Tag Archives: Susan Hale Thomas

Health Care in the US – Where’s the Money Going?

Sleeping in her car hoping to see a doctor at Rural Area Medical, Wise County, VA. Do you and your family do this for a doctor's appointment? Would you do it if it were the only doctor you could see once a year?

Sleeping in her car hoping to see a doctor at Rural Area Medical, Wise County, VA. Do you and your family do this for a doctor’s appointment? Would you do it if it were the only doctor you could see once a year?

Was doing a bit of research yesterday and pulled these numbers from the World Health Organization. This probably isn’t news to anyone but I like looking at numbers and find this really interesting.

Current statistics from the WHO rank the United States at 34th for Life Expectancy with Sweden ranking 1st. The United States currently spends 17.9% of its GDP on health whereas Sweden spends 9.4% and its citizens enjoy universal health care. Americans are paying more and receiving less as 50 million Americans have no health insurance. And look at Cuba whose constitution states all citizens have a right to health care. You go, Cuba!

What’s wrong with you America?

Country Life Expectancy(M/F) % of GDP spent on Health
Quatar      (83/81)                 1.9%
Mexico      (72/78)                 6.2%
Israel      (80/84)                 7.7%
Australia      (80/84)                 9.0%
Sweden      (80/84)                 9.4%
Japan      (79/86)                 9.3%
UK      (79/82)                 9.3%
Cuba      (76/80)               10.0%
Germany      (78/83)               11.1%
Canada      (80/84)               11.2%
France      (78/85)               11.6%
USA      (76/81)               17.9%


Buried under six blankets and illuminated by our cell phone flashlight apps, cloudlike puffs of our breath escape as we giggle under the covers trying to figure out how we’re going to make it through the night. There is no heat save an old kerosene heater that is propped up on an old broom handle.  It’s powerless against the icy stone walls of the farmhouse. Creeping across the marble floor to pee is unthinkable as the cold penetrates the thickest of wool socks straight into your bones.  Without even discussing it, we both end up in the middle of the bed hoping to create a warm spot. Excited for our first full day on the farm, we both manage to fall asleep quickly.


The children play in the streets of Nisf Ijbal at dusk.

We’re here to make a documentary on behalf of the Middle East Investment Initiative (MEII), a non-profit formed to stimulate economic development in the Middle East.  It has brought us to the tiny hilly village of Nisf Ijbal in northern Palestine. But for the Arabic and occasional Yasser Arafat graffiti on a wall, one would think we were in southern France with its rocky hills covered in sweet smelling herbs. Our driver, Eshak, left us yesterday and will be back for us later tomorrow evening.  He’s protective and has become our friend.  He called this evening to check in on us, making sure we were alright since no one had met the farmer before we came.  We feel right at home and have made buddies with their three children, all under the age of five.

The sun is at least an hour or more from rising and Athaan, the Muslim call to prayer, begins. I sit bolt upright and stare directly at the videographer, Caroline, traveling with me. It feels as if we just fell asleep but a prayer that sounds as if it’s coming from under the bed has jolted me awake. It’s been like this since we arrived, the sleepless photographer, me, staring at sleeping Caroline. I love the prayers that drift across the cities of North Africa and the Middle East but this one happens to be piped through a loud speaker directly above the farmhouse.  It’s meant for the entire valley below to hear and even wakes Caroline who has managed to sleep through everything else these past three weeks. I mutter something and can’t go back to sleep. We laugh at the absurdity of the early hour. The heater has gone out and it’s still dark. The rooster is up and so are we, shivering and sliding into our frosty dirty clothes.

The air is crisp, the sun toasty and a beautiful breakfast all from the farm has been set out for us on the terrace outside our room – warm pita, zataar, olive oil, olives, halloumi cheese, tea spiced with maramia, a sweet herb that grows in the hills surrounding the village. I feel my bones defrost with the tea and the sun’s heat. The farmer and his wife join us.

Imagine Daniel Day Lewis in a Gilligan hat, and that’s Khadir, the farmer.  His wife, a very slight and shy Catherine Zeta Jones.  They sit with us while their three children play in the sunshine. “Saha,” we all say, the Arabic equivalent of bon appetit. We speak very little  Arabic and Khadir, speaks very little English.  Somehow we manage to communicate through smiles, gestures and the Arabic book I occasionally pull out.  Our company isn’t awkward but rather somehow refreshing and real.  We’re curious about each other.


Khadir Khadir and his lovely family on the terrace.

We found Khadir through a farming cooperative in northern Palestine and were told that he is a proud innovator and after years of working illegally in a plastics factory in Israel to support his family, he is finally able to make his living off his land in Palestine.  He worked nights for six years sleeping on the factory floor and never seeing daylight or his children. It was difficult and he wanted to come home.  He has since joined the farming cooperative which supports fair trade.  Together, the farmers have implemented organic farming techniques, are now selling their products internationally and have doubled their income.  It’s a big step for Palestine and it’s farmers and it’s been a successful move for Khadir.

Eager to show us his village and his farm, Khadir leads us through the dusty streets after breakfast, greeting the women opening up their windows from the night and the men gathering out in the narrow streets for their first cigarette of the day.  At the village school we plant olive saplings as the children and teachers begin arriving.  Because the children and teachers gather to watch the spectacle of us filming, school starts late.  They serve us coffee, chocolates, and cookies, as Palestinian hospitality dictates.  I detest coffee and this coffee is particularly strong, like sludge in a cup.  I am not able to choke it down and am fearful I will offend our hosts.  Unbeknownst to Caroline, a coffee junkie, I switch my cup with hers. I will confess my sin days later on the plane ride home.

We stop by another olive grove to get Khadir’s horse, a small horse with a sweet demeanor.  A few children and the farmer’s son, Mohamed, who is celebrating his fifth birthday, join us skipping along the way.  Winding down the road to the bottom of the village we reach another grove where we stop to clear some underbrush. It’s winter and Khadir is just doing some maintenance work as the harvest is over.  Yet another pot of tea arrives and we sit in the dirt for our third beverage break of the morning.


A local boy and the horse.

Since there’s not a lot of work to be done, Khadir has the luxury of entertaining us and leads us up a valley along a stream.  As we enter the valley, terraced rocky hills spotted with more olive trees rise up on either side of us.  These hills belong to Khadir and his family.  He is proud to share his farm with us.  It is stunningly beautiful here and he can tell we are pleased and enjoying ourselves.

Khadir thinks it would be fun to put Caroline up on the bare-backed horse and lead her.  It turns out to be comical as she can’t get up without the assistance of two men picking her up and putting her on it.  Khadir stops to take a picture of her for a keepsake.  At some point I end up on the back of the horse with Khadir.


The sweetest horse I’ve met.

It’s turned out to be a lovely day.  With the temperature in the 60s and we’re glad to be outside and warm.  We sit along the crystal clear stream enjoying the sun and watering the horse.  Khadir squats down and cups the water into his hands, takes a sip and then splashes the rest onto his face.  We share some apple juice and feed the horse cookies. Some local girls make their way down the stream bed, their jeans soaked and laughing. I talk soccer with some of the local boys by sketching a field in the dirt with a twig.  From this, we manage to teach each other some English and Arabic.

Saving the best for last, later in the afternoon Khadir takes us on a tractor ride to the top of his mountain.  Caroline and I ride in the back of a trailer with a couple of the kids, I take pictures while she films.  The dirt road is steep and washed out but the view is breathtaking and worth being jostled about.  We’re filthy and completely in awe.  After spending a full day with Khadir and the kids, we’ve all bonded and don’t want the day to end.  We sit in silence on the rocks stretching the time to make it last.  The light is golden, the sky a deep blue and the ground covered in sweet oregano.


The end of day on top of the mountain.

Our driver, Eshak, has managed to find us at the top of the mountain and is happy to join us for a sit.  He translates for us but we’ve understood all along.  Khadir wants us to know we are welcome anytime.  We are family now.

We end the evening back on the terrace with a delicious chicken and rice meal. The kids are washed, the sun has set, the moon is up and it’s time for bed.  The children’s laundry sways in the evening breeze.  We hug the kids, toss the littlest in the air and say our goodbyes.   We feel the same, Khadir.  We are family now.


The laundry and the moon.


Alexandria’s fire department suffered a tragic loss February 8 with the death of Joshua Weissman, a paramedic who succumbed to injuries sustained  while responding to a car fire on I-395.  Hundreds of citizens stood along the roadside in the cold rain to honor him, his family and those who serve our city. It was obvious Weissman was much loved and widely respected and our hearts go out to the Weissman family.

With much appreciation to the paramedics, firemen and policemen who put themselves in harms way everyday to keep us safe.

Click below for the full photo essay.


Like being the movie premiere

There is no such thing as privacy while camping in Sierra Leone.  If I needed to change clothes, I had four little ones staring at me from outside my tent.  If I wanted to bathe, I had half dozen people keeping me company even when I signaled it was time for me to dig the sand out of my bottoms which I prefer to remove when taking a bucket shower. If I needed to pee on a road trip, anyone passing on the roadside would not even think about looking away but rather I was expected to wave and make polite small talk while going about my business.  If I wanted to read a book alone?  Forget that. At one point, I counted an audience of thirty people on Nyangai Island watching me read.

Momo & friends keeping me company while I attempt to put on underwear

Nick & Tanja trying to read with an audience

Got a pee? Want company?


Witchcraft is deeply embedded in Sierra Leonean spiritual traditions.  Rituals often include a devil dancer who pays homage to those who have passed on. Ancestors are thought to be able to intervene, advise, help, or punish enemies.  Not only do some believe the deceased may return as harmful spirits, they even believe a witch or sorcerer has the power to transform the living into animals or inanimate objects.

John Obey is filled with a supernatural vibe.  There’s an energy in the air, especially at night when the only light is that of cooking fires and candlelight. Faces I’m so familiar with during the day reflect a different light in the darkness- a bit of the occult perhaps. Given their vulnerability and belief in the paranormal, this little village provides the perfect backdrop for a sorcerer, A.K.A. a scam artist, to make a tidy profit.

One day a cell phone went missing from the solar shack where we charge up our electronic gadgets.  The next morning during our post-breakfast meeting, Filippo asked if the guilty party would please return the phone to a bin he placed behind the loos and no questions would be asked.  Sadly, that night, the phone did not make its way home.  The next morning, two of the local village managers suggested they bring in the big guns, the sorcerer!  Well, that got my attention.

After the meeting, Hooman and I sat at the breakfast table talking about the sorcerer.  I asked him what to expect.  According to Hooman (A2H), our resident earth-bag architect, the sorcerer is a powerful man in the area whom people fear.  He charges a whopping Le200,000 (US $50) for his professional services. A2H, the sorcerer would  come to the village and gather everyone in a circle.  He would announce that a phone had been stolen and there would be dire consequences for the guilty party if they did not confess by sunset.  The consequences?  A2H, the sorcerer would walk around the circle locking eyes with each of the villagers and with a booming ominous voice predict, “If the thief does not return the cell phone before sunset (eyes bulging and a pause for dramatic effect) they will be turned into a… a…(long pause building even more drama)….a rat!”  Hooman, went on to act out the trembling thief immediately dropping to his knees, hands together, wailing in a high pitched voice, “Oh god no! Please!  Please! Don’t turn me into a rat!”

Although the sorcerer was paid his Le200,000 he never came.  Who’s the real rat, eh?

photo of a 3' John Obey rat courtesy of the very brave Noah Balmer




Mother of three boys and cook for Tribewanted, Yenken works from sunup to late in the evening. She’s a single mom and not by choice.  Over a year ago when she was pregnant with Mohammed, her husband was killed in an automobile accident.  Since property passes to the husband’s family, she and the children were forced to move from their village and ended up with friends in John Obey.

Yenken at home

When Tribewanted kicked off its eco-tourism project in the village, Yenken  landed her job with Tribewanted which has changed her life dramatically.  She is now able to provide for her children and built a small home from some of the unused materials at Tribewanted.  She also just received her first ever micro-loan through Salone Microfinance Trust (SMT).  With the Le500,000 (US $125) from SMT, she plans to tarp her house to keep it dry and will use the rest of the money to stockpile palm oil for the rainy season when she hopes to sell it for a higher price.

Oosman, Mohammed, Yenken & Momo

Yenken was eager to show me her new home in the village.  It’s a mud structure framed with sticks and has a tin roof.  There’s no furniture and she sleeps together with her children on blankets stretched across the dirt floor.  To most it wouldn’t seem like much of a house at all, but it’s quite the rarity to find a Sierra Leonean woman who has her own home.

nearing nap time for Mohammed


VIP Susan Shack is nearly complete and VIP Cally Shack is underway.  I understand the VIP-C foundation is complete and VIP-S now has a custom made bed, closets and shelves going in. Here are a several pics as the shack progressed while I was there in February.

the walls go up while we're in the Turtle Islands

starting the roof- view across lagoon toward beach and ocean

Nick & Oosman in the lagoon–shack, bucket shower & tent home in background. Croc only visible at night.

interior pre-furniture, door and shutters


This morning I listened to an interview on NPR with Secretary of State Hillary Rodham Clinton discussing the importance of women’s voices.  I was particularly interested in a Pakistani woman who was a former child bride and the  first in her village to get a divorce and complete high school.  Despite obvious difficulties and endangering herself, with the help of the U.S. she started a non-profit for women and is building schools.   She said “In Pakistan, women are like animals.”

In honor of International Women’s Day, I have two women’s stories I’d like to share this week. Today is Magdalene’s story.

A few weeks ago I visited some of the outer islands off the coast of Sierra Leone.  Nyangai Island is around 400 x 75 yards large, home to about one hundred fifty inhabitants and few if any speak English.   As our boat approached the shore,one of the first to greet us was twenty three year-old  Magdalene carrying her baby.  I was surprised that she could speak rudimentary English and asked her how she was able to pick it up.

Magdalene with her son (in red) and her brother sitting on the boat

A few years ago she had lived with relatives in the capital city of Freetown where she was able to attend school for four years and then her tuition money ran out.  With all that she had left she went in search of her mother on Nyangai, for me about a five hour speed boat ride, but for her, a twenty-four hour hellacious journey in an overcrowded leaking water taxi.  She told me when she arrived at Nyangai she found her mother and asked for tuition money , but within days her mother left abandoning her and her brothers on the island.  With no money to return to Freetown, Magdalene did the only thing she could do and married for survival.  Three years later, she has a baby and is stranded.  There is no school there for her, much less for any of the children.  She wants to become a nurse but will most likely live out her life on this tiny island.  Imagine the frustration of being stuck out there and knowing what life could be like.

I lay in my tent that night thinking of Magdalene and all of the other women I’d met with similar stories.  What if she were to ask the chief if she could charge people like me to camp on the end of the island, perhaps even offering to cook meals, do laundry, or better yet build a guesthouse that she could manage.  Perhaps she could start a school.  I ran some of these ideas past Magdalene the night before we left and it was obvious she was taking it all in but the thought of asking the chief was incomprehensible to her.  She said it wouldn’t matter because if the chief and her husband did allow it, they’d keep whatever she earned.  Grrrrrrr. The injustice of it all.  Where was her voice?  Where was her spark?  Why was she so complacent?

Imagine a world where all women are treated as equals and not just as chattle. What a beautiful place it will be! It takes an education to embolden and empower a woman.  If she’s treated like an animal, how will she ever believe she can be anything else?  How will she find her voice?


So, I left frustrated, discouraged yet with a spark of my own.  I’m very curious to learn more about microfinance and how to be a voice for women like Magdalene.  I’ll share more tomorrow on Yenken, my friend from John Obey.


Let me start by applauding Tribewanted’s showcase meal which would be dinner. Grilled fish, maybe some couscous or pasta, coleslaw, fried plantains, cassava or potatoes, and Elijah’s special sauce.  All very nice and much appreciated.  However, it goes down hill from there.   Breakfast is o.k. – something like large overbaked hamburger rolls with honey, jam, peanut butter or oatmeal with raisins or fruit.  Occasionally the coveted fried omelette or boiled egg turns up which I want to shove in my pockets for later.

Then there is the matter of lunch.  Enough to break me down into a nut case after two weeks.  Everyday of the week it’s the same workman’s lunch waiting for you at the table. It’s a mountain of white rice topped with either groundnut pulverized with fish and hot peppers, or cassava leaves pulverized with fish and hot peppers. Resting atop the mound of rice are chunks of fish – middle bits, tail bits and then the heads.  After one week, enough already.  After two, absolute agony.  After three weeks, my body takes over and I start to twitch.  Bacon!  Cheese!  Maybe I’m a freak, but I need protein and fat.  The food fantasies start coming fast and furious.  I talk about food non-stop and eye the scrawny but delicious looking chickens that wander aimlessly around the village.

Fish, fish, fish, fish, fish, fish. Bring me a chicken!

The day I lost it was about two weeks in when that morning in the storage closet I found a tub of margarine and nearly cried. That’s when I knew I was losing it.  Later, I sat down at the table for lunch and something snapped.  I was ravenous but couldn’t eat.  I sat and stared at the fish and it stared back at me, as if challenging me to eat it.  I stirred it around and reluctantly brought the spoon to my lips.  I smelled its fishiness and saw those eyes looking at me and I just couldn’t do it.  I couldn’t eat it anymore.

Trying not to be rude but aware I was about to lose it, I stood up, swung my legs over the bench and a startled chicken and took off running like some lunatic.  I ran across the camp, down to the beach and pounded my way north until the beach finally ended where I began to scream , flail my arms and kick sand.  There was no one around anyway so it felt pretty good to throw a tantrum.  I scribbled evil thoughts in the sand which was surprisingly quite therapeutic. On the run back, it became apparent that drastic times required drastic measures.

The chickens were going down that night.

My new friend Wendie and I decided there were too many chickens roaming around and we wanted meat.  We asked one of the kitchen staff to go to the village and buy two chickens for us.  I’m such an animal lover but at this point I would have eaten my own dog.  That afternoon, I rooted through our outdoor kitchen like a mad woman and created some sort of curry marinade.  I must say, it’s the first time I’ve made a marinade while what I wanted to marinate was circling my feet.  Tapping my fingers on the counter, I was ready to kill the chickens myself.  Stomping a chicken?  Not very nice.  So, late that afternoon we watched as four villagers chased the chickens, diving on the ground arms outstretched  and hysterically laughing. I didn’t realize a chicken could run so fast and scream so loudly but they do.  Oh, but the smell and taste of grilled chicken, mmmmmmmmm!  Absolute heaven.  Thank you little chickens.

Can you smell the goodness?


There’s a kid like this in every schoolyard, village and city in the world.  The alpha boy.  When you hear kids screaming, he’s involved.  He doesn’t understand the word “no.” He punches other kids and makes them cry.  He pees wherever he pleases and is proud of it. He plays so hard that he collapses to the ground asleep before he hits it.  He’ll sleep on you if you let him and when he does, as annoying as he can be, you look at him and know for some reason, you love this kid.  Such a strong spirit, a scrapper and survivor. Momo, can’t wait to see you grow up little buddy.

the man


fell asleep in his tracks and fell victim to chickens and bored tribe members


passed out on Nick #1

passed out on Yvonna

Nick #2 had some fun with props

buried by Nick #2 after volleyball game