Either it is the guards calling for each other on the VHF radios, or pigs grunting and having a good time rolling in the soil, or the characteristic high-pitched group singing indicating that compensation after a clan fight has been agreed upon, or a cry indicating that a clan fight is starting, or the paradise bird singing, or an airplane landing, or a fellow expat Skypeing or lighting the gas stove. This morning, it was – surprisingly –my alarm clock.
Up I get, make a quick Skype call to a friend in Finland while applying my make-up (a small, rare luxury I refuse to abandon in the field). Take my morning tea to go and join the other expats and the national staff for the weekly staff meeting. We go through security issues, patient numbers and other relevant matters (this morning our acting project coordinator had to clear out a rumor that had been spreading around the staff that MSF would be now leaving Tari because some of our buckets had been stolen from the waste area).
After the meeting all the staff – from nurses to guards to expats to supervisors – put on expired surgical gloves and walk through the hospital compound collecting each piece of rubbish we find. A tradition we repeat every last Friday of the month to keep the hospital clean and to set a good example. After the rubbish picking I run to the office, print and cut out awareness cards, run to the MSF office to pick up our loud hailer and go with two of my counselors to the MSF car where the driver and our surgeon are waiting. We are going to the Tari marketplace to raise awareness about family violence, sexual violence and the services we offer for the survivors in the Family Support Center. This is a usual Friday activity for us since Friday is the main market day and people from all the surrounding villages gather at the marketplace. Today our surgeon is joining us on a rare occasion when she has managed to arrange to leave the hospital compound for an hour or so.
Tari marketplace © Minja Westerlund
People at the market place are curious about us expats. They quickly gather around us when our national staff start talking and presenting MSF. Many smile and wave and probably wonder what these white people are doing there. When our staff come to the point where they mention family and sexual violence, all eyes are suddenly off us expats and focused on the national staff. Facial expressions immediately get serious and people seem to strive to hear everything our national staff are saying. They recognize the problem with the violence. Many are most likely survivors themselves. On Friday afternoons we usually see patients presenting at the Family Support Center that say they come after hearing our awareness raising.
When we head back to the hospital we are – as usual – accompanied in the car by a living, confused looking chicken that our cook has bought for that night’s dinner. Back in the Family Support Center my nurse consults me about a patient who has been brought here by her mother who claims the daughter was raped. The girl herself denies it. Is it because of fear of stigma or was she really not raped? We discuss how to assure the girl about our confidentiality without pressuring her or disrespecting her story. Later I help another nurse to have a counseling session with a man who severely injured his wife after she beat him during an argument. The wife has left her husband and taken the children along with her and refuses to communicate with the husband. The husband is very distressed and anxious.
After lunch I give our new counselors the last part of their training on counseling skills. Today’s topic is mental disorders: what they are, what causes them, how to recognize them. The training triggers interesting discussions about how mental disorders are generally perceived here. It seems that in this area, as in most other places, there is a lot of unfounded fear of psychiatric patients.
We wrap up the day with a peer supervision session with the staff where we discuss tricky counseling cases. Today everybody is tired and the discussion does not flow as it usually does. We keep the session short. Little do the staff know that together with the medical doctor I have organized a small surprise celebration for the last 15 minutes of the day. One of our nurses recently completed a Provided Initiated Counseling and Testing (PICT) training and we will celebrate it with chocolate and salsa dancing (a new favorite in our clinic).
With serious faces, we ask the staff to gather in the office for a meeting. They come and wonder what is up… until we start the music! We dance and have a great time. We also call in the formerly hypnotized expat (see previous blog post) and he comes and shows us some nice salsa pirouettes (is it just me or did I notice someone blushing?). What a superb way to end a hectic work week! A little sweaty from the dancing we close the clinic and go home. Since the Latin rhythms still work their magic on me, I decide to try to convince the expat team to celebrate Friday with a little dance fest after dinner…