Who or what killed my sister in Liberia?

Commentary

Who are what killed my sister in Liberia?

An anniversary and reflection on her last days.

By Dagbayonoh Kiah Nyanfore II, Monrovia, Liberia.

Sister Gbeh (photo) called me Saturday night, February 28, 2015. She wanted to see me on Sunday after church.

“Is there a problem? I asked. “No, brother”, she said, adding, “I just want to see you”.

Immediately after church, I went over to her house, a hut so to speak, with patched old zinc in New Kru Town, Monrovia, Liberia.

As usual, she was happy to see me. She too had just returned from church. She wore an African dress and was looking beautiful. I was glad that she attended church, because I had advised her to go to church and not always go to sell at the market on Sunday.

“Nyanfore Gbeh”, I called and praised her in Kru traditionally. She smiled.

“I took Tehbel with me to church and introduced her as my grand-daughter. I want her to become an usher as I was”, she happily said. But Gbeh did not say why she wanted to see me. She restated her earlier reason as I pressed her on if everything was OK. As she walked with me to the road to take a taxi home, I repeated to her my desire to buy her a piece of land and build a house for her and the children one day. “God will bless you brother”, she said.

On early Monday the next day, Tehbel called me crying that my sister had fallen and was not talking. “Please come uncle”, she urged.

From my house in Gardnerville, Monrovia, I rushed to New Kru town, which is about 35 minutes drive. I met Gbeh lying on the floor motionless. Gbeh, Gbeh! I called while shaking her. She opened her eyes in response. I ran to the street to get a cab to take her to Redemption Hospital. I was lucky to get one quickly. Tehbel and a neighbor helped me to put her in the car. She was heavy. Tehbel went with me to the hospital.

At the hospital, the receptionist inquired about my sister’s condition.

“She fell this morning and cannot walk and talk”, I replied.

I gave my sister’s vital information when the receptionist asked. There was no computer, so she was writing the information on a sheet of paper. Luckily, my sister was given a bed, which was usually hard to get. The nurse took Gbeh’s temperature and pressure.

“Her pressure is very high”, the nurse reported and gave her drips and nifedipine, a blood pressure medication, to lower the pressure.

“She needs some rest”, the doctor on duty instructed as he also checked my sister. The nurse added that only one visitor should be allowed to be with my sister. Therefore Tehbel left to prepare the younger children for school and to get ready for her class. She is a senior at her high school. I stayed with sister until Tehbel returned. The hospital demanded that a family member must be with the patient at all times and must bring food for the patient. The hospital was short of staff. It lacked adequate medical supplies. There was no wheelchair or stretcher to bring emergency patients into the hospital. The reception room had only two chairs.

“We are not operating like normal time”, a member of staff said. Normal time in Liberia is referred to as the time before the Liberian civil war. It is also used as an excuse for existing inadequacies and the lack of basic services, such as electricity and adequate, clean and safe drinking water and ambulances.

Redemption Hospital was built by the PRC, the People’s Redemption Council, a military junta, which overthrew the Tolbert regime in 1980 and ended the rule of the True Whig Party and settlers in the country. Prior to that, there was no hospital in New Kru Town for the poor. Also, prior to that and now, government officials and the elite travelled abroad for personal health services, giving little attention to the healthcare sector in Liberia, particularly in the rural areas, where the majority of the population have no access to basic health service.

There are two major public hospitals in the country. They were built by foreign governments. The country has “one doctor per 100,000 people”, and has “about one healthcare worker for every 3,400 people”, according to published reports. Projects of lesser priority have more money allocated to them than the fund earmarked for health services in the current national budget. The absence of adequate healthcare puts at risk the lives of the people, mostly the poor. Many have died because of inadequate health services. This is one reason Ebola killed over four thousand people in the country. Liberia had the highest Ebola death rate in the sub-region. Ebola took advantage of the medical vacuum or weaknesses.

Nevertheless, the Liberian people survived Ebola last year, thanks to the resilience of the people, the government’s improved public awareness effort and help from the international community.

Although Redemption Hospital lacked many services, it was the only available health center for Ebola patients in New Kru Town. Ebola killed in Liberia more than 180 healthcare workers, including eight from this hospital. Like in other hospitals in the country, healthcare workers sacrificed and risked their lives in servicing patients at Redemption during the crisis.

Redemption Hospital was cleaned during my sister’s hospitalization. The janitor mopped the floors regularly. On Tuesday, March 3rd, Tehbel reported that my sister’s condition had improved; the hospital had released her; her pressure had diminished; her body had regained strength; she walked home by herself and could talk. I spoke to Gbeh on the phone, she sounded fine. I was happy. I went to New Kru Town after the conversation. Gbeh was asleep when I arrived. So Tehbel and I went to the local drugstore to purchase the prescribed medications. At her house, I spoke to a medical practitioner for her regular check-up and monitoring.

I returned home feeling good about her condition. But the next day, Wednesday, her condition got worse. She was sicker and had stopped talking. Again, I rushed to her house and took her back to the hospital. It was harder this time: Tehbel did not go with me. She had to stay with the children. Finding a taxi was difficult, though I got one. There was no person willing to help me pull her out of the car and take her into the hospital.

“Can someone help me”? I cried out.” I will pay”, I continued. No response! The taxi driver was impatient. He too was unwilling to help. “You are holding me up, I got to go”, he shouted.

I pulled my sister from the taxi by her arms and unfortunately dragged her by her feet into the hospital. The security guard, standing at the entrance, moved to the side to give me way. He was of no help either.

Apparently because of Ebola, people were afraid to touch patients. Therefore I understood the reaction, or the lack of response to my call. Ebola or no Ebola, I could not leave my sister helpless. I did what I had to do. Situations can make you do such a thing. Now I understand why the late Patrick Sawyer had to help his sick sister at a hospital in Liberia. Unfortunately he died (in Nigeria) from the sister’s Ebola.

Inside the hospital, there was no available bed, no doctor was on duty and there were only a few evening staff members. I forced Gbeh to sit in a partly broken chair; she was weak. Her head was resting on my left thigh as I stood. After waiting for a while, I asked the receptionist, “When will a doctor be on duty”? She did not answer or pay me any attention. I kept asking. “When will a doctor be here, madam”?

My continued asking got the attention of another staff member. Perhaps the receptionist had told him of my consistent inquiry and that I was from America. “Who is the American man making noise or causing trouble”? a male staff came out asking us in the waiting area. I did not answer, though I knew he was referring to me.

“I am not an American and I was not causing trouble “, I said to myself. In Liberia when you speak out or question things, you can be considered a troublemaker. Seemingly, the general thinking is that poor people needing public services, such as healthcare, should not speak out. They should be quiet and be thankful for whatever service they get. The silence to the question made the staff member to turn around to the receptionist and ask, “Where is the man”? The receptionist pointed at me. “That man there, that Papay”. Papay means elder or senior in Liberia.

When the man approached me, I stated that I was not causing noise or making trouble, but simply asking when will a doctor be on duty.“Patients are here waiting and needing service”, I further explained. “You are from America, ehn? This is not America. We do not have money to run a fully staffed hospital”, he said.

A few minutes later however, the receptionist called me and asked for my sister’s name. “Elizabeth Nyanfore”, I said. “Is this her first time here? She asked. “No ma, she was here yesterday”, I informed her. She continued, “What is she here for? I repeated what had happened. The receptionist did not appear to have or look at the information taken the other day, just yesterday. She was writing the same information on another sheet again. “And how old is she”? I gave my sister’s age and date of birth. “What medications were given to her or prescribed? She asked. “I do not know “, I answered and asked. “Isn’t that information in her chart”? She did not answer or appeared not to listen. She repeated. “What medicines did she take”? “I do not know”, I said again, adding “but her grand-daughter has the medications at home. She is not here”. I replied.

The receptionist requested that I call Tehbel to bring the medicines. I did. When Tehbel brought the medications, it was revealed that she had, unknowingly, given sister too much of the doses prescribed. This put Gbeh into a deep sleep, as we were told. “You want to kill your grand-mother, ehn?, a medical assistant jokingly said to Tehbel. “But she will be alright”, he added, reassuring us that things would be fine. They checked sister’s pressure and sugar level, she was fine.

Gbeh was given a bed and placed in a hallway leading to the main room. I sat near her bed, holding her hands, comforting her and telling her she would be fine and would get well. She was just looking at me, not saying a word. As I held her hands, in a flashback I remembered when we were children residing in Claratown in Monrovia: our respective mothers sent us to live with our father’s people, who were financially well-off and able to send us to school. Dad was ill after graduating from Cuttington College and could not help us.

I went to live with Uncle James, James Nimely or Nimely Nah in Grandcess, now part of Grand Kru County. Gbeh went to Aunt Mary in Harper City, Maryland County, Liberia. Uncle James was a superintendent of Grandcess and was a wealthy man, a real estate tycoon. His father, Dagbayonoh Nimely, was our great grand uncle, brother of Dagbayonoh Nyanfore, our great grandfather, a dogbwo-klohbarh, a traditional leader of Grandcess from the Nyapo-Natieo panton.

Aunty Mary or Mary Nyanfore Wilson was a high society woman in Maryland County. Her husband, Mr. John Wilson, was a government official. In addition to her own properties, she and her husband owned properties and a large rubber farm of hundreds of acres in Maryland County. She was our dad’s sister. She was the oldest of father’s siblings and was helpful to us, the James Nyanfore children, during his illness. Gbeh and I were to become a success story, coming from a Monrovia ghetto to places of opportunity for a better future.

But I ran away from Grandcess to Harper City primarily because of mistreatment. I was happy to reunite with Gbeh. We played together and hid ourselves to speak Kru, our traditional African language. Aunty disallowed us from speaking Kru in the house. Speaking “mother tongue”, as it was called then, was considered uncivilized. Hence, many educated natives, desirous of acceptance by the Americo-Liberian/Congo ruling settlers, played down their native culture. Within a week, however, Aunty Mary sent me back to Grandcess. She could not disobey Uncle James, her elder brother, though I pleaded with her to stay. Gbeh cried to see me go. She left Harper later and returned to her mother. I did too.

When I awoke from down memory lane, a healthcare worker passing by asked if Gbeh was my wife. “No, sister”, I replied. I guessed she felt that only married people could show such affection. I fed sister with bread and tea, which Tehbel brought. Gbeh did not have appetite for sold food. “Eat the bread and drink the tea, I urged. She tried to eat with some difficulty but drank the tea easily. ”Eat Gbeh, you need strength”, I encouraged her.

A few days later, my sister got better, though still weak. She could open her eyes and talk. Tehbel and I asked her what solid food she wanted. “Palm butter and fufu”, she replied. Tehbel and I laughed. “She wants palm butter and fufu this time of the night”, I said to Tehbel smiling. I turned back to sister. “OK Gbeh, Tehbel will cook that tomorrow”, I said. My sister was moved to the main room with other patients. There was bed space now.

As stated earlier, my sister lived in the Borough of New Kru Town, a settlement established around 1945 for the Kru people who previously resided in old Kru Town. Apparently, it was understood and planned that in a subsequent year a port would be built on Bushrod Island and certainly in 1948, the Freeport of Monrovia was constructed as a gateway for the economic development of the country.

The old town was located in down town Monrovia in the area now called West Point. The Liberian Government tore down old Kru Town for industrial/commercial construction, which never happened.

Like Gbeh, the inhabitants of New Kru Town live in abject poverty. She was living in an old rundown one room zinc shack with six grand-children, including Tehbel’s little girl.

New Kru Town is considered “the largest slum in Liberia” and has a population about 75,000, mostly youth, “below 25 years old”, and over 75% of the labor force are unemployed, as stated in a published document. That rate is just 10% below the national figure of 85% unemployment, which has been constant since Charles Taylor’s administration, about 14 years ago.

With this high unemployment, almost all of the schools in the borough are private, making life more difficult and adding financial pressure on the poor to educate their children. Seemingly, as I look back, the town’s glorious days are in the past, as viewed by me who was born in New Kru Town. Unlike currently, New Kru Town then was cleaner, not congested and united. It had some of the best soccer teams in the country.

New Kru Town was the home of YB, Lone Stars and Yankees. The teams kept the town together. Old Kru Town too had Bame, meaning “let’s die” in Kru. It was the greatest Kru soccer team ever with famous goalie Pa Bornico Daniel. The borough’s rival town was Claratown with its mighty teams –IE, Landipools and Young Tigers with Jackson Weah, Jasper Wleh and Togopay and team owners, including PSJ. Dennis Nyanfore and “Taxi”, a fast running player, were among the best footballers in New Kru Town. D. Tweh was the political leader of the people, the Liberian downtrodden. Nahklen was the governor. Each team had its women supporting group, wearing uniformed African dresses, singing and cheering for their respective teams. The churches were also instrumental in the community. The now Grandoe Church, the Peter Wleh Church and the Methodist Church were the original religious institutions in the borough. The Samuel Doe Church came later from Monbo Town in Duala.

Majority of the adult males in New Kru Town worked at the Freeport or worked at sea as seafarers; some were fishermen. The schools were generally free, enabling many of us to get kindergarten and elementary education.

For example, the Methodist Day School and the William V.S. Tubman Public School, which I attended respectively, were all free. Parents who could afford tuition sent their children to St. Mary, a Catholic school, which was established later. Some kids went to Demonstration School in central Monrovia. The advent in 1951 of the “Point Four Program”, a US technical assistance project, helped improve the community as there was electricity and fine concrete houses in the neighborhood.

The Dr. West or the Colonel West community was located in the coastal beach area near the Atlantic Ocean. It was a fine place with an ocean view. West of the borough, the lagoon area, also had a water view with the St. Paul River entering the Atlantic Ocean, dislaying a spectacular scenery. The sea did not encroach inland. That was New Kru Town.

Its population later increased when Claratown was demolished by the Methodist Church in 1971 and the inhabitants, all Kru, migrated to New Kru Town.

There are more schools, churches and other human services organizations, including the head office of the Women and Children Advocacy agency (WOCAD) in New Kru Town. WOCAD advocates for the rights and empowerment of disadvantaged children and women in Liberia and is non-governmental.

My sister worked as a ticket collector at the Duala market. She made 400 Liberian dollars a month which is equivalent to $5.00 US. She augmented her income with money which she made from selling at the market at Duala. She paid about $5.00 US a month for rent. She told me that the job was hard. At times she argued with marketers or vendors who did not pay their market fee, when she tried to collect payment. She worked long hours from the job and from selling. I asked her why she worked at that job, which paid so low and was so stressful.

“Brother, it is hard finding work in this country; the job provides me the privilege of not paying for my market table and mostly, it pays the rent”, she answered.

Although when I was in America I sent her money to help, I started giving her a monthly stipend since I came home. My coming to Liberia showed me concretely the gravity of her condition. I wish I could have done more. Sometimes I blame myself for staying and studying too long abroad. All my sisters in Liberia, except one, have died, including my mother during my studies. I am the oldest son of my parents, therefore the family responsibilities rest on me.

I left Liberia for the US as a teenager for high school. However, had I come home early without completion of my studies and without preparation, I would have encountered financial strangulation and starvation, a suicidal decision which could have forced me to compromise my principles and integrity, and I would have been unhappy. I also blame her son for dumping his children on her knowing her condition. Feeding and clothing the children and paying their school fees worried her. The children put pressure on her too. I blame other family members for not helping her although she had financially able relatives in Liberia and abroad.

In Monrovia, for example, she had a nephew who was at that time a minister in the government; another nephew is an official of a major bank and a niece who holds an important position at the Freeport of Monrovia. Regrettably, they did not see her or look for her for years before she died. And they did not attend her funeral either.

But Gbeh boasted of her family background simply to indicate that she was somebody, though in reality, she was also suffering financially and living in poverty. Poor people act like that sometimes. They gladly talk about or feel good and happy to see a better- off relative. Unfortunately, the feeling is not usually mutual.

My return home has shown me also some of the behaviors of our people: they would come around you when you have money or when they want something. When you do not have, they would pull away from you. You would not see them around. Many are selfish, care only for themselves and their children. They would certainly take advantage of a situation, if you are kind but weak or a “nice fool”. The poor must care for themselves, they have no justice. I experienced this behavior. When I came home on short visits with plenty of money, people would flood my compound.

Since I returned and have been home for long due to illness, only one person or two would occasionally stop by to say hello. People no longer come around. Some people say that my illness is caused by African science, a spiritual power, which harms or kills the intended victim. I just listen whenever they tell me. I always ask. “If our people have such a power, how come they are still poor, oppressed and marginalized by others”? I just listen, when they try to explain.

My sister’s condition was not special or unusual. Many people like her live in Logan town, Claratown, West Point, Slipway and in other ghettoes or slums in Liberia. Most Liberians sleep with empty stomachs. They force themselves to sleep so they would not feel the hunger at night. I blame the government for the acute poverty and for the poor healthcare system. Liberia is very rich in natural resources, but only a few people enjoy the wealth.

The average Liberian, or 84% of the population, lives on less than $1.25 US a day while some government officials and others make $15,000-$30,000 US a month, meaning they live on $500-$1000 US a day. About 63% of the people have no access to clean and safe drinking water. Over 80% of the country is without electricity and about 98% of the population do not have electricity. When you walk in the streets of Monrovia, you can see poverty in some people’s eyes or faces. At the same time, others display their wealth in the midst of impoverishment, and they feel no guilt!

Despite my sister’s poor condition, she had a deep sense of self value and principle. If you did not like her, she would not like you. She did not run after relatives to beg them for help. She did not allow people take advantage of her. She would stand up for her rights and for what she believed to be right. I admired that, she was like daddy. He was an advocate and had value, principles and integrity.

But my sister was not without faults. Besides argumentation with marketers, she was a “hot pepper woman”, a woman with a hot temper constantly involved in “palava” or confusion with people.

”Your sister is not easy, advise her to cool down”, that was what neighbors would tell me sometimes when I visited her in New Kru Town.

Her condition in the hospital was declining. She stopped talking. On Thursday, March 17, Tehbel called to say that the hospital had discharged sister. “Is she well now or improving”? I asked. “No, the hospital said that they can no longer keep her. Come uncle”, Telbel said crying.

I hired a car to New Kru Town. Before going to her house, I stopped at the hospital to inquire about the problem. The hospital informed me that they lacked the capacity to keep a patient for long, that I should take her to a private hospital or get home-care service. I asked for a medical document regarding her condition and a follow-up prescription if possible. “No, we cannot give you that”, said a staff member. I went to the administrator, she was in a meeting, but an assistant got the information requested. I then went to my sister’s house and took her to my house. I had already decided to bring her home temporarily and had arranged with a registered nurse to attend to her. I also talked to my private nurse, Ma Mary, to prepare the guest room and provide other needed services. My sister was still weak. Her eyes were closed.

Gbeh, you are home in my place and you will be alright”, I said as she lied down.

On Friday morning, March 18th, about 5 , I woke up to check on her. She was asleep; her heart beat was unusually faster. I got kind of concerned. But it was early, so I went back to sleep. At 8: 15 AM, Ma Mary arrived and went to sister’s room. I too followed. My sister was up but her condition was still the same. I left. At 10:30 AM, Ma Mary called me to come into the room.

“Please come”, she said. “What happened, what’s the problem”? I nervously asked. “She was crying, tears were coming down her eyes as I was feeding her.” Her heart is beating faster”, Ma Mary stated. “It looks like she wants you to come, she added.

"Gbeh," I called my sister. She tried to open her eyes. She looked at me briefly; she opened her mouth and took two deep breaths. The breathing suddenly stopped. I looked perplexed. “Is she breathing”? I confusedly asked Ma Mary. “Please check”, I further requested. While Ma Mary was checking, the registered nurse walked in. We told her what had happened. She checked Gbeh’s heart, pulse and eyes.

"We need to take her to the hospital now," she said, adding, “I am going to call the hospital to send an ambulance”. She walked out without answering my question, “Is she alive”?

A few minutes later, Reverend Jallah , the pastor of a church opposite my house, sent a message requesting me to his office at the church. At first I replied that I was busy. Yet he insisted. I walked to his office, I was standing up and my hands were resting on a chair facing his desk.

"Sit down, brother Nyanfore," he politely requested. I sat down. He praised me for my involvement in the church and in the community. He also talked about my care and love for my sister. I said to myself, "Why not get to the point Rev, I do not have time, I am busy."

He looked at a Bible on his desk and said “your sister passed”. I did not get that at first. “So what are you saying”? I asked. “I mean your sister just died. The nurse told me because she did not know how you would take it,” he responded. I was quiet; I tried to compose myself, I got up, he was looking at me. “OK, Rev. I will see you”, I said and left.

I went straight to my sister’s room; I requested to be alone. I looked at her, I thought of her life, her poverty and her suffering.

I prayed for her and talked to her in Kru; with tears in my eyes!