First week in a one-week-old country

I’ve spent most of my first week in the MSF office in front of my computer, the same computer that I was sitting in front of a week earlier at my parent’s house near Chicago. Five flights later and the scene has changed quite a bit.

I’ve spent most of my first week in the MSF office in front of my computer, the same computer that I was sitting in front of a week earlier at my parent’s house near Chicago. Five flights later and the scene has changed quite a bit. The airports and planes became smaller and smaller until I buzzed into the town of Raja on a World Food Program single prop. The dirt runway is about a block from the office, which is a football field away from the hospital where we’re doing the bulk of our activities. While the planning and research that I’m doing on the computer is critical for my work, I’m looking up from it and getting away from it whenever possible, curious to get a grip on what’s going on, excited to get my hands dirty.

As a watsan (water and sanitation... guy), I’m charged with overseeing things at the hospital having to do with water quality and quantity, latrines, hygiene, vector control (mosquitos and such) and health care waste management.

The hardware side of things should be straightforward enough; install the pipes, dig the pits, build the structures, smile and cut the ribbon. With this being the bush, this isn’t the case. Supply, supply, supply is the difficulty, because of our remote location. The local market is a scene. I love it but it has nothing to sell to me for my work. Even for food it simply lacks. Pipes? Not one. Taps? Sorry, no. Cement? Maybe, who’s asking? Onions? Yes, but they’ll cost you. Onions are like gold here. Potatoes aren’t even available anymore but we have a giant stash in the kitchen. There’s no wine... it’s a genuine dearth.

The software side is where things become more complex and challenging for a watsan. Software is people- training them, building for them, or maybe even listening to them. People are complex enough, but even more so when they don’t share the same language, receive the same cultural truths, or shop at the same Whole Foods locations. How can I design latrines for people when I’ve been in their country for less than a week? Which is a coincidencce as their country was only a week old when I arrived.

As much as I’d like to think that my job is the most important (psst: it totally is), we’re a medical organization and I’m actually here to support the medical activities. Our energetic Argentinian doctor showed me around the hospital. Building by building, room by room she pointed out the inadequate number of water points, the deficiencies of the waste management system, problems with existing structures and ideas for future ones. She did all this while greeting men and groups of women and children with the energy and efortlessness of someone running for public office. “Salam aleikum. Tammam?” “Tammam” They replied with smiles. She did everything short of kissing babies, although I think she did save a baby’s life. Our last stop was the pediatric ward and just as we were wrapping up our tour, we were interuppted with a medical issue that she had to deal with right away. This is what the whole thing seemed like as it happened:

‘So, a drinking water stand here and a handwashing station over there?’ I say, squinting and adjusting my glasses with the eraser of my pencil.

Over her shoulder, as someone hands her a baby struggling to breathe, ‘Sorry, I have to hook this baby up to the oxygen machine, set up the IV, advise the national staff on the baby’s treatment plan for the coming hours, get someone to run and tell Wilson to turn the generator back on so we have power to run the machine, use a translator to communicate to the mother what we’re doing for her child.’

‘Oh no problem, so I’ll just stay right here and make a little map of the ward and draw little dots for handwashing stations and squares drinking water stands? Cool, I’ll just be here then.’

Of course all she really said before jumping to action was, ‘Sorry Emmeeeett, hold on.’ But after days at my desk working on the technical stuff, examing the stock in the warehouse and inspecting the watsan facilities around the hospital, it was very nice to get hit on the head with this very medical experience, to be reminded of what we’re actually doing here. The whole whirlwind tour with her was exactly what I needed in order to connect the proposed watsan improvements with who I’m doing it for and how it should be done. Anyhow, I still need to do more to engage the national staff- from doctors to cleaners- as well as patients on their thoughts regarding my work. Then we’ll have to work on getting the right parts out here. It’d also be cool to get some wine.

That’s all for now. Going forward I’ll try to shed some light on our work and on the situation in the rural, beautiful, and until now quiet Western Bahr el Ghazal state of the newly indpendent Republic of South Sudan. I’d appreciate any comments and questions you might have. Until next time, I’ll probably be at my computer.