Fieldset
A cold morning in Chaman

I can see my every breath. The heat that made sleep impossible not so long ago feels far away. The cold keeps people inside and the number of patients who seek our services has decreased a little bit.

 

I can see my every breath. The heat that made sleep impossible not so long ago feels far away. The cold keeps people inside and the number of patients who seek our services has decreased a little bit.

 

In the ER we see more burn victims than usual because people are trying to keep warm. A completely veiled woman arrives with burns on large parts of her body. We place her behind a screened-off area for women. We are about to examine her but we are not allowed. Her husband is not present and therefore can’t give his permission for us to examine her and remove her burka. She is twisting and turning because of her injuries. A nurse is permitted to place an IV cannula and give her painkillers and fluids while we wait.

 

I have called for female staff from the paediatric ward but they cannot come right away. I have wanted to hire female staff for the ER since day one but it is not culturally appropriate. This woman suffers longer than she would have if she were a man. It is difficult to respect but I unfortunately have to accept it if we want to continue working here. My heart aches.

 

17:52. We can feel the blast all the way to our house and I run out into our courtyard. A cloud that looks like a mushroom is growing in the sky not far from where I stand. The chain of phone calls has started and all off-duty staff are already on their way.

 

When I arrive at the ER there is only one nurse because the others are having their evening prayer. We begin to carry down the boxes. Sixteen casualties arrive before all the staff are there. The objective in a mass casualty is not to prevent chaos: that is an impossible task. The objective is to make the time of chaos as short as possible. To fail to plan is to plan to fail.

 

There is chaos and blood everywhere but we manage to create order. In the middle of everything a small mouse runs over the bloody floor and we laugh and continue to work. Two hours pass and we send eight injured on the difficult journey to Quetta. We treat the others and everything begins to calm down. I declare a stand-down of the incident to allow things to return to normal. We exhale. Ten minutes later, a second blast.

 

As I am writing these words a chill goes through my body. All the windows were blown out exactly like in August. This time we had bomb films on all the windows except three. I was standing below these three windows and all the glass landed on me but in some strange way no one was hurt. No more time to exhale. The blast was the consequence of the bomb squad’s failed attempt to disarm the bomb and it literally blew up in their faces.

 

Another seven injured came in, many of them police. This time the time of chaos is even shorter. The police officers who had previously maintained the calm outside of the entrance now found themselves in another position. They were now the attendants of their injured friends and colleagues. There are weapons everywhere and that elevates the pulse even more. Another three injured begin their journey over the mountain to an operating theatre far away.

 

Everything worked almost as it should and I am extremely proud of my staff and our response. A feeling travels through my body — a feeling that I have found my place in life here. It is a complex feeling and I suspect that many of you do not understand why we all work for Doctors Without Borders, far away from our families and safety.

 

You, who have found your place, cherish it and be happy that you have.