Final days and coming home

At the end of nine months working on a project for refugees in Irbid, Jordan, an MSF doctor blogs about coming home...

Heir Island Ferry

There is a rush to leaving.


My end-of-assignment evaluation finished in the last hours of my last working day in the project, after my final Arabic lesson (my teacher was not going to give up on developing my language skills!), but before a final roof-top evening with colleagues and friends from Irbid.

Then I was off to Amman first thing for debriefing meetings with senior colleagues, both medical and logistical.


My work has been so much in the project in Irbid that I still didn’t know my way around the offices in Amman. However, I valued the chance to pause and reflect on my experiences and their relevance to the wider project in Jordan and MSF.

Debriefing took all day. I’d planned to meet up that evening with a colleague, who was going to be in Amman because she worked in two MSF projects. I’d suggested a vegetarian restaurant knowing that, although she is veggie, she’d not been there and the food was great.

I was really honoured and delighted that six further colleagues chose to come down from Irbid and Ramtha to join us. (This meant 3-4 hours driving that day after a full day of work just to share a meal with me; really touching and very special.)

After the meal there wasn’t long before getting a lift to the airport for the overnight flight via Paris to Amsterdam and a further day of debriefing.


I was lucky to have been able to arrange to see more senior colleagues than is normal for a first-assignment returner like myself. Whilst in Amsterdam I was able to enthuse and share my ideas about the importance of three things I had worked on during the project…

Firstly, I spoke about developing Patient Satisfaction Questionnaires as a way to ensure that the patient voice is heard and kept in full focus in a project like this.

Secondly, we discussed how the team could continue to develop our work on measuring the quality of the care we deliver from multiple perspectives.

Finally, we talked about the demonstrated viability of colleagues doing 360-degree evaluations (also known as ‘Multi-Source Feedback’ or ‘MSF’!) of performance involving colleagues in virtually every role throughout the project.

The excitement of the meetings, interspersed with more routine meetings that someone returning home from their first MSF assignment goes to (e.g. with the psychosocial counsellor) kept me engaged, despite the challenge of a night “sleeping” in airports and aeroplanes.


The next day I was booked in to brief the doctor who would be succeeding me in my role in Irbid. We were meeting in London, and I’d chosen travel straight after my briefings in Amsterdam, rather than have another early start for a flight. I arrived at the end of a UK heat wave, and crept, exhausted, to my hotel.

I’d had a few email exchanges with my successor, plus a couple of Skype calls, but we had not met.

I’d done some preparation and an (excessively!) detailed handover document, but was worried about whether I’d planned how to use the six hours that we had together well enough.

In the event, we talked for so long that exceeded the time we had booked in the meeting room, and finished in a quieter corner completing the quiz that I’d designed as part of the handover, to help her to know that she could access all the relevant background documents easily.

It was wonderful to know that the project in Irbid had a new Medical Activities Manager who was so friendly, capable and gifted.

Strange and familiar

It was time to get a train home! It’s a journey that I’m very familiar with as in the past I’d had occasional days at meetings in London.  It felt very odd to be both doing this routine journey, but also coming home after nine months away. This feeling of simultaneous familiarity and looking from outside or from a distance has persisted intermittently since I’ve been home.


Mike Tomson and family at WOMAD

I’ve had a great welcome home, and started off with four wonderful days of family reunion, camping at a festival of world music with my wife and two of our children.

There was space for being embedded in the music, but also space to be and to talk together without the normal routines of life at home (or the routines of MSF life!) The music was great too and it only rained a bit, as a gentle welcome back to the UK for me!

Since I’ve been back

I’ve had a mixture of discussions about my time in Jordan, and it continues to be interesting how this time is seen by others.

From some neighbours who know how long I’ve been away, the questions might as well have been about a two-week holiday in a slightly unusual destination. 

At other times I’ve had an almost forensic exploration of what I was doing and why or how, which have helped deepen my insights into my own experiences.

Personally, I have struggled a bit with people assuming that I’ve been a hero and survived enormous danger - though I know that colleagues who have been in more challenging contexts deserve this praise and respect.

Time to reflect

I have been able to avoid rushing into more work, either in the UK or abroad. It has been really important for me to pause, reflect and digest my time away and the impact it has had on me and my home.  

The two decisions now that I am 60 years old that I have made are that I’ll not return to work doing what I did before I worked in Irbid, and that I’ll arrange life so that there is more time for family and wife than there used to be.

It has been really good to have the support of being in contact with MSF colleagues. Those who were in the field with me have been great at keeping on contact, so I know enough of what is happening in what was my major focus. I have avoided the temptation to suggest things or get involved in the normal challenges of work there.

I’m also still in contact with those who did the pre-departure training week with, and more recently the great crowd that I worked with on our Welcome Back Days (soon, I think, to be called PPR or Post Primary Return).

It was really good to share the common frustrations (about individual and how some senior colleagues managed these difficulties) and the solutions we had all found independently.

Adjusting to home

I’ve filled the space that would have been work time … with manic gardening (it is amazing how much things can grow in nine months and getting light back has been important).

I’m aware that as well as gardening being a bit of occupational therapy, it has been wonderful to be physically active after the desk-based work I did in Jordan. I’ve enjoyed moments of pausing and being mindful of the joys of British wildlife (except the pigeons which have destroyed our cabbages - so currently little love for them!) and having a few days being blown about by the coastal winds.

It has taken me a while to contact old friends.

Pausing and thinking about this, I guess that there are several reasons. It is easier to be in contact with MSF colleagues and my close family, who know about the life I’ve had for the last year.

There is a struggle to know how much others want to know… there is also a fear that their lives have gone on perfectly well without me so why do they need me contacting them?

(More recently I’ve started seeing more people from my old work and other lives, and of course the interest is there and the enthusiasm is there for contact… )

So now I’m fully back, the house has been (largely) reorganised so that changes we both needed are starting to be put in place... and it is time to stop this blog… and start new chapters.