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Sierra Leone: 'What is the most challenging place I can go?'

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August 29, 2012 - After returning home to the U.S. from a month-long stay in Sierra Leone, Matt Yettaw attaches cost to items in a new way.

"There is a price on everything now," says the 2011 Brandon High School graduate. "If I spend $35-$40 on dinner at a restaurant, I think, 'What does that equal for Sierra Leone and what would it pay for?'"

Yettaw, who is entering his sophomore year as a political science major at Alma College, recently spent hundreds of dollars on school supplies, including new books, pencils, paper, and even bath towels. As he made the purchases, he thought of how in Sierra Leone, $1,200 can buy a 4-year college education.

"Coming back to what we live in— people wear nice clothes here and drive nice cars and eat three good meals a day and if you have a headache, you take a Tylenol," he noted. "I got on a clean flight with hot meals and a tv monitor and it's hard now looking at all the decadence here. It really was a life-changing experience."

Yettaw, 19, left for Sierra Leone July 4 and stayed four weeks, returning home Aug. 3. His trip was offered as a scholarship travel program through Alma College for which students apply.

"I literally asked my professor, 'What is the most challenging place I can go?'" he recalled. "We have so much here, I wanted to experience somewhere where they have very little. Sierra Leone is the poorest country that Alma sends students."

Indeed, Sierra Leone is one of the most impoverished countries in the world. A civil war that lasted from 1997-2002 further devastated the already struggling country.

Of more than 100 applicants, Yettaw was one of only 25 students chosen for the program this year and one of four that chose Sierra Leone. Each student was granted $4,200 to cover the cost of the flight and each student gave a donation of $2,000 to the hospital. The travel scholarship program is a humanitarian aid project and Yettaw designed his own program, with a plan to work at the Magbenteh Community Hospital for a month, observing surgeries, volunteering in the pharmacy, and working on a project to pay for new prosthetics for many of the people who lost limbs in the civil war.

Just getting to the hospital was an adventure. The students each brought a 50-pound suitcase, filled with food and their own personal items, and also a 50-pound tote filled entirely with medical supplies including Tylenol, Advil, sterile gloves, gauze, masks and more to fill the hospital storeroom.

After 24 hours in transit, 17-18 hours in the air, and a stop over in Belgium, the travelers arrived at the airport in Freetown, the capital of Sierra Leone. The country's sole airport was run down, with open pipes in the ceiling, cracks in the walls, and security consisting of two booths against the wall. The visitors were swarmed by natives asking to carry their bags to earn tips. Yettaw notes that 350 U.S. dollars is about 3/4 of what the average person in Sierra Leone makes in a year.

Freetown is a 4-hour drive from the hospital in Makeni, and it was a harrowing trip to get there.

"There are no rules to the road," said Yettaw. "Motorcycle and vehicle accidents are one of the biggest killers in the country. Police are not mobile. have one vehicle, they're lucky. While driving out of the city, there was literally an inch between cars and people were knocking on the windows to sell you stuff. Cars there are a decade or two old and very beat up. There's no carbon filters on any and you breathe in a lot of diesel."

As cliched as he knows it sounds, Yettaw saw a lot of Africans carrying things on their heads, including wood, cans of pop and items in large bowls. Some of the government buildings in the capital city were fairly nice, but he said the majority of the buildings made the worst slums of Detroit look good. In the pouring rain, people were selling their wares while sitting on the ground.

Once out of the city, Yettaw saw a very mountainous country, with poorly constructed, half-built houses on hills, most with walls of oncrete bricks mixed with mud and rusted tin roofs covered with tarps to keep the rain out. Electricity was very limited, but with no light pollution, the night sky was stunning.

Upon arrival at the hospital, they found the facility to be a collection of one-story buildings. Yettaw and a friend shared a room consisting of two beds covered with mosquito nets, a broken wardrobe, and a toilet and shower area.

Yettaw was ready to get to work.

On Mondays, he worked on the prosthetics project known as "Arms Around Sierra Leone," and would travel with a physiotherapist and patients to Freetown, leaving at 8 in the morning and return at 8 at night, with Yettaw taking photos and videos of patients and documenting the casting process. His work will be used in the United States for updates to American donors and fundraising purposes.

The rest of the week, he would work in the pediatrician's office in the morning as the registrar, taking names, weighing children, and if they were running a fever, giving them Tylenol. On Tuesdays and Thursdays, he observed surgeries from 11-4, right alongside the surgeons, learning how to read machines, check oxygen rates, and blood pressure. He saw hernia operations, three amputations, and about 10 Cesarean sections. Instead of the anesthetics used in the U.S., surgeons in Sierra Leone use horse tranquilizers, cheaper and more readily available. Post-surgery, instead of morphine, patients receive two Tylenol.

On the days when he wasn't observing surgeries, he worked in the pharmacy, a closet-sized room, helping to fill prescriptions. Antibiotics are used there that haven't been used in the U.S. in three decades, Yettaw said, as Sierra Leonans haven't built up immunity to them yet.

Yettaw had been warned he would see death. Children are often lost to typhoid and malaria and in the space of four days, nine children died. He recalls in the pharmacy one day he filled a rush prescription for a little girl in the children's ward and a short time later he heard wails of anguish. An orderly returned with what was left of the child's prescription.

"It was really sad and it really makes you think about how lucky we are to have the care we do in the U.S.," he said.

Work at the hospital ended between 4 and 6 p.m., and Yettaw helped one of his classmates conduct interviews for her research project on the prosecution of individuals after the war. With power only available from 7-10 p.m., the students would try to skype their families from the one building enabled with wi-fi.

Proper nutrition was one of the biggest struggles Yettaw and his fellow volunteers faced. They had two meals a day. Breakfast consisted of a loaf of bread, with jam and tea. Yettaw was thankful they had brought peanut butter for protein. Dinner was rice, sometimes with just a curry sauce, other times accompanied by chicken or fish. No lunch and on Sundays, the chef had the day off and volunteers had to fend for themselves.

Yettaw lost 15 pounds during his month in Sierra Leone.

"The food, once it's on your plate, you don't think about where it came from, you just eat," he said. "There is no refrigeration, so you eat and pray you don't get typhoid... I was hungry for the first couple days, then my stomach shrunk and you get used to eating that little of food."

Yettaw noted that the students ate much better than the people who live there, who typically have one meal a day, boiling chopped up potato leaves or cassava leaves in a pot of oil, stirring until a thin green soup is made, adding handfuls of hot chili peppers and pouring over rice to eat day in and day out.

"They can get chicken sometimes, but a lack of protein is where the malnourishment comes in," he said. "When food is more spicy, you drink more water and it fills you up. You feel full and eat less."

Despite the devastating conditions, Yettaw was surprised to see how upbeat the Sierra Leonans seemed in general.

"There was a lot of joy," he said. "They love to sing and they are just a happy people. They have to be, because conditions get so poor over there. We got stuck in the pouring rain and we thought, 'We'll just walk back,' and every person we saw invited us in to their homes, to get out of the rain. They are very friendly, nice people."

When Yettaw and his American companions were leaving Sierra Leone, he knew he would likely never return. He wondered how he and his friends at home in the United States could best help.

"My professor said, 'You are not going over there to save the world. Do as much as you can, but in the end, it's not enough. Go and learn and tell others what you know,'" said Yettaw. "People here in the U.S. live in such a bubble. You see things on the news and think, 'That's really horrible,' and then you sit down and watch a sitcom and go to bed. You hear a lot of people say, 'America first, take care of us first, and let the world take care of itself,' but without money we spend around the world, people would die."

Yettaw recalls that as he left, the hospital employees, which includes a surgeon from Holland who has dedicated a year to working there and receives a stipend of $200 per month, asked him to tell others about Sierra Leone, to not let them be forgotten.

For Yettaw, Sierra Leone and its people will always be remembered.

Susan covers Brandon Township and Ortonville
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