Back.

April 19th, 2011 by Chris

My mission is now over and I write this from London, UK, where I’ve been fortunate enough to get a free bed and room as my old friend’s flat-mate is on holiday.  She returns tomorrow and I’m relegated back to the floor.  It’s been great to catch up on sleep, although I can’t shift the habit of waking up for every sound, my mind still hasn’t switched off.

After my first mission, I was reluctant to blog about the mental readjustments I went though following what people call reverse-culture-shock.  I was nervous that it would make me sound like I had mental health issues.  But since then, I’ve realised (partly thanks to the book by fellow blogger James Maskalyk: “Six Months in Sudan”) that most of us MSFers go though something similar.  Having longed for McDonald’s and Pizza Hut, long lie ins and an absence of the stress of “the field”, after a few days I realise that I am a stranger in what used to be home.  Partying with old friends feels shallow and excessive when I look at the bar bill.  My mind wanders as people talk about things that I consider trivialities.  People don’t understand what I’ve been doing: “did you have a good holiday?”, “let me get this round, I know you’ve been travelling”, “yeah, I wish I had done that after university” – not really grasping that what I do is actually a skilled profession, not a gap year.

So I’m back early, I cut my 12 month contract short to 9 months.  Nigeria is tiring, the context is frustrating, the needs close to infinite.  And I felt exhausted.  And then, back in London, I’m already wishing I was in Libya helping where the need is massive.  But I should rest.  And I will.  And after some time, I’ll do it all again.  Thanks for reading my story.

 

December’s Cholera

April 5th, 2011 by Chris

Things have been busy. So busy, that I have neglected writing this blog. Since I last wrote, our team has dealt with Cholera in 3 of the 4 states we work in. The cholera happened during the flooding, so that presented us with a double emergency. Testing times…

Extra international staff arrived and set up 2 separate cholera interventions.In total we treated over 20,000 people.

After the peak of the outbreak passed, the extra volunteers departed, some destined for Liberia (where refugees for Ivory Coast were arriving), some Haiti and some for Chad, both of which also had Cholera. Two weeks after they departed, reports came in of a new outbreak in the town of Argungu, Kebbi state. This was a dilemma, our extra international staff had gone (3 of us left in the team) our national staff had just departed and out stocks were low after a prolonged intervention. We had to make a difficult choice, did we throw all resources and stock into treating this outbreak in Argungu and therefore leave us with no resources for any second outbreak? Or did we hold back, expecting a second outbreak?

In the end we decided we had to try and contain the outbreak to Argungu and we sent all our tents, buckets, and essential ringer lactate (intravenous rehydration fluid) which was our real bottle-neck. Being a liquid, it is heavy and therefore expensive to transport by air. If each litre costs about a euro, transportation of each litre costs about 5 Euros. Each patient needs about 7 litres.

In 24 hours, me, my two assistants, a water & sanitation expart and some local helpers built a cholera treatment centre. We had a stock of about 2,000 litres of ringer lactate and about the same due to arrive in a few weeks.

In the end, things worked out. Our team managed to contain the outbreak to Argungu and prevent it spreading to the rest of the state. I gathered all the staff together as we were closing the centre about 6 weeks after opening and thanked them for the work they did. They had treated about 400 patients, half would have died otherwise, but even more importantly, they had stopped the cholera spreading to the rest of the state. We’ll never know how big a disaster that might have been. But we avoided it.

Doing so is maybe one of the achievements I am most proud of here.

Malaria Blog

October 19th, 2010 by Chris

I headed to Canada for my holidays full of enthusiasm, ready to meet the parents of my long-suffering girlfriend.  Turns out it wasn’t just enthusiasm I was full of.  I was unlucky enough to have 2 different types of malaria at the same time, including the most dangerous Falciparum strain.
At first I didn’t even realize what was happening, I was tired, which was expected after a crazy month of the flooding, plus “acute watery diarrhoea cases” popping up all over the north.  So I slept all day, and blamed the chills on the Toronto climate.  After a few days I became convinced I had a tropical bug and emailed our Medical Coordinator, who spelled it out very clearly that I had malaria and was go to straight to hospital.  After the signing of promises that if I were to sue for medical malpractice, I’d come back to Canada to start the legal proceedings, provision of credit card details, agreement not to sue for lost property and agreement for the $2,820 minimum daily charge, I got to discuss medical issues.  “Where does it hurt?”, the doctor asked, “everywhere”.  On a scale of 1 to 10, how much does it hurt?  What’s a 10?  10 is the worst pain you ever had.  Then it’s 10.  Has anyone you work with had similar symptoms?  Yes, plenty of them.  The doctor laughed at me when I asked if I could go home – pointing to the soaked mattress where I had lay down for about 5 minutes.  After 100 more questions and a blood test, I was diagnosed with severe malaria and it was clear I was going nowhere.
I spent 4 nights in hospital (I thought it was 3 until I checked the records to write this blog), drifting in and out of consciousness.  The malaria, or the cure, I’m not sure, plays tricks on your mind.  It makes you paranoid.  When I read through the text messages I sent from my bed, it is clear that I was skirting around the edges of sanity as I wrote them.
One night, sure I was going to die, I wrote my will in my head.  My girlfriend had to use the money in my bank to fly my body to Scotland and donate the rest.  I didn’t have the energy to put it to paper.  But the pain in my head was so severe, that I was convinced the malaria had gone cerebral and I wasn’t going to make it.
I didn’t read a book, I didn’t switch on my computer, I just slept and wished away the pain.  On the last day I had the energy to take in my surroundings.  Staff brought and took away food 3 times a day, cleaners made sure the place was spotless, there was a TV on the wall, I shared a washroom with my 1 roommate, there was a coke machine in the corridor and a fridge of juice to help myself to.  I imagined the typical MSF malaria patient experience in Nigeria.  Then I imagined the typical non-MSF patient experience.  Quite different.  About 250 million people get malaria every year and about 2 million of them die from it.  I had survived the world’s biggest killer and it’s made me very happy to be alive.  I guess I had been taking that for granted.

Flooding worsens

September 13th, 2010 by Chris

After a very busy week responding to the Kagara flood on September 1st, my heart sank at news of more flooding on the 9th of September. A doctor and I went to investigate.

Last week Kagara was chest deep in water, with all the surrounding crops and food storage destroyed. This time, we saw village after village facing the same catastrophe. Time and time again we saw people desperately trying to hold back the water with sandbags. When I climbed on top of the MSF vehicle for a better view, I saw water stretching to the horizon.

Flooding in Sokoto state

Local people speculated that the gates on the Goronyo dam were open to release pressure on the dam. As we drove there to investigate, our driver said the water was higher than he had ever seen.

We drove along the 6 km main dam that held back a massive lake stretching as far as the eye could see. At the end of the dam, water crashed through the open gates, creating a spray that rose above the road.

Our driver started getting upset with the dam workers for having the gates open, until I explained that they had to release the pressure or the dam would fail.

We drove on to the secondary part of the dam – the spillway – where we realized something was horribly wrong.

A huge section of the spillway was missing, and a river flowed through the 150 m gap. Local men, who had been praying on top of the dam, explained that water had flowed over the top until the dam gave way the night before. The lake had dropped 7 m in an instant, and an unimaginable amount of water had flooded through. It was no wonder that the villages were drowning.

Flooding in Sokoto state

We headed back to base to brief the top management. We didn’t really know how many people had been affected – definitely more then 50,000, but maybe double or triple that number. The needs were massive – in the immediate term, shelter and water. With the crops and food storage destroyed, more problems were likely in the future.

The team agreed that shelter and distribution of clean water were short term problems that we would help solve. Within 24 hours we had plans for extra staff, a budget approved, and a plan to set up water distribution points, blanket and tarpaulin distribution and health education.

On Saturday as I write this, we are deciding where to store the good as they flow in, and going to the factory where the water tanks will be made to check that they meet our specification.

It’s hard to take in what we see. I’ve been too busy to hear anyone’s personal stories.

Fortunately we don’t need to submit proposals and wait for approval. We planned for nine scenarios, and this is one of them. We have a plan, and many of the supplies we need are in place already. But it’s going to be a big challenge to get supplies to the right places.

Above all,  the people affected by the floods have a long struggle ahead, especially in meeting their long-term medical and food needs.

Flooding in Kagara

September 10th, 2010 by Chris

Wednesday 1st September 2010, 10:30am. The coordinator of our mother and child centre in Goronyo called. She had received reports of 200 deaths in nearby Kagara village, caused by flooding. The immediate needs were shelter, food and water.

By 1:30pm I was half way there, with a 10-ton truck laden with tents, water tanks, pumps, cooking equipment and blankets. Half way there, but stuck in a traffic jam caused by a cow sitting in the middle of the road on top of its broken leg.  Hundreds of drivers sounded their horns and shouted at the single policeman who had the unenviable tasks of sorting out the situation. We waited in the heat, just as people somewhere up ahead waited for us.

We arrived at the MSF base in Goronyo by 3 and collected our water and sanitation specialist.  We continued on to Kagara, turning off the main road onto a smaller one bordered by fields submerged under floodwater. I had been skeptical of the initial reports of 5,000 displaced people, but as hundreds passed us I started to realize that this was big.

On the right side of the elevated road, the water was chest-deep. As we approached the village, we could see collapsed houses and people wading with their belongings on their heads. In the village, the water flowed ankle deep over the road, and we only knew where to drive by looking at the people on either side of the vehicle.

Chris at Goronyo secondary school with people displaced by flooding

At a high school allocated for temporary shelter, we saw around 1,000 people sheltering in about 25 different buildings. The school’s geography teacher had assumed command and showed us the facilities: 40 pit latrines and two water tanks fed from boreholes, one with a solar-powered pump, one connected to a broken generator.

It was getting dark. Time to make an assessment and decide what to do. With shelter, latrines and food all at hand, access to clean water was clearly the priority.

We returned the next day to find that water levels in the village were even higher. A tanker had distributed only brown river water, nobody seemed to be using the latrines, and the school’s water taps were dry. The number of people, goats and sheep had more than doubled, and the ground was covered in livestock excreta.

Installing a water tank on top of a 1.2 metre sand platform was a challenge.  Our small team and a pickup truck struggled in the heat to move 15 tons of sand to create a platform.  For the guys observing the Ramadan fast, not eating or drinking, the struggle was unimaginable. By the end of the day the platform was about 30 cm high.

Displaced sheltering at Goronyo secondary school following flooding

By Friday, some additional MSF staff had returned from a vaccination survey to reinforce our team. I tasked them with a census, and we realized we had 5,500 people sheltering at the school.

I was invited to a meeting with the local authorities. “Please try to find where we can buy some water,” I pleaded to our driver as I dashed into the meeting, pulling off my muddy boots. Inside, the community leader sat in an armchair and everyone else sat on the floor in their elegant robes.

As they talked in Hausa I worried how long this would take, conscious of the time pressure. When I was introduced I apologized for my appearance — having helped push the pickup out of the mud earlier, I had a nice mud spray up to my waist.  They smiled, and I relaxed as I realized they knew MSF and liked our hands-on, fast moving approach.

I explained my priorities and asked for their assistance with water supply and community health education. I finished just as the call to prayer began, the perfect opportunity to get back to work.

I returned to find the water tanker we had hired stuck in the mud. It was going to be a tough day.

The team continued shoveling sand to build the stand for the water tank, and made a fence out of barrier tape and sticks to facilitate a distribution of mosquito nets and blankets to all the mothers. Two local guys announced our plans and within five minutes almost 700 mothers were pressed against our flimsy fence. As the first person entered our enclosure, the others decided they weren’t prepared to wait and pushed down the fence. At the same time, a torrential downpour began. We had to push the crowds back as tensions escalated.

Our weak fence, our slow distribution, and our lack of crowd control were a failure, and I reluctantly agreed with the team that we had to stop before someone got injured. Fortunately, the crowd didn’t want to wait in the rain and went home. We scrambled to cover the blankets with a ground sheet.

I went back to base soaked, bitterly disappointed and tired. That night, we made plans for a safer distribution.

I woke the next day determined to complete the distribution successfully. This time we got permission to use a small fenced-in area, and we created a corridor around it. We employed  10 crowd controllers, loaded our supplies inside the fence and got the blankets and nets to the people who needed them. Passing women smiled and thanked me as they passed with their blankets, and I smiled back.

Displaced receiving blankets and mosquito nets following flooding

We completed the tank stand at 5 pm, arranged security, and negotiated with the tanker driver to fill the tank with clean water, before our tired team started the journey back to Sokoto.

I started texting my thanks to the various people who had made our journey possible, and realized that I hadn’t eaten or had a pee since 6 am. My head started to spin. As we neared our base I started to worry that I couldn’t walk or speak properly. “Take me home,” I said to the driver, relieved that I could still talk. Dressed in filthy clothes and having run on adrenaline and cola for three days, it was time to eat, wash and rest.

Emergency Planning.

August 19th, 2010 by Chris

Emergency Planning.  That could be the title of just about every blog I write in the next year, I think.  Almost everything I am doing is planning ahead for emergencies.  Some more likely to occur than others.  It rained heavily today.  I was woken at 6:15 by the rain pounding the tin roof like a machine gun.  The rain might please our neighbours in Niger Republic to the north – they have been suffering a dry spell.  But rain here also increases the risk of cholera.

The planning I am doing at the moment is organizing our warehouse.  Compared to where I’ve worked before, the number of different items we stock is not that high.   But the quantity of some items is very high.  We moved an articulated truck, mostly laden with Plumpynut from the office to the warehouse at the weekend.  Plumpynut is a peanut based therapeutic food that is used to treat malnutrition.  I learned today that our warehouse has about half a million portions.  They come in boxes of 150 that weigh about 15 kilos each.  I thought I was good, carrying 2 at a time until a helper turned up and lifted 3 at a time all day long in the heat.

We also have quite a stock of auto-disabling syringes.  There are the type used in a vaccination campaign.  The warehouse has exactly 393,877 of them.  Plus whatever extra we just carried in.  I’ve not counted them yet.

Getting our stock levels right for these items is critical.  Our medics will call for them one day and we need to know exactly how many we have and everything needs to be ready to go.  We also have lower quantities of technical items.  A lot of what we stock isn’t items, but kits.  MSF is great at this.  Our logistical people at HQ have learned from the countless emergencies in the past and put together everything you might need for a particular scenario.  So the water pump comes with all the gaskets, tools, spare parts, instruction manual, jerry can, hose and oil.  The bladder tanks come with shovel, pickaxe, valves, boundary tape and repair kit.  We spent a lot of today making sure kits that have been used in the past have all the accessories.

The power at the warehouse is reliable.  It reliably stops every day at 12 noon.  So we have a generator.  Thankfully, our capital management team is not in the national capital, right next to us.  So we benefit from them being nearby by using their resources.  They have a guy who fuels and services the generator.  That’s one less thing for me to worry about.  I’m used to being the only technical person in the region, so it’s nice to have support close by.

Unloading the truck at the warehouse

That also means I can call upon their assistance to fix things at our locations.  But sometimes I prefer to fix things myself.  Every time I fix something I improve my technical skills.  Yesterday, I cemented all the holes in our house walls.  Hopefully, that will reduce the mosquito and mouse situation.  I only mixed cement for the first time this year on a MSF course, so it was good to get the skills into practice.

This evenings’ task was to put a seat on the toilet in the house.  I’d been putting  it off until I could find a pair of surgical gloves.  The bolts (which were the only remaining part of the previous seat) weren’t looking so clean.  So trying to put on the gloves with my hands still wet was the first mistake.  Picking up gloves made for the hands of a pixie was the second mistake.  I ended up with the glove palm stretched over my whole hands with the tiny fingers not fitting on to my sausage fingers.

Then I realized that the new seat had no bolts in the pack.  I had to use the horrible plastic bolts from the old seat.  But the heads on them were too wide.  So I had to file them down with a metal file.  Which only just clogged up with plastic, as I used it.  Sweating in the heat I was worried I would rip through the gloves and unleash an ecosystem of bacteria.  I eventually filed down the bolt and wished I had left the tasks to the support team.  I left the tools in the bathroom floor planning to soap and shower them tomorrow.

I had spent about an hour of my first weekend trying to buy a solid plastic or ceramic seat, everyone I saw was flimsy plastic.  “I was looking for a stronger one” I explained to the salesmen in every shop. “But this one is stronger” each of them told me, more confidently and with a wider smile each time.   I hope it lasts until at least my end of mission.

Emergency Planning.

Emergency Planning. That could be the title of just about every blog I write in the next year, I think. Almost everything I am doing is planning ahead for emergencies. Some more likely to occur than others. It rained heavily today. I was woken at 6:15 by the rain pounding the tin roof like a machine gun. The rain might please our neighbours in Niger Republic to the north – they have been suffering a dry spell. But rain here also increases the risk of cholera.

The planning I am doing at the moment is organizing our warehouse. Compared to where I’ve worked before, the number of different items we stock is not that high. But the quantity of some items is very high. We moved an articulated truck, mostly laden with Plumpynut from the office to the warehouse at the weekend. Plumpynut is a peanut based therapeutic food that is used to treat malnutrition. I learned today that our warehouse has about half a million portions. They come in boxes of 150 that weigh about 15 kilos each. I thought I was good, carrying 2 at a time until a helper turned up and lifted 3 at a time all day long in the heat.

We also have quite a stock of auto-disabling syringes. There are the type used in a vaccination campaign. The warehouse has exactly 393,877 of them. Plus whatever extra we just carried in. I’ve not counted them yet.

Getting our stock levels right for these items is critical. Our medics will call for them one day and we need to know exactly how many we have and everything needs to be ready to go. We also have lower quantities of technical items. A lot of what we stock isn’t items, but kits. MSF is great at this. Our logistical people at HQ have learned from the countless emergencies in the past and put together everything you might need for a particular scenario. So the water pump comes with all the gaskets, tools, spare parts, instruction manual, jerry can, hose and oil. The bladder tanks come with shovel, pickaxe, valves, boundary tape and repair kit. We spent a lot of today making sure kits that have been used in the past have all the accessories.

The power at the warehouse is reliable. It reliably stops every day at 12 noon. So we have a generator. Thankfully, our capital management team is not in the national capital, right next to us. So we benefit from them being nearby by using their resources. They have a guy who fuels and services the generator. That’s one less thing for me to worry about. I’m used to being the only technical person in the region, so it’s nice to have support close by.

That also means I can call upon their assistance to fix things at our locations. But sometimes I prefer to fix things myself. Every time I fix something I improve my technical skills. Yesterday, I cemented all the holes in our house walls. Hopefully, that will reduce the mosquito and mouse situation. I only mixed cement for the first time this year on a MSF course, so it was good to get the skills into practice.

This evenings’ task was to put a seat on the toilet in the house. I’d been putting it off until I could find a pair of surgical gloves. The bolts (which were the only remaining part of the previous seat) weren’t looking so clean. So trying to put on the gloves with my hands still wet was the first mistake. Picking up gloves made for the hands of a pixie was the second mistake. I ended up with the glove palm stretched over my whole hands with the tiny fingers not fitting on to my sausage fingers.

Then I realized that the new seat had no bolts in the pack. I had to use the horrible plastic bolts from the old seat. But the heads on them were too wide. So I had to file them down with a metal file. Which only just clogged up with plastic, as I used it. Sweating in the heat I was worried I would rip through the gloves and unleash an ecosystem of bacteria. I eventually filed down the bolt and wished I had left the tasks to the support team. I left the tools in the bathroom floor planning to soap and shower them tomorrow.

I had spent about an hour of my first weekend trying to buy a solid plastic or ceramic seat, everyone I saw was flimsy plastic. “I was looking for a stronger one” I explained to the salesmen in every shop. “But this one is stronger” each of them told me, more confidently and with a wider smile each time. I hope it lasts until at least my end of mission.

3rd August 2010

Goronyo Visit

July 25th, 2010 by Chris

The team were very busy prior to my arrival and with no NERU emergencies (another MSF team were dealing with lead poisoning) in our 4 North-West states being self-sufficient, they decided to take the full weekend off for the first time in months.

Having only been here for a few days, I didn’t feel like spending a Saturday doing nothing and decided to take the opportunity to visit one of the nearby projects. The Zamfara lead poisoning project was 3 hours away, and Goronyo was only 1 hour, so I decided to visit the closer one.

After getting approval from the Logistic Coordinator for the trip, I wasn’t able to reach my counterpart logistician or the project coordinator by phone. I send them an email telling them to call me if my visit would be inconvenient.

I packed one of the large chocolate bars that I had brought with me from Scotland, some water, my camera, some tools and clothes. I wasn’t planning on staying overnight but during the week, recent visitors were forced to spend an extra night there after some confusion about the local security situation.

The journey took an hour through beautiful scenery, mostly flat orange-red desert with small dry bushes. We passed dried out river beds about 2 to 5 metres wide. After an hour and various police check points we arrived in Goronyo. The team were working, but not too many outpatients come on a Saturday so they had time to show me around the hospital site that we share with the Ministry of Health. I saw limp and skinny children with their mothers in consultation with our medical staff and some very sick looking patients lying in the hot hospital rooms. Not yet knowing what is culturally acceptable, I kept my distance.

Photo: Chris H | Hospital Ward

Photo: Chris H | Hospital Ward

My logistical colleague, a water and sanitation specialist showed me around the hospital and told me about his plans to improve the waste disposal area, the sewerage system and the water distribution. He also showed me around town. On Sundays there is a large market and people travel from Abuja and Lagos to buy onions, maize and millet. Grumpy camels carried sacks for the traders setting up their stalls for tomorrow’s sale.

Photo: Chris H | Grumpy Camels

Photo: Chris H | Grumpy Camels

We departed a few hours later and during the journey home I saw the rain of the rainy season. It fell heavy and the passing motorbike drivers were soaked through, but the ground never held the water and it soaked into the dust. A few minutes later the rain stopped and everything looked just as it did before the rain.

On Sunday I went to Sokoto’s “International Airport” (there is indeed an annual flight to Mecca, but on the other 364 days it only receives planes from Abuja and Lagos). The team doctor and coordinator arrived and I got the chance to meet my new boss for the first time.

I now have 3 weeks to absorb as much information as I can from the boss before he leaves after a 16 month stint in Nigeria.

Arrival in Nigeria

July 21st, 2010 by Chris

After numerous warnings about the problems that me and my luggage might face on our journey from London to Sokoto, via Abuja, I was pleasantly surprised by the efficiency and friendliness I encountered at all stages of my flights to Nigeria.  An immigration officer even walked me through to the departure lounge to show me where to board my connecting flight.

A smiling driver was waiting for me at the airport, as were a number of new colleagues who were on their way back to Amsterdam or Abuja.  The coordinator of the team I was joining was going to the capitol to get a Canadian visa for a training course and the rest of them had finished shorter missions that MSF had been running, some were dealing with measles and meningitis while others had been part of our response to lead poisoning.

I jumped into our vehicle along with a Dutch lady who had been on the same flight and was coming to be the new coordinator of the lead poisoning team.  She had been to Nigeria before and chatted to the driver about other international staff who had passed through Nigeria in the past few years.

I listened and observed my new home.  The main roads were sealed and in good condition and on either side of them was red dusty ground.  Small, single story blockwork houses and makeshift shops constructed from timber and corrugated iron stood back from the road as people and goats wandered between.  Men in their full-length elegant shirts with matching brightly coloured trousers whizzed about us on motorbikes.

Arrival in Nigeria - motorcycles

Sokoto is hot, but not unbearably so.  After Wikipedia taught me it was the hottest city in the world, I had prepared myself for worse.  Apparently I’m here in the cooler period known as the “rainy season” although I’ve not seen any actual rain yet.

The office that the Nigerian Emergency Response Unit occupy was a bit of a mess upon arrival.  The logistical staff were counting and packing the items left over from the recent emergency interventions.  I’ll be in charge of the logistical element of the emergency responses to emergencies that occur in the North West part of Nigeria.  My tasks in the short term are to plan ahead for the various emergencies that could occur and make sure we have suitable stock levels and are ready to respond as best we can.

For me the first few days have seemed a bit strange.  My MSF experience to date has all been in hospital settings with all the drama of sick and injured patients.  So far, I’ve only seen an office and a warehouse.  Hearing the stories of the recent outbreaks in which we vaccinated over 80,000 people for meningitis and over 75,000 children for measles, I know we are going to be busy and I’m looking forward to seeing some action.

Driving through town today (I noticed the Landcruiser had done over 335,000 kilometers) I asked the driver what the people of Nigeria thought of MSF.  He said that people were very happy with what we did, but at first they didn’t understand why we came to their country.  At first people – unfamiliar with international aid – thought that our injected vaccines were designed to sterilize their children.  I’m glad we clarified that misunderstanding!

New Beginnings in Nigeria

July 20th, 2010 by Chris

After Chris’s end of mission in Papua New Guinea, he has decided to take on a new challenge by working as the logistician for MSF’s Nigeria Emergency Response Unit. The NERU as it’s known in MSF, specializes in sending its emergency team, composed of doctors, nurses and logisticians, to respond to epidemics in the northwestern states of Nigeria. Chris arrived in Nigeria in July 2010, and will be working as part of the NERU team for the next year.

The End

December 29th, 2009 by Chris

I left Papua New Guinea in the middle of October. I am writing this at the end of December. Since then I went to South East Asia with the intention of relaxing, but actually ended up partying all night most of the time. Later, I met with MSF to debrief and then with a psychologist to see if the mission had any adverse affect on my mental health. I also was invited to talk to MSF and others about the PNG mission, opportunities that I really enjoyed. During these talks I received some very thought-provoking questions. People wanted to know if it was difficult to fit into a society that was so different to my own, referring to the sorcery and violence. The truth is that it wasn’t that difficult to adapt to Papua New Guinea. The people were so friendly and warm towards me that it was leaving that was difficult. And as I write this, 2 months after leaving, what I am finding very difficult is adjusting back to the society I left. Media headlines on the personal lives of celebrity singers or sports star disenfranchise me from society. I enjoy partying, but so many times I wonder about how much money we waste on processed food and alcoholic drinks and if we can enjoy ourselves without them.

Photo : C Houston

Photo : C Houston

I spent the first weeks believing that Papua New Guinea was the most wonderful experience of my life so far (I still do) but that it had not fundamentally changed me as a person. My two weeks in post-tsunami Sri Lanka was my life changing experience. But as time passes, I start to realise that PNG did change me. I observe people more and I am saddened by extravagant and unnecessary spending or obsession with fashion and celebrity culture.

In a few weeks I return to the life I had before, I love working for MSF but I have the opportunity to work in London and my bank balance forces me to accept a job back in the UK. But I’m fairly confident that I will return to PNG and that I will return to MSF. I have left a bit of my heart in both of them.

I’ve received quite a lot of nice messages from people who have read this blog, many thanking me for the work I’ve done. Some people say that the MSF logisticians are the ones behind the scenes supplying the medics with the things that they need. But actually there are people behind the logisticians who deserve some thanks: Ken, runs the MSF Canada website and my blog – cheers dude. I want to say thanks to Isa for her inspiration while writing this blog and for the thought provoking questions she asks when we have our conversations. I want to thank my three wonderful bosses, Julia, Isabel and Claire for their direction, for their trust and for the laughs. Huge thanks go out to David J our driver, artist and carpenter in Lae for doing so much. I want to thank David K and Adam B for being my brothers. I want to say thanks to Marc (head of mission) for the sacrifices he has made for MSF and I want to say thanks to Karen for the constant laughs. I want to thank Nadia, the hardest working person I met in MSF. I want to say thanks to Keith and Otas, the guys who took over from me for being so super cool. My biggest worry towards the end of my mission was about leaving what I had been doing with people who would do a good job. With Keith and Otas I can relax knowing things will go well. I want to say thanks to Mevis, Emasi, John, Yako, Kobe and Hewali and especially Awaro for guarding us when we worked and slept and especially thanks to “lifesaver” for putting himself between us and harm’s way in 2009.

I want to say thanks to Jui for being the easiest going person to work with. And I want to say thanks to all the other national staff who continue to work hard, long after us expats complete their missions in Papua New Guinea. A final special thanks go out to Norman, the nurse who saves lives.

Epilogue

So I hope you enjoyed reading my blog. If you are reading it because you want to join Médecins Sans Frontières as a volunteer, I would encourage you to do it. It was the greatest experience of my life. If you are reading this as one of the many individuals who make up the vast majority of our funding, then thanks for allowing me to help. If you are reading this to learn more about PNG then I hope I gave you some insight about the tragic violence that occurs there, but I hope you also saw the warmth of the people there. I met some of the most wonderful, warm friendly and trustworthy people in the world in PNG. The paradox of the violence and the warmth of the people is something I can never understand. If you are reading this because you have an interest in addressing the sexual violence in PNG then I urge you to act. In my last few days in PNG, my former boss told me about a patient who had been imprisoned for weeks, moved around a province and raped by different men each day. Sometimes, when I see what makes the news where I live, I want to scream at people “open you eyes, see what is happening in the world”. But I don’t. Instead I write this blog. Thanks for reading it. Please tell people about PNG.