Mike is in Irbid, Jordan, where MSF / Doctors Without Borders is providing vital health care to people who have fled the war in Syria, and to vulnerable Jordanians. This post was written in the run up to Christmas...
About a week ago we started what is going to be a gradual reduction in the size of the team as we come up to Christmas. E was the first to leave having finished the nine-month contract that she’d had here.
For me, the most obvious consequence of E leaving is that I now walk alone to and from the office, and I’ve missed the company and relaxed chatter we had most days, as well as her support. (Getting suggestions from her before I arrived of things to bring for the team I was joining, and that my fellow international staff might value it if I went to the duty-free shop too, was important to me.) More personally, I’m more aware now that my sense of humour, which can be rather dry, may be less understood or enjoyed by the rest of the team. I didn’t ever actually check with her, but I think that her changing facial expression when my more dry comments were made was a shared understanding and bond based in part on having both lived in UK!
I was warned by Jordanian colleagues that the traditional Jordanian meal was like a drug and that people would be groggy afterwards...
My immediate manager left for a well earned three-week rest the following day, back to home town and family. So the team dynamics have changed, and at a more prosaic level we have pondered moving rooms, and adjusting the food we eat each week. The community (now mainly men) has moved to being more carnivorous in its food preferences, and I now find myself the one most likely to want to have a fully vegetarian meal. I have taken on the role of the keeper of the herbs and plants which are on the balcony. The basil would now find it too cold out there with night temperatures down to 5-6 recently. Not sure whether there is a significance to being the keeper of the plants?
Not sure whether there is a significance to being the keeper of the plants?
By the week after Christmas, the resident international team will be down to two of us, though with visiting senior staff from Amman coming up for blocks to stay here and support us. Thereafter though, we should have refreshed colleagues returning and some new people here to join us for a month or so (physiotherapy adviser and non-communicable disease adviser, and an associate project coordinator) and a long-term colleague to take on the vacant mental health adviser role in the new year.
Having some fun at the celebration. Photo: Hussein Amri / MSF
Soon after these departures, we started preparation for celebration of the 3rd anniversary of the MSF Irbid Non-Communicable Disease Project. We’d not really been aware of the date until rather late, so getting out the invitations and getting press, publicity and things for people to do in our two clinics was a mad rush.
In the end, we had health promoters running quizzes (and giving out prizes of MSF logo pens, and for the key questions black MSF Irbid 3rd year anniversary caps) and we had lots of party balloons (one of which I managed to twist into a child’s crown to the bemusement and then delight of a young Syrian lad). But the highlight was the speeches.
It was a great occasion to celebrate the shared vision and achievements
At the clinic I was based in, the speeches involved our project coordinator; the head of MSF’s work in Jordan who’d travelled from Amman; the firm who do our lab tests; representatives from the Chamber of Commerce (whose building we are based in); and the charity Arabian Medical Relief Society. (We work closely with the latter in this building, as we rent our space from them).
It was all much more formal than I’d expect to see in the UK now, which at one level was peculiar, but it was at the same time a great occasion to celebrate the shared vision and achievements.
Mike at the celebration for the three year anniversary of the non-communicable disease project in Irbid. Photo: Maya Abu Atar / MSF
The formal speeches appeared to work here for the team, and the patients who were there too. I managed to wear a staff T-shirt with logo and branding, and to hold the back of another T shirt detailing the 3rd Irbid MSF anniversary, so that whenever there was a picture of a speech-maker taken by the press we (probably) had details of the project and the MSF logo in sight too!
There were also a lot of statistics shared, looking at the number of patients enrolled and the numbers with different conditions. For me the most interesting data was more subtle: some research looking at the first two years of our work shows that the team has consistently made a significant difference to the level of diabetic control in our patients.
The team has consistently made a significant difference to the level of diabetic control in our patients
For those who like the detail, a drop in the HbA1c score from average 8.47 to 7.74 was achieved in the first six months of care, bringing the score, despite the smaller range of drugs to achieve this, relatively close to what would be achieved in a western country. Similar results apply to blood pressure BP change on joining the programme. We achieve a good average improvement in our patients and then largely maintain these improved levels and so reduce their risks of harmful health changes.
It was fun to work getting all this sorted with the communications lead for MSF and a small team of us in the project too. We’d never have achieved the buzz that there was, nor got the press and the important people in the room at the same time with prizes and logos all on display, without her. I’ve valued seeing more of what Comms people can do – and starting some important personal political discussions about life in this area of the world which I hope to continue.
The team celebrating the fantastic achievement of the project. Photo: Hussein Amri / MSF
Then most of us moved on to a team celebration at a restaurant. Nobody seemed to worry that it was now 4pm and an odd time to have a big meal. Given the short notice we gave everybody it was inevitable that the whole of the team could not get there, but most of the team joined us.
I was warned by Jordanian colleagues before we started that the traditional Jordanian meal (Mansaf) was a drug and that people would be groggy afterwards. This was certainly true! Whether eaten with the right hand alone by a group who chose to stand and jostle for places to eat, or using a knife and fork, the yoghurt-cooked lamb was rapidly finished and only the bones left. We then took over a whole corner of the restaurant, and spread out and lounged for quite a while.
We had mint tea and more raucous laughter
We had mint tea, more mixing of people and more raucous laughter. My colleagues told me that eating meat was something that you don’t do every day in Jordan. I checked this out, and discovered that this meant lamb; eating chicken most of the other days of the week is not really eating meat after all?!
We then went on to a final party in one of the international staff flats, with a good mix of national and international staff from our project and another local MSF project joining us. Those who have lived in the West will need little description of this. It was not too big, though we were joined by colleagues from another project. The music (not surprisingly given the range of cultures) was pretty varied, and I got a chance to dance and explore space and rhythms: wonderful. The next day (well, technically the rest of the day the party finished in) was Friday so a day of rest.