For most of my life I never even thought about my knees. Standing, walking, kneeling, and carrying things were a normal, unconscious part of the way life worked. Then a few years ago I began to notice pain as I went down steps, especially when carrying a suitcase or box. Once my knee gave out, just collapsed in a hotel stairwell as I was carrying my suitcase down one flight. After a diagnosis of arthritis, I take medication to reduce the swelling in my knees. Now, most of the time I don’t experience any pain or loss of mobility and actually forget that I have arthritis in those joints.

In Sierra Leone this week, I was staying at a hotel that was built into the side of a steep hillside. Between the entrance to the hotel reception area and my room there were 84 steps. When going to the veranda for dining there were 18 more. There were no elevators or handicap access ramps and no other way out or in. Each day I walked at least three round trips, and on my last day I made the trek seven times (more than 1,260 steps). After the first day, every step brought some pain, and by the last day even getting up after sitting was painful and difficult. Read the rest of this entry »