It's Saturday morning in Zamfara in north-western Nigeria.
I’ve been trying to write this all day, but it’s been delayed by 16 calls from a contractor, a visit to the hospital and 30 minutes standing still on top of a septic tank – trying to trick a gang of rats spotted hiding underneath. It’s a far cry from the engineering offices I’m used to, but at least I’m not medical: they never get a break!
It’s amazing how big an impact some advice and a tiny investment can have...
I’m on assignment with MSF as a ‘flying watsan’, which means I look after the water and sanitation over all our projects in Nigeria, rather than being based in just one project. It sounds very Indiana Jones, but in reality I should be called a ‘driving watsan’ – there are lots of long, bumpy rides between the four projects.
I’m mostly based in Sokoto, which is a city in northern Nigeria, but feels like a large West African town. First thing I did after being matched to this project was to Wikipedia ‘Sokoto’ where it said it’s one of the hottest cities in the world. Not ideal!
There is a good mix of work here that keeps things interesting. I’m assigned to the Emergency Response Unit which is a specialist team that responds to epidemics and situations where people are internally displaced due to flooding or violence. It can be quiet and then suddenly things change and you have to travel into the communities to reach patients with only a couple of hours’ notice.
We did an assessment for a suspected cholera outbreak last week and the conditions in the local hospital needed some improvement. We brought in some hygiene materials to set up handwashing and oral rehydration salts (ORS) points and it’s amazing how big an impact some advice and a tiny investment can have.
Next is the Noma Hospital in Sokoto. Noma is a terrible disease in which bacteria literally eat away facial tissue; like a jaw, cheek or nose. The facility in Sokoto is the only hospital dedicated to this disease in the world.
In collaboration with the Ministry of Health, MSF surgical teams provide reconstructive surgery four times a year to these children with severe facial deformities who are often hidden away from their own communities. I’ve seen some of the surgeries and it’s amazing to see how quickly they can fashion a nose or an eye lid from folding some skin.
After the surgeons are gone, the team will be quietly helping the patients through the next stage of their recovery; things like helping kids adjust to being visible in community life or intensive physiotherapy.
At the moment I’m digging a new borehole in one of our outreach towns, Bagega. This town is known for artisanal mining in the region and, as such, lead poisoning cases.
After engagement with the community and mining cooperative, we agreed to provide wash areas for them, as this helps to reduce the causes of lead poisoning. Miners not having access to wash facilities at work can accidently contaminate their homes. This inevitably affects kids the worst as they have weaker immune systems and play on contaminated soil throughout the day.
My most exciting project is supervising construction of the underground water reservoir I designed, which will finally bring sustainable running water to the hospital. It should have a huge impact and will be finished in early 2018.
Having the reservoir means we'll be able to provide more hand washing points to stop the spread of disease, make life more comfortable for the mothers during their stay, save resources spent trucking in water and overall promote good hygiene in the hospital. It was nice when I arrived in the town that the locals knew why I had come and were so appreciative that the hospital would finally have a reliable water source after so many years.