Mud, mud, and more mud

On Friday I took my first trip out into the field. My supervisor, a Congolese man named Raphael, needed to meet with someone in the town of Foya, less than 50 miles away. Despite many of the staff members cautioning me that the roads were very bad since the rains, I was excited to be seeing more of the region.

About twenty minutes into our trip, I began to appreciate a bit more my colleagues’ statements about the road conditions. About every half mile or so, the dirt road turned into giant mud trenches. Though luckily we did not get stuck anywhere along our way, the trip took us over four hours. In the dry season, it takes only one.

If the way to Foya was difficult, the way back was far more challenging. Around 5pm, we arrived in the town of Kolahun, the half-way point between Foya and Voinjama. We stopped at the IRC-run hospital to pick up a patient with a ruptured intestine. Since the Kolahun hospital does not have an operating room, we needed to transport the patient with her daughter and a nurse to the larger hospital in Voinjama. We placed a mattress in the back of our land cruiser, and Martina lay down for the ride. While I had cringed at many of the constant bumps and jerks on the way to Foya, the ride felt a million times worse knowing that we had Martina in the back. To be honest, I really do not know how to describe just how bad these roads were and how painful it must have been for Martina, with her intestines already ruptured. I tried to take photos of the mud (I posted a few below), but they really do not do the situation justice at all. At one point, I tried to calculate the longest stretch of flat road, and I couldn’t ever get past twenty seconds. Martina’s daughter was so bumped around and nauseous from the road and car fumes that she threw up intermittently for most of the trip.

In addition to being jerked around as our vehicle navigated through potholes and ditches, eventually we got stuck in the mud. We were only able to get the car out by having half a dozen Liberians rock the car back and forth with all their strength until the front wheel could get enough traction to pull out of the ditch. This took countless tries over a half hour period, and all the while Martina was lying there in the back seat with only her daughter and the nurse able to steady her as the car jerked to and fro. The saga didn’t end here, however. Instead, once we finally got going again, the sky opened up and started to pour, turning the road into a giant muddy soup. Luckily, we did not get stuck again, but the trip back still took several more hours.

As we bobbed along the road, I could not help but wonder about a lot of things. First, as the rain poured down, I wondered how it must have been for people during the war, having fled their homes and villages, to survive in the jungle with no escape from the rain and mud—not to mention all the diseases that came with them. Never having experienced a war myself, I have no idea if it was silly of me to wonder about the rain and to feel like it must have just made everything worse. Maybe the rain was the least of everyone’s problems. But watching it pour down so relentlessly, I couldn’t help but wonder. Second, as I stared at Martina, lying there in the back of the car, surely in terrible pain, I wondered what other horrible experiences she had been through? Did getting jerked around for hours in the back of a land cruiser with her intestines ruptured seem like a minor form of suffering in comparison? Or did she wonder what trick God was playing on her to allow her to survive so much only to have her die in the back of a car because of something so seemingly insignificant as mud? Third, I thought about Mali and the different challenges faced by individuals trying to access health care there and here. In Mali, Malado died for many reasons, but the final cause was the lack of available and affordable transport to get her to a hospital. Though the health district has an ambulance, patients have to pay, and it would have cost about $100. This was an unthinkable amount of money for Malado’s family and well beyond even my means while I was in Senossa (I only had about $30 and there are no ATMs). In contrast, here in Liberia, IRC provides free health care and transport to patients throughout the county. But what good is free transport when the roads are completely impassable? It was horrible sitting for hours in that car knowing that even with all IRC’s funding and four-wheel drive-equipped vehicles, we might not be able to get this woman to an operating table in time to save her life.

In the end, we arrived safely in Voinjama and were able to drop Martina off at the hospital. The doctors intended to operate on that night or in the morning, but I haven't heard yet if she survived. Another patient died in the car on the way to the hospital yesterday because of the roads.

When I was in Monrovia and expats complained about the Liberian government’s priorities, wishing they would “just pave the damn roads already,” I was unmoved; investments in health care and education should come first. But progress in many key areas relies on people and programs being able to get from one place to the other in the country. Although I still don’t think that the roads should be the government’s first priority, I will not be so indifferent the next time someone laments their poor condition or warns me of a long, bumpy day when I am next headed out to the field.