Pakistan: Project management and Billy the cat

Edoardo shares his experiences after six months working for Médecins Sans Frontières / Doctors Without Borders in Pakistan

Edoardo is in Pakistan, where he is working as Project Coordinator in Quetta, Balochistan – ensuring that everyday Médecins Sans Frontières / Doctors Without Borders (MSF) actions are safely in place to provide the community with free, high quality mother and child health care. In this post, he shares his first impressions after six months in the province...

I have been working here for six months and it has been quite challenging, on several occasions, due to the high levels of insecurity. But that aside, I've met a great team of people.

Billy the cat

My Pakistani colleagues are exceptional professionals with a great sense of respect. The MSF international staff I've met here, some of them on their first assignment, have  always been full of positive motivation and adapted quite well to the restricted life we have outside of working hours.

For example, to pass the time, we often organise cooking dinner together, we play table tennis or practise yoga.

Our logistician adopted a small cat which she named Bean, but I call him Billy – which in Urdu means "cat". The cat is not only entertaining, but also good for stress management… at least for those who are not stressed by having pets running around the house!

Meet Bean/Billy the cat who was adopted by the MSF office. Photo: Sarah Clement

Meet Bean/Billy the cat who was adopted by the MSF team. Photo: Sarah Clement

Not being new to South Asian culture and languages (I spent 10 years mainly working in Nepal before joining MSF), I have fitted in quite rapidly here.

Since my assignment began, I have tried to speak Urdu proactively with my Pakistani colleagues, which helped to break the ice with them.

From the first day I stepped foot here, in the dry, rocky Huna valley, I have admired the mountains. I cannot visit them during my stay here, due to security restrictions on our movement, however, consolation has been found by looking at the land behind our house, which is full of apple trees.

Making a difference in Balochistan 

Every day I wake up to make sure that all the MSF project staff are doing the right thing at the right time.

In the winter, most mornings were very pleasant, with an intense blue sky and a warm sun (just like the sun you get in the Italian Alps during March and April).

There were many operational changes during last year and I have helped relocate our team to a new office, which involved a big team effort during the last days of 2017, including New Year’s Day 2018. All our staff members where busy finishing the move while it’s likely that half of the world was recovering from the night before.

Winter sunrise from the MSF office in Quetta. Photo: Edoardo Nicolotti

Winter sunrise from the MSF office in Quetta. Photo: Edoardo Nicolotti

In Quetta, we are working in the outskirts of the city in a town named Kuchlak, where the majority of the population are Pashtun – many of them are Afghani refugees who have settled here since the mid-80s.

MSF has been running a mother and child health care centre here since 2006, offering treatment that includes nutritional support for children under five years old.

Basic emergency maternity care is provided through a unit which is open 24 hours a day. My colleague, a Canadian midwife named Zuzana, is doing hard work there along with the local health visitors.

During 2017, MSF provided 25,905 consultations in Kuchlak.

Our efforts give happiness to many families on a daily basis, as we assist at births and add a new member to the community, which I find very satisfactory and valuable.

Project management

MSF also provides support and treatment to patients suffering from leishmaniasis, an often-neglected skin disease, in other hospitals in the centre of Quetta. We have medical teams rotating to different locations to ensure constant follow-ups with patients.

Quetta is also the pathway to other projects MSF is running in the Balochistan province: in Chaman, a town on the border with Afghanistan, 130 km (81 miles) from Quetta; and in Dera Murad Jamali, in the east of the province.

A typical morning breakfast at the MSF house. Photo: Edoardo Nicolotti

A typical morning breakfast at the MSF house. Photo: Edoardo Nicolotti

During my first three months here, managing the medical activities was challenging for several reasons. This included extra movement of staff and logistic freight to various project locations, each with security implications that required strong risk analysis.

In the coming month, I am going to attend a project management course in Amsterdam. I hope to come back to Quetta after a few weeks with new tools to give MSF’s work here a greater impact, along with a refreshed spirit and new inspiration from newly arriving international staff.