Fieldset
Decoupage

Logistics is full of surprises. Kim blogs from Chad...

I'm part of an impromptu-assembly line, cutting slits into small pieces of paper. I'm the last stop in the line, and after me, the little slips of paper tumble into a small tupperware box. The person before me in line keeps me supplied with small, white rectangles.

We're preparing sample-collection materials for blood testing for a drug-resistance study, but it sure feels like kindergarten arts and crafts time. Not all work here is hard. We're having a blast, making fun of ourselves passing the time at scissorplay.

The 2cm by 3cm rectangles with 4 strips of 1/2 cm by 1 cm will be sent to the rural health centers in a matter of days. There, the Health Care Workers will collect a small drop of blood (from a malaria-positive, consenting patient) on each of the 4 strips, dry the sample, and prepare it for shipment to Bamako for analysis. We're part of an Epicentre study investigating the possibility of resistance or mutation in one of the parasites that causes malaria. MSF has been distributing malaria prophylaxis to the at-risk population in the district of Moissala each rainy season for the past two years. This will be our third year, and Epicentre is repeating its initial resistance study to monitor the response of the parasite. We don't want to breed a superbug.

I figure out that I can cut 3 slips of paper at a time. Things go faster.

These slips of paper are at once highly specific and very non-sophisticated. The lab in Mali has worked extensively to specify the exact weight and density of the filter paper to be used, along with the size of each rectangle, the location of each cut that I'm now carefully completing. All of that specification, and it's being carried out on a Sunday afternoon in sweltering Chad, by a logistician, an epidemiologist, an administrator, and a couple doctors. With scissors.

I try four slips of paper, but my scissors are too dull. I eye the scissors of my neighbor, planning to swipe them when she goes to the bathroom.

The slips of paper have come here from our Paris office (I don't know where the filter paper was manufactured before that), then will spend a couple months in the remote rural health centers of Moissala. After that, we'll collect them and send them off to Ndjamena. The team there will take care of the customs documents necessary to send them to one of finest malaria labs in the world, located in Bamako, Mali. These pieces of paper are pretty well-traveled.

1000 slips of paper later, we're ready for a two-month long study.