Lost in Transition

Today I woke up and didn’t know where I was. The air was cool, the room dark and still, the sheets wrapped around me smooth and unfamiliar smelling.

Today I woke up and didn’t know where I was. The air was cool, the room dark and still, the sheets wrapped around me smooth and unfamiliar smelling. A minute or so’s confused fumbling about for my glasses afford enough time to realise that I don’t think I’m in Kansas any more Toto – I’m in my childhood bedroom in my parents’ house in the UK. It’s 5am and today is the beginning of my last official day of mission as I am due to go into the London MSF office to debrief. After today I am officially unemployed.

The little kick of adrenaline that is coursing around my body as a result of my initial disorientation on waking is enough that I know that I won’t be able get back to sleep even though it is still pitch dark outside. I pull myself into a sitting position, switch on the light and hug my duvet tightly around my legs where a draft has snuck in around my feet.

The stillness is baffling. Other than the whispersoft hum of the motorway in the distance, there is not a sound in the room but my breathing. Bizarre, when only last week my room was constantly alive with the sounds of bats and geckos in the roof space, and the background noises of the Zemio waking up – music from the church, dogs barking, women calling to each other. And the ever present roosters with their messed up ideas of when dawn actually is. Actually, that is a definite improvement. No crowing. It’s something of a relief not to be woken up and instantly want to go outside and commit poultricide.

It was a difficult last few weeks on project. The absence of an expat doctor during his holiday left us three nurses in the hospital struggling to manage some complex patients . Even though the doctor in capital was only ever a phone call away, remote advice is just never the same as having someone by your side. The unwelcome responsibility of being the most senior medic in the project, coupled with the added pressure of wrapping up all my work and presenting it to my successor is some form of semi-coherent handover led to a worse than usual end-of-mission mental fatigue and anxiety related sleep deprivation. I am compensating for this now with a tendency to sleep so deeply that I forget to move during the night and wake stiff and sore in the exact same position that I passed out in.

The previous few days I have woken up in a visitors room in Bangui, a transit hotel in Casablanca, and a guest house in Berlin – all necessary if disorientating stages on the journey home. And from my parents’ house this week I will go to Bath and into a spare room at a friend’s house, and from there probably onto a little UK mini-tour of visiting people that I haven’t seen for almost a year. So I may as well get used to this displacement on waking as it’s likely to be a feature for the next few weeks.

And it’s not just the waking displacement. There’s a disassociation overall to the transition stage at your end of mission which – for me at least – makes it hard to connect in a meaningful way to the supposedly familiar things of your home country. I’m in many ways a creature of habit, and the habits of being in the field are hard to break. You can call it anything from re-entry to reverse culture shock. Something as simple and familiar as brushing your teeth becomes fraught with danger, as a trigger as small as the sensation of strangely cold water on your lips as you go to rinse your mouth screams a contrast with the last scorching nine months when a glass of really good, cold water was an unimaginable luxury. And you’re about to spit this precious mouthful out, you ungrateful, wasteful wretch. Except you’re not ungrateful, not really, back here it’s not seen as a commodity except in your own confused little brain. And you are so very aware and so very grateful for it. Small wonder I feel like a minor victory has been won if I can make it past midday without dissolving into tears.

Try explaining even a fraction of this mangled thought process to most people around you though and they look frankly panicked. For the most part my circle of acquaintances is worldly enough to understand that we in the west live in a time and place of unbelievable and undeserved privilege, but they know it in a sensible and largely abstract way, and are ill-equipped to deal with the rude realities of my emotional wreckage that leave me occasionally in heaving sobs at the sight of things like street lights and electric kettles.

There’s no easy answer or coping mechanism for this stage. I think a fine balance is the best you can hope for – gradually reconnect with the things of home, try not to lose touch too fast with the things and people you have left behind. Be gentle with yourself – tread lightly in social situations, allow yourself time alone, time staring at photos or just out into space. Hug a lot (try and refrain from bawling on people’s shoulders during this), drink wine, get outside and go for long walks. Avoid shopping centres.

And most importantly, don’t blame people around you for taking first world trappings for granted and for not understanding where you’re at. After all, the point of this work, the belief at the root of it – is that all people in all countries deserve this standard of living – clean water, safe streets and schools – that these things can and should be taken for granted by all people, because all people are entitled to them. So if I’m honest, the end result of aid work, (or more ambitiously perhaps, entirely and fairly redistributing the world’s wealth) would be a whole world full of people that takes these things for granted, precisely because I believe everyone should have them.

Maybe it’s not that I’m not in Kansas any more. In the film The Wizard of Oz, when Dorothy is lifted out of her ordinary life and catapulted into her yellow brick road adventures, black and white cinematography is replaced with the vivid technicolour that represents the land of Oz – and the reverse happens at the film’s conclusion when she clicks her heels and returns to her family. There is no place like home – but when home starts with Heathrow airport and the London Underground I hope I may be forgiven for finding it a little drab and grey at least to begin with. The brilliant sun, vivid fabrics, intense emotions and hectic near constant noise of CAR seem a world away.

You can’t rush the process of gaining perspective. Peace can’t be faked or forced, all I can do for now keep putting one foot in front of the other and let the journey carry me. So I’m not in Oz anymore Toto. And the “little girl lost” feeling is unlikely to go away anytime particularly soon. But amid the comforting anchors of friends and family I trust that it will gradually fade. And I will begin to find myself  – and life in colour – again soon.