Afghanistan: Building maternity wards (and a volleyball court!)

Report from a logistician turning his skills at the Boost hospital  in Afghanistan which is one of the biggest MSF-supported hospital projects in the world: providing surgery, internal medicine, emergency services and intensive care. It also specialises in treating tuberculosis and malnutrition.

Jan Pouza is an electrician and crafstman from the Czech Republic. His talents as a handyman have proved very valuable in his new job as a logistician. Fresh from his first MSF assignment in Afghanistan, Jan writes about constructing hospitals, sleeping through shelling, and making lifelong friendships.
At the start of my MSF assignment in Afghanistan, I joined the Lashkar Gah project in Helmand Province. Armed clashes have affected parts of the province for years - increasing pressure on medical staff working in the capital, Lashkar Gah.
Despite these tensions, the Boost hospital still continues its activities in Afghanistan. It is one of the biggest MSF-supported hospital projects in the world: providing surgery, internal medicine, emergency services and intensive care. It also specialises in treating tuberculosis and malnutrition.

Getting started: becoming a builder

I had a bit of rocky start on the job. Despite having no background as an engineer, I was thrust into several ongoing construction projects - challenging, but definitely not boring!
Since 2015, the Boost hospital building has been undergoing an extensive period of rehabilitation: modern central heating was installed, and the interior was painted and refurbished to provide better infection control.
To top this off, a new 54-bed maternity ward, a 24-bed neonatal intensive care unit and a 10-bed paediatric intensive care unit were also built.
I'm happy to say I was given plenty of responsibility for this work, and learned a lot about construction by being a part of it. 
By the end of 2015, with the new maternity facilities in place, 12,721 babies had been delivered in the hospital! This means approximately seven per cent of deliveries in Afghanistan are assisted by our staff.
Photo of the new maternity ward in Boost hospital, Lashkar Gah in Afghanistan

The new neonatal intensive care unit in Boost hospital, Lashkar Gah in Afghanistan. Photo: Kadir Van Lohuizen / Noor


Going where I'm needed

Working in Lashkar Gah was a good experience, and I have many fond memories of it.
However, the tensions in the capital caused a reduction of patients in local hospitals. With pressing need elsewhere, some of us moved to help in other MSF projects in Afghanistan. 
I myself was relocated to Kandahar. It was a very good opportunity see a second MSF project in action.
The facility specialises in multi-drug resistant tuberculosis diagnosis and treatment - a major yet under-reported public health concern in Afghanistan. 
In Kandahar I once again found myself in the role of construction logistician. What was great about this project was that I could start from the very beginning, from the design of the floor plan. I also got to work with a project coordinator, who is very experienced in construction. This is a great opportunity to learn as much as possible, adding knowledge to what I'm already doing.
I must also add that the the quality of work done by local construction companies in Kandahar is amazing.

Life in the compound

The compounds we live in and the food we eat in Afghanistan both have a great reputation among MSF staff. Even though it was my first experience, so I don't have anything to compare it to, I too can say it’s really good.
I was bit afraid of gaining weight in Afghanistan because the food is so good. But occasional diarrhoea (we call it Lashkargaitis), a lot of gym, ping-pong, volleyball and missing beer made my belly almost flat.
I'd never played volleyball before, and I can proudly say I'm not bad now - I even built a volleyball court in the compound. And in ping-pong I am one of best (maybe the best) in both projects! 
I've had very good experiences with my colleagues and bosses. I made a lot of friends, with both national and interational staff, and I already miss many of them. It’s very good to find friends and learn more about them and our cultural diversities. 

Security Issues

I was wondering how an experience in a conflict zone would affect me. To be honest, it's still hard to describe.
During my first breakfast in the project, everybody was intensively talking about shelling. I thought those people must be bit weird to have this kind of conversation just after getting up. But then I realised I must be a really good sleeper, because all this was going on the previous night, and I was the only one who didn’t hear anything.
That continued until fighting started nearer to Lashkar Gah during the day. Still, I did not feel nervous. The national staff were quite calm, and I think that calm spread to all international staff as well. 
Photo of Jan next to an MSF field vehicle

Jan next to an MSF field vehicle. Photo: Jan Pouza / MSF


I'm filled with pride

I am happy and proud of myself, my friends are proud of me, and I am proud of MSF. If an organisation I love likes me back, that would be excellent, wouldn't it?
MSF's reputation is great. On holiday I met some girls working with other international organisations. It was awesome to hear all the positive things they thought about MSF.
The Czech MSF office has asked me to participate in a program writing letter to our supporters. Some donors already found me on Facebook, and wrote me mesages of appreciation. I felt really good about that - all of it is excellent. 
The only thing I really missed in Afghanistan was the freedom to take photographs while on assignment. On my holiday in Sri Lanka I was like an unleashed dog; I rented a scooter and travelled around as much as possible.
I was so physically tired when I got on my flight back, but mentally I was fulfilled. 

What's next for me?

I would be very happy to go on another assignment with MSF, as soon as posible. But first I need a holiday!
After my return from Afghanistan, I plan to travel for while: first to Bangkok, then continuing to Myanmar, Laos, Vietnam and Cambodia.