For a handful of dollars

New staff member Jonathan joins the team in Agok, between Sudan and South Sudan for the first time, and learns a useful lesson…

MSF finance manager Jonathan Pernet in Agok, South Sudan

5:30 am, the alarm goes off, but it does not wake me. A small horde of dogs managed that half an hour ago. I get up and get ready quickly, anxious to fly to Agok.

My backpack has been ready since last night, next to the front door of the room where I have spent a good deal of my time since arriving in South Sudan. Precisely fifteen days in fact, because my quarantine ended yesterday, with the results of the PCR test which each person must take before joining the "field".

A one in two chance

The journey is short to Juba Airport. I thank the driver before heading to the airport entrance. Or rather the entrances. Two terminals, which means I have a one in two chances of choosing the wrong one. I'm not the anxious type but for some totally obscure reason, if there's one thing that makes me stressed it's the likelihood of missing a flight. At this moment, I have absolutely no idea where to go, and so I take a step back and scrutinize the other travellers who wear distinctive signs of being NGO staff.

I have a ticket mentioning UNHAS (the United Nations Humanitarian Air Services). I need to figure out which queue to join. At that moment, I hear an airport employee mention my first destination: Rumbek. I am reassured. The likelihood that I'll end up watching my flight leave without me reduces somewhat.

Once inside the airport, I take the time to observe the building. When I first arrived in Juba my only concern was to get out as quickly as possible to find the MSF driver waiting for me. Here as elsewhere, it would be a little strange to want to stroll through an airport once you have reached your destination. However, now I have enough time to tackle this activity, maybe not exciting, but at the very least interesting.

I can't help but compare the organization of the passenger flow to what is familiar to me, especially in Switzerland. The difference is certainly noticeable, but it’s clear that in the end, everyone seems to get where they need to on time.

The journey begins

On the plane, the fatigue from my early morning awakening overtakes my desire to out look at the landscapes. So it’s not the flight to Rumbek that contributes to my memories here. On the other hand, the second flight – from Rumbek to Agok – is much more captivating.

We embark with a colleague from MSF, whom I meet on the tarmac, in a small plane that has barely twenty seats. We quickly realise that we will be the only two passengers on this flight. The attraction of the instrument panel is then far too tempting, and we sit directly behind the pilot and co-pilot.

We take off in less time than it took for the safety briefing, which was as serious as for a long-haul flight. For almost an hour, the scenery almost completely obscures my interest in the maneuvers initiated by the pilots.

The view  from above

As a Swiss person, I am used to mountainous, rocky landscapes; to lakes next to meadows or forests, as green as they are varied. To landscapes which evolve according to our four seasons.

Here, there are two main seasons.

The dry, arid, dusty season whose temperatures can approach fifty - you read that correctly - degrees Celsius. The second season, known as the rainy season, liberates all this nature imprisoned by drought for months. So, the cycle of life accelerates oh so fast! I won’t get to see the rainy season until May, around the end of my assignment. For now, I can contemplate these expanses as far as the eye can see from the air.


The MSF compound in Agok
The MSF compound in Agok

I see paths in this dusty land, which I imagine traced by a various farm teams. Our altitude is low enough to clearly see the details of a panorama that is both lunar, but also composed of patches that remind me of more familiar landscapes. How is it possible that such trees survive such an arid, aggressive climate? It is easy to guess the furrows that rivers have carved during the previous rainy seasons. I imagine that nature, and the people who live here, will be delighted to see rivers emerge again in a few months.


We are approaching our destination. The houses are more and more noticeable. I wonder where will land, as I can’t see any area free of trees, houses or small herds of cattle.

What I would normally think of as a runway is quite different from the airstrip in Agok, but, just as the crowds at the airport seemed disorganised but were nonetheless efficient, we make a smooth landing.

The journey to reach the MSF project seems to take only a few seconds. Certainly my impatience accelerates the course of time somewhat.

As soon as I arrive, I am warmly received with the words “Welcome to Agok Paradise!" Thinking back to my briefings, my first thought is that a paradise seems improbable, but the reception of my new co-workers seems to contradict that!


The MSF compound in Agok
The MSF compound / Le complexe MSF

The MSF compound in Agok includes both the hospital and accommodation for international staff. The compound manager shows me around. Everyone has their own tukul – a building style typical in East Africa. I had read that these buildings are usually round, but ours are square. Regardless, there is everything one could hope for, which is above all a bed surrounded by a mosquito net. I even have a small table and some shelves.

Everything I have observed so far is beyond my expectations. The tour continues and I quickly realize that the term “paradise” could be justified. Not that Agok is full of luxury, but at least the basic needs are met. This is less certain for the neighboring communities, and it is indeed in this desire to provide quality and dignified care that MSF has been here for more than a decade now.

Our living area

As this project has been established here for several years, various living spaces have been set up for the international staff staying in the compound. A "living tukul" furnished with armchairs, a dining room equipped with refrigerators, and showers with running water are enough for me to look ahead for the next six months without too many fears about my comfort.

On the sanitary side, the water is certainly cold and the term “latrine” is more appropriate for our toilets, but the water is drinkable absolutely everywhere and the cold showers are a relief in the heavy heat.

This drinking water is also accessible to residents of the surrounding area directly near the entrance to our project. A first tangible element of support for the people here, whose access to basic necessities is difficult to say the least.

A small handful of dollars

My first steps in my new role are taken together with my predecessor, who is here for a few more days to hand over to me.

One thing that quickly gets my attention is a discussion among several colleagues in the supply management team. It appears that a trader who supplies meat for the meals for hospital patients has decided to increase his prices by a small handful of dollars.

The amount is so insignificant that at first this discussion seems almost laughable to me. Are we that strict on the budget that we negotiate our contracts so hard? Wouldn't it be wiser to dwell on other elements of our common mission here?

My first lesson

This is my first lesson: I quickly come to understand that if the arguments seem to revolve around a handful of dollars, this is not what we are really talking about.

This handful of dollars, even if it could be beneficial for a particular supplier, has the potential to distort the local market, with price increases that might be manageable for an NGO like ours but have repercussions on everyone else for a few kilometers around.  What about the MSF charter which emphasizes helping people, independently, impartially, and neutrally?

Would we be truly neutral if, by operating our hospital, we were, even unintentionally, the triggers of an increase in the prices of consumer goods for some of the inhabitants of the region?

I'm learning that MSF's work here is a bit like being a tightrope walker. Knowing how to stay calm even when stress is (omni) present. Understanding the influence, and sometimes the consequences, of a movement, no matter how small. Keeping a course, a goal while being forced to be patient, sometimes even stopping or backing up for a moment.

The real guarantors of success

International staff like me are here in the project for periods ranging from a few weeks to several months. It’s long and at the same time very short. Long for those close to us who are waiting for us at home. Long for us in the field. But we are only travellers through the life of the people here, which is inscribed in years, in decades.

The majority of the MSF team in Agok are local people. They are the real guarantors of the success of this project over time. International staff like me will only be very short parentheses. We will take our turn. They will stay.

And it is for this reason that the international staff must never forget the impacts - positive as well as negative - that we can have on the community here. We work for the local people, not the other way around - whatever our job titles. On my first day in the project, the example of a handful of dollars to acquire a few goats summed up some of the complexity that the humanitarian sector conceals. But it is ultimately for this that I decided a few months ago to get involved with MSF.

My first day in the field ends. I was lucky to arrive on a Friday. Now is the time to get to know the other Agokians better!


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