We started our week working late night Sunday night finishing a big project proposal. A project to benefit 11 thousand people across villages 40-80 kilometers around us involves a serious amount of logistics, rigorous cold chain procedures, much collaborating among all departments, and multiple excel attachments. One late night was not enough to finish and we continued running through the staffing headcount and our nurse’s field notes and maps to refine logistics until Friday, truly, very exciting.
Adding to the excitement and debates among our four expat team (our Burkinabe logistician has been on vacations for the past two weeks) this week’s visitors contributed vastly to complete the milestones we had proposed (similar to my previous corporate job, MSF establish weekly, quarterly, and annual objectives and performance reports to headquarters and donors published online).
The steady tide of visitors over the last weeks has brought a refreshing novelty effect to our long office hours and much appreciated distraction at meal times with unique stories. This week we welcomed our interim logistician and the assistant medical coordinator from Ndjamena. Both are seasoned MSF Chadian staff and were instrumental to kick off construction work and to refine our project proposals.
Given the sanitation risks among a recently established camp with 11,000 people, MSF built 70 latrines in May and we have now started 70 showers/latrines. Our interim logistician started construction this week and I tagged along to see the safe storage of our material, to do payroll, and check on how our staff is handling the increased activity. Though our project is small for MSF standards (30 Chadians + 5 expats), these short term construction projects increase our staff by 20-30 on a weekly basis. Unlike our clinic and water sanitation sites, our showers/latrines take us deep into the ‘neighborhoods’ amid the bush that surrounds the cleared grounds of Danamadja camp proper. Food is scarce and though shelters have been built by a couple of organizations, many still take refuge under self-made shelters.
As we walked from site to site we crossed through the settlements of dozens of refugees. There’s a real feeling of life intrusion as you walk through huts, makeshift kitchens, camp fires, and kids’ playgrounds - good old mud cakes, soccer, and tire swings hanging from trees. The lives of whole families are settled in small parcels of land amid the bush that vary in size from 5m² to 10m². I would try to keep talking to our logistician as I felt the deep stares but couldn’t avoid the occasional sight crossing with an elder, feeding mother, and many exasperated men; in the end I relaxed as some kids would run around us saying ‘bonjour’.
A few days later, upon our second and third tour around the same sites, deep stares turned into slight nods, smiles, and ‘ça va’ as our showers are halfway done. Our swift reaction and involvement in the heart of the camp have earned us the respect of the internally displaced people. We hope such respect leads to trust the MSF camp clinic when maladies arise.
The visiting assistant medical coordinator from Ndjamena came to provide technical support for our medical team. Luckily he had an open agenda and helped me understand plenty of HR policies in terms of employee health benefits, which I oversee.
MSF medical insurance covers all our Chadian employees and their dependents but given the remoteness of our location, some medicines and additional specialist studies require referrals to regional clinics and/or travelling all the way to Ndjamena. Such movements involve detailed internal forms and a system of authorizations and receipts - characteristic of any medical insurance - that I need to fully understand in order to accurately explain to our employees. Going through a day-long briefing on how to handle confidentiality and the administration of our staff medical needs I have come to understand an unseen facet of HR professionals.
Our multitalented guest also provided an experienced view of the logistics and coordination involved with a variety of projects that we have in the works and helped out with a much needed inventory of our storage facilities.
By the end of the week we nicknamed our visiting colleague Dr. Bruce Lee, partly due to his Zen demeanor, 3rd degree Karate black belt philosophy, Russian medical school stories, and Black Sea swimming and Sochi mountain-skiing survival stories. Complementing his Zen, Dr. Lee’s speech carried much assertion and confidence that left no doubt of his message; though at first it sounded as if he spoke in imperative sentences to us, in the end we understood it was his way of ensuring a precise message.
The MAN Dr Lee, stoic for the picture
Picture the following: the whole team huddled around my laptop finishing our project budget as I try to condense which shouts and points to include on the lengthy excel file – and sprinkled throughout the exchange Dr. Lee dryly - and correctly - intervenes saying ‘that’s wrong’ or ‘don’t do that, increase your budget’. Clear and concise were Dr. Lee’s middle and last names and he made our late office hour’s debates more entertaining. Needless to say, the whole team has enjoyed the spontaneity and lack of ‘sugar-coating’ of his comments.
Aside from his professional medical insight, Dr. Lee shared his two cents with others: for the cook that meant instructions to cut thinner slices of cucumber for salad, for the early morning running crew to be at peace while exercising and correct stretching, for our nurse to improve our vinaigrette dressing recipe, and for our housekeeper to stop lighting charcoal for our ironing out of concern for the environment.
For this last one however, we were obliged to intervene; while we care for the environment, no electric irons are to be found in town and we must accept and admire the charcoal-iron abilities of our housekeeper. I dare to say no other humanitarian professional in Gore has better pressed shirts every morning – only to be promptly drenched and wrinkled in sweat as we leave in our hardtop land cruisers in 89% humidity and 38°C heat.
Recapping last week’s news, our fish vendor - Mama Poisson – made up for her past misdeeds. Last weeks she had conned us into buying iffy fish. I spared her the confrontation with our displeased cook and played good cop asking her to look over our health and she’ll ensure we keep doing business. Next day she showed up with new ‘merchandise’ that was delicious.
Day after however, while negotiating two fish for 7000 francs (~400 francs = 1 USD), I pushed for the small one of the pair and she ended up confessing that it was already rotting. But how so if she tried selling both a minute earlier! I could not contain my laughter and as I tried to send her home without buying anything, she agreed to sell the ‘good one’ at no profit to her (or so she claimed :). The saga continues.
On a random note, this morning during our usual morning toast and jam breakfast I hypothesized out loud about a world without flies. Such an idea has always arisen sporadically to me over the years and the dozens of flies that hit our table early morning reminded me. However, I wondered that with flies disappearing, surely some bizarre and obscure trophic cascade might cause a worldwide ecological collapse across food chains, and voila the wonders of nature.
Such nature talk reminded our nurse that while en route to our mobile clinic sites this week she came across massive dung trails that our Chadian colleagues assure are from wild elephant herds that roam the region. She tells me that there have also been gorilla sightings. Clearly I need to hurry up and shadow the much-postponed mobile clinic trip this upcoming week and verify myself.
Maybe that’ll be my first good picture :)