Pakistan: No such thing as too much Chai tea!

Annke looks back on her first posting with Médecins Sans Frontières / Doctors Without Borders (MSF) as an ER nurse supervisor in Pakistan...

Here I am again in my favourite coffee shop in my home town Witbank, the very spot where the dream of becoming a fieldworker with MSF was born last year in October. I arrived back in South Africa just a few days ago – a bit better-travelled, a bit wiser and much more experienced in field work. As I enjoy my frothy cappuccino, I reminisce about the last seven months I spent at MSF’s project in Pakistan.

Annke, Parvez and Nazir take a selfie

Annke with Parvez and Nazir, the ER Supervisors.

How did this experience change me? What did I learn?

The first thing is: if you put your mind to it, you can do it! You can have an enriching experience when you take a chance on something you never thought you would do. I took a chance and had an adventure of multi-layered proportions. I got to travel, to experience a different culture and I came home with many stories to tell.  

My dad always says: you are the sum total of your experiences. These months in Pakistan were larger than life to me, rich in people, personalities and cultures. When I think of the friends I have made, the challenges I overcame and the team that I became part of, the sum-of-me is definitely much richer.

I learned I can be comfortable and active in a culture that is different from my own.  As I write this, I notice two women walking past the coffee shop wearing hijabs (Muslim head scarves). I did not notice this before, but now, after wearing a hijab myself in Pakistan, I notice it and understand a bit more about covering one’s hair as a woman. I have become more aware. I have always been a people-watcher, now I am a bit more understanding of what I see.

The MSF Pakistan team share a cup of Chai

That last cup of ‘never-too-much-Chai-tea’ on my last day as the ER Nurse Supervisor. Photo: MSF

I learned how respect is an essential currency that you have to posses. At the hospital, I worked with a large team of mostly men and I know that respect is earned. Apologise when you make a mistake, ask humbly when you do not understand, but always be respectful. Never before have I been treated with such respect as I experienced from the ER team. And this is the standard I hold myself and others that I meet to.

I learned that a large nursing team can work well together. I always tried to teach my nursing teams here in South Africa to be adaptable, to be fluid. This ER team in Pakistan already has it.

A few months ago we received the message that the Emergency Room was going to be painted as part of the regular building maintenance.  ‘How are we going to get that done?,‘ I asked myself. The patient flow is about 12,000 per month. (It is not 20,000 like in August, but 12,000 is still a large amount of patients to be accommodated in this setting and it is working well.) To have to move the rooms around to open up a space to be painted, is no easy task. I was expecting long faces and groans from the staff. Usually nurses do not favour change. In my experience, nurses like things the way they are working now.

This ER team operates like the waters of a river. They just flow. 

Regular maintenance is just that – it’s a regular and very necessary thing. So the national supervisors came up with a painting schedule that would have different rooms moving around like pieces on a chess board to keep the ER activities running smoothly while allowing the logistics team to paint.

I watched all this happen and thought to myself that this ER team operates like the waters of a river. They just flow. I did not see any frowns or bad attitudes. When the patient flow was slow, then the ‘river’ flowed more slowly, resting a bit, enjoying tea. When the patient flow was high and it was busy, everyone was busy, all working together. The water of this river flows swiftly to get the nursing care done. If there is a big rock in the river bed, the team just flows around it.

The final thing I got from my time in Pakistan is that I am now convinced that there’s no such thing as ‘too much Chai tea’. As I moved between the different areas, I was invited to share in many cups of tea on any given day. And I enjoyed every single one.