First assignment: Preparing for the swamps

From wading through wetlands to cooking on open campfires, British health promoter Elizabeth has an unexpected first assignment ahead of her…

A member of MSF staff crosses a swamp in South Sudan

I am writing this from Amsterdam airport, eagerly awaiting my first assignment as a health promoter with Doctors Without Borders / Médecins Sans Frontières (MSF), to South Sudan.

Since having been accepted onto the register five months ago, I had imagined a mixture of different locations that I might be sent to work.

I pictured the hospitals in Afghanistan and the mobile clinics' set-up at the periphery of tightly packed refugee camps in Lebanon and Jordan. In these places, the “operational environment” can be fairly static, with wounded or unwell patients arriving at the facility’s waiting room and registering their name with the member of staff behind the welcome desk.

Swamps, canoes and swimming

However, my new project is based in Bentiu Town, an area in the north of South Sudan. I will also regularly visit the communities south of Bentiu.

When I first saw my job description and learnt about the role, it dramatically challenged my original assumption of what I thought it meant to work for MSF.

Never had I imagined that my assignment might be a small bit determined by my sporting history and current level of fitness!

As my job description reads: the role will be physically demanding”, of which the prospective candidate must be comfortable walking long distances” and may often need to wade through swamps and canoe over open water.”  (In the case that problems arise, the individual must also be able to swim.)

I was asked to note down relevant experience that would demonstrate my suitability for the role. Surpassing MSF’s application forms and competency criteria, never had I imagined that my assignment selection might be a small bit determined by my sporting history and current level of fitness!

I referenced my Duke of Edinburgh’s Award expeditions (a scheme founded in the UK where young people often complete long outdoor hikes), a 125-mile canoe race and a handful of completed half-marathons. Experiences that had slipped off my CV some years ago – ironically, to make space for what I viewed as more relevant experience for my role as a health promoter.

Outreach visits

I try to picture what life in the assignment might be like. At the very least, I know that work on the project will be far from static.

For up to ten days a month, I will travel to ten different communities across a wide geographical area. This is what MSF calls “outreach”, an operational style centred around mobility, door-to-door visits, and engaging with communities in their everyday living environment.


The Sudd - a vast swamp in South Sudan
The Sudd - a vast swamp in South Sudan

Away from our project base in Bentiu Town, on outreach visits, the accommodation set-up will be very basic. As the job-description reads, it will consist of: “setting up tents and cooking on open fires etc” with team members mutually expected to “muck in".

I am unphased by this, I had always prided myself on being a resilient and very happy camper.

Some people refer to “the Sudd” – the vast swamp in South Sudan – as the biggest swamp in the world.

In an effort to highlight my suitability for the role, I referenced my hiking trips in unenviable off-peak conditions in Italy, and my numerous stays in hard-to-reach mountain shelters known as “bothies” in the Scottish Highlands.

Undoubtedly, camping in South Sudan will come with its own challenges, and there is only so much someone departing on their first assignment can be prepared for.

The Sudd

My friends, similarly starting their first assignments with MSF, sent me pictures of themselves at their project based in Pakistan. They were wearing the local dress – floor-length skirts and detailed headscarves.

Meanwhile, sitting with me at the airport, my large rucksack is stuffed with items that noticeably contrast with those long flowy clothes. I have three torches, blister plasters, trekking boots and several pairs of waterproof trousers; the latter of which I hope will equip me properly for our outreach visits during the rainy season.

Some people refer to “the Sudd” – the vast swamp in South Sudan – as the biggest swamp in the world, and colleagues from MSF inform me that during the rainy season the route between swamp and path can become greatly blurred. 

I try to guess the distance I might be walking, deliberating as to whether I should buy protein bars, electrolytes and sports energy gels at the airport.

The number of occasions I will be swimming through swamps and “wading through bogs” remains unclear. For now, I am happy to wait in anticipation…