The next point of order:

“As I’m sure you all know, our security guards are not empowered to deal with internal security threats.” Internal security threats? This sounded serious. Images of armed men wearing balaclavas surfaced in my mind. “I am of course, referring to the mangoes.”

Mangoes? Really? Dear reader, please do not judge me harshly for what happened to me next, which was a bad case of the giggles. I was not laughing at anyone, nor was I belittling the importance of comfortable bottoms or threatening mangoes, I just had a surreal moment. To my credit, I don’t think anyone noticed. If you had looked very closely, you may have noticed my pursed lips, a very slight shudder of my shoulders or bobbing of my Adam’s apple. Apparently the mangoes, along with all the other fruit, legally belong to the landlord of the property we rent, and our security guards are not employed to stop other staff members from eating them.

Before leaving that evening, still smiling, I notice a fallen fruit on the ground in the MSF compound.

“I’m not afraid of you,” I whisper to it playfully. The next day I tripped over that very same fruit, sustaining a small laceration to my left knee. Karma, presumably, telling me not to be a smart-arse.

A fortnight or so later, I was tasked with conducting the performance evaluation of a member of staff under my supervision, a man I had recently met and knew little about. Kevin is a register. His job is to enter all the information for each child onto their record card and into the register books. This includes the week-by-week weight of the children, from which he draws a nice clear graph in the notes.  As I have often told the registers, their job is really just as important as the doctors:

Correct data + bad doctor  =   bad clinical decision

Incorrect data + good doctor = bad clinical decision

As we went through his evaluation, it transpired my predecessor had noticed a few areas in need of improvement in Kevin’s work. The evaluation system we use gives a kind of final score, and Kevin’s was somewhat low. The evaluation process is fairly new to him, and he expressed a fear for his job. The look on his face said this was quite genuine. After a moment’s hesitation, I sigh and give in to perhaps not the most professional course of action.

“Kevin, I’m going to let you into a little secret. Don’t worry too much about this score. You’re not going to get fired.” Visible relief washed over him. “The bits you need to focus on are right here.” I pointed to a small table on the back of the form. “These are things you did well – keep doing these and build on them. Here are some things that you didn’t do so well – these are areas you need to concentrate on improving. If you do that successfully, next time your score will improve. Then you can say you are making progress, I can say I supervised you while you made progress, the admin guys can put the evaluations in a drawer somewhere, and we can all go home.” Kevin smiled. I kind of wish someone had explained this to me 10-years ago. It would have saved me a lot of time.

I could go on, and I’m sure anyone who has worked in a large organisation for any amount of time has had moments when they could take bureaucracy, strangle it to death and feast on its entrails. The truth though, is without the bureaucratic process, nothing our project aims to do would get done. We could not keep track of the 700 patients currently in the programme, and we certainly could not have treated the 10,000 or so children since the project began.

So, Bureaucracy, you may become so complicated that you have ended up looking like a cross between a particle accelerator and a combine harvester. You may smell of stale sweat and fresh tears. And you are certainly not popular at parties, perhaps hanging out in a back room somewhere with Inheritance Tax and Celine Dion. But you do have an unenviable and practically impossible job to do, and I think generally, you do it as well as it can possibly be done. Bureaucracy, grudgingly, I salute you.

This post was first published in Spanish in 20minutos.es