Nasom

The Cameroon trip (or at least the first one of the year) is over and its time to say nasom (thanks in the local Douala language) for a great trip that has meant an awful lot to me. Having lived here (and I mean lived rather than visited, or come on holiday) for over a month I feel more at home than I ever have in Cameroon before and I've learned a lot. The chance to be with Dad has been fantastic and we have worked well together, having made progress on several fronts: the web-site, the ongoing management of the Global Health Dialogue foundation and conference centre and the future of the family property in Cameroon.  There is more to do in all these areas between now and when I return in the new year.

At Bisi's flat in Douala

I've also been able to spend some time with Bisi, my elder sister who I only met for the first time five years ago, and we have also got on really well. Over the last few weeks I've seen all my seven remaining brothers and sisters except one, seen many more relatives while visiting the family village and had the chance to catch up with friends in Douala, including those in the PwC office who took me out and gave me some good tax advice.

Zaks takes a short pause from work

Everyone has made me very welcome but I would like to say nasom especially to Grace (Dad's wife) for looking after me for most of my time here, Bisi for putting me up in Douala and Mr Zaks who works here at the house in Buea doing a variety of jobs and who is always smiling. He also has an uncanny ability to predict the rather volatile weather of Mount Cameroon.  For example, if it is sunny at dawn and it is either a Tuesday or Saturday it will rain later.

Nasom too, of course, to my colleagues at PwC London for supporting me in coming here and to Suzanne for agreeing to do without me for all this time. In 23 years together we have never before been apart for more than a week and even then only twice. I've missed her enormously but we have spoken once or twice a day by phone or skype. Indeed the ability to see each other on a skype video call has caused great excitement and now everyone here is learning to use it. A real highlight of the trip was seeing my 12 year old nephew Carl, who lives here, manage to get through to his mother in the USA by video call. I will never forget the look on her face - it was a beautiful moment.

But time to go home. The end of trip has also featured a terrible emotional low with the sad news last sunday of the sudden death from a stroke of one of our friends, Rob. We are all so shocked to lose such a great guy so early in life and our thoughts are with Kate and their three young children. We will always remember Rob especially for making us laugh - from his impression of the Sphinx on the floor of an Indian restaurant on my stag night and the Braveheart performance at Eugene's wedding, to his poetry and the blow-up crocodile races in our pool in Spain. So nasom to Rob for all those memories.

When I decided to come away for the year it was because I believed that you don't get too many second chances in life. For all the reasons above I'm so glad I did it.

Nasom.

Cameroon - a emerging country?

Some closing thoughts after over a month here which has left me loving the country more than when I arrived but feeling deeply frustrated like many of my compatriots. This has been my first trip home to Cameroon since I’ve worked in international development at PwC so it has been interesting to look at it frmo that perspective and gather the opinions of people locally.

There is good news. I certainly see signs of modernization and entrepreneurial spirit. Mobile phones are being used innovatively to make up for gaps in communications and banking infrastructure – e.g. sending money and avoiding the limited fixed-line capacity. If you have the money you can install satellite tv and the young population (50% of the roughly 17 million people are under 18 years old) are connected on facebook just like in Europe. The crumbling Bonaberi bridge and approach roads that link us with Douala across the Wouri estuary have been repaired for the first time in 50 years of independence. There is enough food for everyone so no one starves and the level of poverty in urban areas is said to be relatively low by African standards, at about 12%. Almost all primary school age children receive education and the country has huge reserves of natural resources to exploit.

On the other hand, the average life expectancy at birth is 46 and poor health hampers development. HIV/AIDS remains an issue, among other infectious diseases that should not be spreading or killing people in the 21st century. Rural poverty is a much greater issue (very visible in my family's village) and according to some estimates half the population live on less than $2 per day. Major infrastructure is missing and, as I saw in Kribi, planning for development is poor. No motorways exist and the two main cities are linked by a dangerous single track road. Internal air travel and trains are limited, making transport of goods slow and expensive, for example our beef comes from cows that travel by train from the north then walk 70k from Douala (having walked along way to the rail station in the first place) as there are limited facilities for refrigeration. Tourism – a potential source of income – is under-developed despite huge potential, while corruption is endemic, hampering business and reducing the value of local government expenditure and international aid.

So what to do? Locally we need better management of natural resources, more investment in human capital (health and education) and infrastructure and in particular the eradication of corruption. The developed world could help by writing off the debts it gave to the corrupt leaders it often supported, lowering trade barriers against Africa, ending subsidies to developed world farmers and reducing the threat of climate change by changing their own lifestyles.

Among people I've talk to here there is scepticism that the west has the political will to do all of this because of self-interest, so countries like Cameroon will have to help themselves. As a starting point stronger leadership across Africa at the highest levels is needed to end the dependency culture that has grown through the time of slavery, colonialism and post-independence aid.

Kribi - Cameroon in a Nutshell

I went down to Kribi for a couple of days with Dad and my cousin Lobe to have a look at the Global Health Dialogue Conference Centre that my Dad built and which was inaugurated two years ago on the occasion of his 80th birthday.

The International Dialogue Centre

While there we also inspected a development site at Bebamwe just to the north of the town that he owns and which we are considering developing into a complex of apartments to meet the demand primarily from the ex-pats arriving here.

Kribi beach

There is no doubt that the Kribi area in the south of Cameroon on the Atlantic coast offers real opportunities. It has beautiful white sand beaches and is surrounded on all other sides by lush tropical rain forest inhabited by pygmies and wildlife that, in many places like Bebamwe, extends to the beach itself. In addition it is the second busiest port after Douala and a new deep water port is being constructed as part of huge planned infrastructure developments. These developments include an aluminium plant to exploit the nearby bauxite reserves and a new power plant to add to the already operational gas pipeline from Chad that runs the length of the country to come out into the sea here. International banks and contractors are looking at Kribi with great interest and the beaches, abundant fresh seafood and national park rain forests offer good touristic opportunities.

But all is not well in paradise. There are already signs of pollution on the beaches, the electricity went off during the day for an average of five hours while we were there and for an area that promises high quality new infrastructure, the main road through the town is an embarrassment with its huge pot-holes. One might also ask how the huge developments that are planned are going to operate if the town can’t even provide electricity to meet current needs during the day? Power cuts are common enough here when the peak load occurs after dark but failing to power the town at 4pm in the afternoon in broad daylight on a sunny day really isn’t good enough.

The latest World Bank report says that Cameroon has great potential but significant challenges. Nowhere is this summed up better than Kribi where the harsh reality of poor planning and/or implementation is getting in the way of realising that potential. But if you like drinking beer and eating barbecued fish on the beach then its absolutely fine!

Dibombari - Ancestral Home

My family village is in Dibombari, an administrative region for around 50,000 people around 30k to the north of Douala and 7k along an un-tarred road with incredible ruts and potholes that is impassable at times in the wet season. The area contains a number of small rural villages of which ours, Bwataka, is one. Dad is the chief of Bwataka, as the nominated person from the “ruling” clan, which is known as Bona Lobe (sons of Lobe, the founder of the clan). This is a kind of sub-chieftancy to the main chief of the area, which in turn is part of a larger grouping of Douala speaking peoples known as Pongo. The various chiefs meet regularly to discuss matters of importance to the villages (one current topic being the recent discovery of oil!).

Dad - the Chief of Bwataka

The clan is believed to have originated from the Congo area but migrated here by sea a couple of centuries ago in search of new land and possibly to escape disease. They settled as part of the wave of people that now form the Douala tribal group here and my forefathers have been here ever since. The original Lobe (which is also my Dad’s name) was my great-great-great-grandfather. Surnames do not exist traditionally and identity is passed on orally, such that I was taught at a young age that I am Mukala, son of Lobe, son of Money, son of Ekosso, son of Ngube, son of Lobe. My Dad created the family surname, Monekosso, by combining the names of his father and grandfather and now most of the family uses it. On this trip while researching the family tree I now know three more generations of ancestors going back to a man called Pongo, for whom the local area was named.



Typical village view: across the street from our house


Bwataka remains the spiritual home of the family, despite the death of my Grandma four years ago at the age of 99. Like many African villages there is a Christian church but traditional healing and witchcraft are taken very seriously. Today we visited for a funeral - a very important cultural event for which people save for years. They are occasions when huge extended families come together and I sat under a tree with my older sisters Bisi and Tiki, watching the service and meeting large numbers of relatives, all of whom are incredibly welcoming to me.

Bwataka village cloth from which traditional clothing is made

The village has been a very special to me since Suzanne and I first came here just after my Mum died 22 years ago - half a lifetime ago now. There is sadness too because over the years many of the family have died including my brother Ngube, Grandma (also called Suzanne) and uncles George and Adolphus (the latter born in 1939 and named after Hitler, as my Grandfather was a big fan of the Germans who ran Cameroon before World War I!). But their memories live on in the pictures in the house and the graves that sit outside. Of my immediate relatives only my uncle Emmanuel remains at the age of nearly 70 and, as is customary, I presented him with a bottle of whisky.

Uncle Emmanuel and me

Many of the younger generations have drifted away to the cities - hence the family tree project - but it was good to see so many out in force today.

Beer and Fish

Eating and drinking in Cameroon reflects a mix of European and traditional cultures. Having grown up in Europe I find some of the traditional dishes here challenging, mainly because of the texture of food. However, food is plentiful here and I know I can always survive on the local staples of beer and fish!

Fish is often marinated in hot chili sauce, roasted over charcoal and served with dodo (fried slices of ripe plantain – a large green type of banana) - not a million miles away in spirit from British fish and chips. This is served in many roadside shack-bars along with copious amounts of the many varieties of local and imported lagers. My guidebook says that beer-drinking is “an extremely popular pastime” here, which is not wrong!

As a former health minister my Dad approves of the consumption of fish with beer but feels that some spend too much of their limited budget on the latter! However he also says that, in the case of Guinness, it adds to the diet which is traditionally deficient in vitamin B because the local staple root vegetable has very little vitamins. As well as the many Brasseries du Cameroun breweries which overcome appalling road conditions to reach every last corner of the country, Douala also has a Guinness brewery, one of only five outside Britain and Ireland, reflecting the huge popularity of the drink.

Also good here are the prawns which gave the country its name. When the Portuguese arrived in Douala in 1492 they found the Wouri estuary completely silted up with huge prawns (cameroes in Portuguese), a natural phenomenon that occurred every few years (less so now because of pollution). I've eaten some very good fish, prawns and crab caught fresh locally at Limbe on this trip.

As regards the traditional local dishes I’m not as adventurous as I used to be on trips here. I have avoided the Douala favourite, ndole, a bitter green leaf cooked with spices, groundnuts or melon seeds with meat (not always the best bits!!), prawns and dried fish. I have tried a couple of other green leaf based dishes, such as huckleberry leaves with corn fufu and the local Buea dish of eru, the latter being my Dad’s favourite which is always cooked in the house on a Friday. Last week he warned me I probably shouldn’t try it as it contains too much hot chili. Those of you who know my liking for hot Indian food will know that at that point I felt obliged to have a go. I was pleasantly surprised, on putting it in my mouth that, compared to a vindaloo, it seemed pretty mild. What I hadn’t realised as I reached for some more was that the chili is felt in the throat as it goes down, rather than in the mouth. The result is a feeling somewhat like being throttled as your throat closes and your eyes bulge and start to water profusely!

Web-site launched!

My first challenge from a work-perspective here has been to get the web-site live for Global Health Dialogue. The web-site is the vehicle for my Dad’s vision to spread good practice in community health around through a network of experts, local practitioners and community groups. I'm pleased to say that he was able to announce the launch while in South Africa to speak at a global conference on medical education standards. He has been working as an adviser to the Bill & Melinda Gates Foundation on quality control for medical teaching around the continent and took the opportunity to introduce the web-site at the conference.

It has been quite an experience working with Dad and his team and some local young web designers to develop the functionality and manage the content we already have so that we are ready to start building the network. The site http://www.globalhealthdialogue.org/ is now live despite the difficulties of working with limited band-width connections, power cuts and ageing technology.

Some things are true everywhere though and I arrived to find a gap between the technology people who know little about health and the health people who know little about technology and web-sites. The plan was therefore to insert me (who knows little about health or technology!) to bridge the gap. The site is far from perfect but I think its a good start. Have a look and see what you think! The more difficult job of actually running a network and building a dialogue which can influence health outcomes on the ground begins now.

Douala - the Armpit of Africa

I'm not sure whether the nickname the "Armpit of Africa" derives from Douala's geographical position (where the arm of west Africa leaves the main body of the continent) or whether it relates to the 100% humidity which makes it feel like one is living in an armpit. Cameroon's largest city, port and economic capital is over-crowded and decaying, but above all full of life.

Cathedral, Douala

I spent three days visiting family and friends in Douala. Its a growing city mainly because of migration from rural areas which has led to new suburbs growing up as the city spreads. It is fascinating to see the different environments in which people live: I stayed with my sister Bisi in up-market Bonapriso where richer locals and ex-pats can sample cosmopolitan restaurants but walking distance away is poor New Bell, home of the rags-to-riches national hero, footballer Samuel Eto'o Fils. My brother Penda lives in industrial Bonaberi across the huge estuary of the river Wouri, where everyone seems to be selling something unless they are in one of the many roadside bars consuming the beer products of Brasseries du Cameroun and the local favourite Guinness, which has a brewery here (one of only five outside the British Isles). The administrative centre Bonanjo contains colonial buildings, banks and offices around the corner from the hotels and smarter shops of Akwa.

Place du Government

Nightlife abounds everywhere - Cameroon is almost as well known for its music and beer consumption as for football - but perhaps the most memorable part is the traffic. My friend Marshall drove me around the city after dark, hooting with laughter and passing comments out of the window at other drivers while expertly navigating between huge potholes. Meanwhile motorbikes pass the cars and the many yellow shared-taxis on both sides in both directions as they evade the huge puddles that can be a foot deep and cars appear at strange angles at major junctions in the absence of traffic lights. However despite the chaos it seems to work and we got across the city and back in surprisingly little time. But this was Sunday evening and the weekday rush hour is another matter...

Eto'o: Living Legend

Football is big news in Cameroon, especially the national hero Samuel Eto’o Fils who has played for more than a decade with Real Madrid, Mallorca, Barcelona and Inter Milan. He won the Champions League, League and Domestic Cup treble with Inter last year and the same treble with Barcelona the year before which is a unique achievement. For Cameroon he has won two African Nations Cups, the Olympic football tournament, appeared in three World Cups and scored over 50 goals including a record 18 in the finals stages of the African Nations Cup. He has also been African footballer of the year three times.

Samuel Etoó in national team action

Football shirts are fashion items here and when I was last here 2 years ago the shirt of choice was FC Barcelona. When they sold Eto’o shirts were burned in large numbers and now Inter shirts are everywhere. Much to my disappointment the second most popular team now appears to be Chelsea. Despite another popular Cameroonian, Alex Song playing for Arsenal, the Cameroonian public seems to favour teams that actually win trophies!
Eto’o is here this week to play for the national team against DR Congo. However Song, like some other prominent players, is not here having allegedly fallen out of favour with Eto’o (who isn’t the manager but I'm told he might as well be). These rumours have caused a split among those of us who think Eto'o is merely a world-class player and those who think he walks on water. I found myself in the middle of a very heated debate on the subject after midnight (and after too many beers) in a bar in Douala. When I ventured that we might be better off without Eto'o if it is true he is influencing team selection like this, I was told that my belongings would be at the airport in the morning and I would be deported for my views!

My plan to travel to see the game in the capital Yaounde was dashed by the sudden late decision to switch the match to Garoua in the north of the country. Despite Congo objecting that Garoua is in the epicentre of the current cholera epidemic and that they had already paid for their hotel accommodation in Yaounde, the African football federation (which has a Cameroonian president) backed Cameroon. So I had to settle for watching the game on tv in Douala. A dreadful Cameroon team achieved a 1-1 draw courtesy only of an embarrassing own goal by the Congolese right-back who will probably have to claim political asylum rather than return home!

Dr Livingstone, I presume?

Well, perhaps not quite up to Livingstone's explorations but in between working on the various projects that Dad wants to take forward (amazing energy for someone approaching 82!) and spending some time with him, which is fantastic, I have had a few opportunities to go out exploring the Buea area on foot – this is peculiar because rich people here are supposed to go everywhere by car.

My favourite trip so far was an excursion up the slopes of Mount Cameroon behind the house.  Having walked to some nearby villages, curiosity got the better of me and I struck off into the forest that runs around the mountain behind the house. This is genuine thick rain forest – in fact the other side of the mountain is the second wettest place on earth (after somewhere in India), wetter even than Manchester.

I was told that the path led to a neighbouring village but the path soon ran out.  Nevertheless my persistence (hacking through the undergrowth which has thrived in the rains and climbing over fallen trees) was rewarded when, having ascended quite a way up the mountain, I found a path heading across and down which eventually led me to the village of Likoko Membea passing a few tree-fellers (not ideal from a rainforest conservation perspective).

Quite relieved to see civilsation (it was nearly dark as I had unwisely left quite late and without torch) and to have got out of the forest, I was beaming like David Bellamy emerging from the bushes.  I was soon met by a young lady with her daughter who asked me if I was from the forest? When I said I was from London she displayed good knowledge of the main differences between London and Likoko, the principal ones being they have a mountain but we have a lot more chicken to eat (it is surprisingly expensive here). Having been taught a few words of Bakweri language I made it back to the house via the road just before night fell.

Global Health Dialogue

My Dad is a former minister of health here in Cameroon and also was regional director for the UN World Health Organisation for the whole of Africa for 10 years.  Now nearly 82 he is still travelling to speak at conferences and doing consultancy work for the Bill & Melinda Gates Foundation in relation to the quality of medical training in Africa.  He is shortly off to South Africa to speak at a conference and next month has another engagement in Uganda.

Father and son

Since leaving government a few years ago he has been running Global Health Dialogue to promote good practice in community health.  Until recently the work was based on production of regular newsletters in paper form but the aim now is to move into the digital age and start to spread ideas and build a community health network internationally that can share experiences.  We are in the process of working on a website to be launched shortly and this will be a vehicle for making available Dad's leading thinking in this area.
Cameroon has a number of health challenges, although it is one of the better-off and politically stable of African countries.  HIV/AIDS has taken its toll here and life expectancy at birth remains less than 46 years compared to around 80 years in the UK.  The world bank says that the only one of the Millenium Development Goals that Cameroon will achieve by 2015 is universal primary school education, which by implication means that targets for infant mortality and maternal health will not be met.  As I write this Cameroon is experiencing a significant Cholera epidemic in the north of the country which is beginning to spread south.  Local  community groups that we are in contact with don't have access to good information on what to do to prevent cholera and treat the disease if it arrives so GHD has a role to play in this sort of urgent situation, as well as in promoting change that will lead to longer term human development through improved health.  Micro insurance to buy health services is another current area that we are looking at.

One might argue that none of this sort of intervention should be necessary as it is the role of government but things aren't that simple here.  Despite years of international aid very little of it seems to trickle down to the population such that exactly 50 years after independence there has been no progress in many key areas of public health.  The idea now is to use the internet to foster communication between communities so that good practice spreads at grass roots level.

Introduction to Buea

Our family home is in Buea (pronounced Boy-ah) on the slopes of Mount Cameroon.  When the Germans took over "Kamerun" as they called it in the 1870s this was the colonial capital for a while.  They chose it because of its strategic location on the mountain close to the coast and because they could build at sufficiently high altitude to reduce the number of Europeans that would die of disease.  The climate is significantly cooler than the nearby economic capital, Douala.  There are still German-built colonial buildings here that have survived over a century while all around has a more temporary feel.

Buea

After Germany lost their colonies in 1918, Buea became the capital of the english speaking part of Cameroon.  Nearby Douala is over the border into the french speaking side which dominates the country despite it being officially bilingual.  Our family home village in Dibombari is also in francophone territory although the dominant language there is Duala, one of over 200 african languages in this incredibly diverse country.  Many of the languagess are spoken in a small area only - here in Buea the language is Bakweri although you will also here a lot of Pidgin - a kind of simple broken english that is unintelligible to normal english speakers.
Buea is growing fast particularly because of the university although the mountain is its original claim to fame.

What to do in the event of an eruption....

Its an occasionally active volcano - it last erupted in 1999 shortly after my family moved here, the last of seven eruptions in the 20th century.  You can still see the lava flow that happened that day which fortunately completely missed the local towns.  In February every year the Mount Cameroon race is run - a marathon that goes up the mountain and back down again!