Chris is currently out of the office

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.

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.