will take a long time, a decade or more, to bring the Liberian education system to where it needs to be.  There will be many other teachers - from the United States, Nigeria, Liberia, and elsewhere teaching in that school in the coming year.  My hope is that the reading room will be a resource they all can benefit from and build upon.  But, there is also a small part of me, the part that says "Look.  I did that.  And remember me.", that wouldn't mind if one day, when asked who started the reading room, someone answered "There was a teacher, Ms. Gray, who came from America - the first one we had since the conflict.  The first one in the all of Grand Kru county, in fact.  She started it.  She would come to the school on Saturday in these crazy chicken pants, with a bucket and broom, to clean and to organize the books.  She started it."  

The People You Meet

The thing people sometimes say when someone is going somewhere "new" for an extended period of time is "I couldn't image going there by myself."  The thing is that, once you get there, you aren't by yourself.  Below are a few of the people I encountered. 

People Around Town

Alfred, in his shop.  Not from Barclayville, he moved to Barclayville for the business opportunity.  He is in the process of expanding his shop, one of the best stocked shops in town.  When I was basically told that I couldn't borrow someone's hammer (maybe because I'm a girl?), I went to Alfred to purchase my own.  He didn't have one in stock, but ordered one. 

Sis Patience's Cook shop - where I ate about 70% of my meals, or so it seemed.  She knew that my favorite was rice and beans.  Price for a heaping bowl of white rice and an accompanying bowl of stewed beans (or greens or eggplant)?  100 Liberian dollars (72 Liberian dollars = 1USD).  The eating area is through the blue door. 

Sis Patience's Cook shop - where I ate about 70% of my meals, or so it seemed.  She knew that my favorite was rice and beans.  

Student (and friend) Shaka (right) and his sister/auntie (?).  Shaka was in one of my 10th grade classes.  He helps to run his mother's shop (shown) - where I bought the fabric for my fantastic chicken pants!

Student (and friend) Shaka (right) and his sister/auntie (?).  Shaka was in one of my 10th grade classes.  He helps to run his mother's shop (shown) - where I bought the fabric for my fantastic chicken pants! 

Shaka's sister/auntie makes "acheke" - a dish from C'ote D'ivoire.  It consists of cassava (served similiarly) to rice with onion, spice, a whole fried fish, and fried plantains.  The food is on a table behind her. 

Regina, my 11th grade student and president of the BCHS Girl's Club.  She rolled her eyes when I tried washing my clothes with a wash board.  And always called out "Miss Gray!" when I walked by. 

Johnny Toe Jr. (left) and Myking Suah (both in 10th grade) interview me at the Grand Kru radio station. 

Johnny Toe Jr. (left) and Myking Suah (both in 10th grade) interview me at the Grand Kru radio station. 

The boy who lives across the street.  In front of my house. 

Angel (right) at his tailoring shop.  His brother (left) temporarily joined him at his business.  Angel was often amused by my various reeussts.  And very patient when I showed up at his shop with a piece of old fabric I had found in the market that I wanted transformed into something.  He also told me about the history of Barclayville and his experience during the conflicts.  

German Agro staff, including Martin Embola, at a local tea shop. 

German Agro staff, including Martin Embola, at a local tea shop.  They are talking to Mah Nyanti (standing, left), the BCHS's agriculture teacher. 

Football match. 

At a football match.  The young man on the left in the blue shirt was an 11th grader (with an interest in physics and math). 

People at School

Langford explains basics of beekeeping to BCHS students. 

Students at the school's "Queen contest" - a fundraiser for the school. 

Jackson Wisseh (left), the principal, and teacher John Faya (right) at a school function. 

Jackson Wisseh (left), the principal, teacher John Faya (center), and Anthony Nyanti (right), the VP, at a school function.

Mr. Nyswah and teacher walking home after school. 

At my farewell ceremony.  Mr. Nyeswah, the administrative VP, is on my left.  A fellow teacher is on my right. 

Students at my farewell ceremony. 

Students at my farewell ceremony. 

The teaching staff at BCHS. 

The BCHS administrative and teaching staff.

Christopher, the Reading Room resource coordinator.  After we established and opened the Reading Room, the principal contacted authorities in Monrovia to say that, now that we had a Reading Room, a staff person should be sent to Barclayville.  He came several weeks later. He will be writing to various departments and organizations to get more materials for the room. 

With the security guard and office assistant (left).  She sold peanut butter squares that I would buy for "breakfast".  They were a mixture of peanut butter, ground cassava, and sugar. 

Students after my farewell ceremony.  10th and 11th graders. 

Students after my farewell ceremony.  10th and 11th graders. Including the principal (in the hat). 

UNMIL (UN Military Operation in Liberia)

At an UNMIL party at the beach.  UNMIL consisted of a military side and civilian side (and the military side recently left).  The military side was furnished by the Pakistanis. 

At UNMIL beach party.  Rashid (right) and Pakistani soldier (left) help themselves to rice and goat meat cooked in an enormous pot. 

Alison O. speaks at UN Peacekeepers Day.  A Liberian member of the UNMIL staff, he is not from Barclayville, but has worked there for many years. 

With Alison.  Right before departing Barclayville.  I am holding a HUGE pineapple given to my at the ceremony on behalf of the people in my neighborhood. 

 A brief stop-over in Ghana:  

With Rabi.  Who I met two years ago on a bus from Accra to Tamale.  I spent 2.5 weeks in July traveling around Ghana with her during which time we visited a variety of places and often were hosted by her friends. 

Rabi and her friend Sharon, during our visit to Volta. 

Little Spoons

Every mainstream tourist shop in the Western world seems to have the souvenir that I love to hate:  little spoons.  Those little silver colored spoons with the name and perhaps an image of the location somewhere on the spoon.  They are often of cheap quality and come in a white plastic box with a clear cover and red fabric inside.  I think they are ugly.  And a dumb way to remember a place. 

However, there is something awesome about little spoons.  They are small and easy to travel with.  Given some of the items I have traveled home with, “small and easy to travel with” is very attractive.  Over the past few years I have brought home honey in glass jars (one of which broke en route), water color paintings (that needed to be kept dry), alcohol made in the Korea that the US doesn’t like, heavy and bulky kilims (aka woven floor coverings that aren’t carpets; carpets are knotted, not woven) and various other odd objects.  (I also once arrived at Logan airport with a set of IKEA euro-square pillows before they were easily available in the US; imagine my conversation with the customs official.  “Pillows?”  “Yes, pillows.”)  

After spending six months in Liberia, I was searching for appropriate items for family and myself.  Aware that my most over-the-top gift was from a member country of the axis-of evil, I was at a loss for how to top that one.  Thankfully for my law-abiding family, I decided that Grand Kru gold dust, 18 grams of it, which a couple engaged in illegal gold mining brought to my house one afternoon, probably wasn’t a good gift.  Nor should I ask if they knew anyone involved in the illegal diamond market.  It’s one thing to not declare a box of chocolate, it’s another thing to violate international law.  (Should I ever travel to Afghanistan, heroine will not be my souvenir of choice either.)  

I found my items for family – not as small as little spoons, but least not breakable.  I, however, always get items for myself also.  Given that Liberia doesn’t specialize in kilims or carpets, I moved on to my other souvenir of choice - paintings.  Yup.  I, who hate blank walls, have a tendency to purchase paintings and other walls art.  My requirement for paintings is that the image needs to represent something I have seen in the country.  It needs to depict an image in my head, from my experience.  It needs to speak to me.  

However, I also have a talent for falling in love with either the most expensive or otherwise most prohibitive items available.  For example, in the Monrovia American Embassy, there is a fantastic (and very large painting) of the rubber plantations.  I saw it and fell in love with it.  Unfortunately, a) it is not for sale, and b) if it were, it would be thousands of dollars. 

When I arrived in Monrovia in July for my final stay, I headed right for the art shops.  There was one painting I had seen months before that I remembered and wanted.  A woman with a washboard doing laundry.   

While in those shops, I saw the thing I really wanted – a painting of rubber plantations.  The painting of the woman doing laundry was a reasonable size, given that oil paintings can be removed from frames, rolled up, and put in a suitcase.  The painting of the rubber plantation was a larger and might not fit in a suitcase (rolled up), but it was awesome and worth the effort.  So, I decided that both paintings needed to come home with me.   

Washboard painting being removed from frame and rolled up. 

Painting depicting Liberians working in a rubber plantation - Firestone is the most well-known. 

And then I looked in the back of the shop.  “Wow.  That’s awesome.  Wow.  That’s huge.  Crap.  I want that.”

Art shop in Monrovia.  My painting is the large blue, black and white one on the ground.

A third painting.  Depicting four women doing various tasks – cooking, pouring water from a basin on her head, cleaning fish, and pounding cassava.  The woman carrying water reminds me of my neighbor Rita who helped me fill the barrel of water in my bathroom when I arrived.  The woman cooking reminds me of the women in the market on Saturdays who fry doughnuts.  The women cleaning fish remind me of the women who purchase the fish in Picnicess and travel to Barclayville with fish on their heads to sell.  And the woman pounding food reminds me of the many women pounding cassava.  All those in awesome bold blue, black and white.

I asked the price, hoping it would be at least $300, because if it was more than I wanted to pay, I could easily walk away. 

“How much is that one?” 
“$150”.    

And in my head, I thought “Crap.  $150.  I could get him down to $100.  Now, I need to buy it.” 

A few days later, I showed up with the cash and, for $110, purchased a painting that is a meter high and longer than I am tall.  It is huge.  But it is also an original piece of art that reminds me of Barclayville and some of the women there.  

I have jokingly explaining to people that “I am decorating my house, which I don’t yet have.  By the time I get the house, it’ll be completed decorated.”  If I liked little spoons, somewhere I would have a displace case with a whole bunch of those silly items stacked next to each other and either blank walls or walls covered in faux art from Pier 1 or IKEA.  Instead, I now need home with sufficient wall space to hang all of my various treasures, including a ginormous painting.