When we were told that we would be going to the city of Am Timan, we were quite impressed that it actually appeared on the map. Forth largest city in Chad, apparently. We were certain that if nothing else, it must at least have one dingy restaurant that sells deep-fried chicken and fries, served with warm orange Fanta. Sign us up!
Am Timan is a provincial capital with a population of about 50,000. As a capital, it is home to all the government and military officials, housed in crumbling brick compounds, thatched tukuls, or under the mango tree, depending on rank. It has wide streets filled with grazing goats and tethered donkeys, and a bustling market area that from a distance is a kaleidoscope of colour as women flutter about their business. And of course, the ever perplexing presence of a cell phone tower in the absence of running water or electricity. Where does everyone charge their phones?
Kaleidoscopic market place in Am Timan
MSF began operations in Am Timan in February, 2010. We work with the Ministry of Health in the main reference hospital for the district, responsible for pediatrics, maternity and a large feeding program. If you have a soft spot for cute little black babies, our side of the hospital is the place to be.
Am Timan reference hospital
As MSF projects in the notorious eastern border region of Chad are in constant threat of evacuation or closure due to the precarious security situation, the original strategy for Am Timan was to establish a long-term project in a more stable, adjacent location. While maintaining minimal operations here, we would then be able to provide medical, logistical and human resources to any emergency that sprang up, either along the border or elsewhere.
Well, with over 600 malnourished children, 60 cases of severe malaria and 100 newly birthed babies in a single month, that strategy has since been scratched. The medical needs in this region have proven far greater than first anticipated and all available resources have gone into meeting them. Because the region is stable, we are now able to expand our operations into health centres outside of Am Timan as part of an outreach program.
Since it is a longer-term project, there are plans to extend our services to include tuberculosis and HIV programs, with the aim of enhancing existing national programs. With this comes the operation of the laboratory and extensive testing and counseling services. So now that our original programs are well established, but many needs still uncovered, we are set to grow, kicking into high gear. New construction, expanded medical orders, more expats and national staff, and even a few more piddly Jimnies painted bright pink.
We have been here in Am Timan for a couple weeks now. No sign of a deep-fried chicken joint, but exciting times at the hospital nonetheless.