As well as the hospital in Shamwana, MSF supports six outreach health centres around the area, with a seventh opening imminently. Each health centre receives a monthly supply of medicines and has a ‘pharmacist’ present responsible for ordering and dispensing to the patients. As the expat pharmacist I have a role in supervising the pharmacy operation in each health centre, through close collaboration with the outreach team.
The first challenge I encountered in this role was actually getting to the centres. The first one I visited is a three hour drive away, meaning to spend any meaningful time there an overnight stay is required. For the first time since I’ve been here it also happened that I would be the only expat travelling in the car, which was no problem until I realised that made me “security responsible”; the main duties of this role are to maintain radio communications with the base and update them of our progress and situation on the road.
Calling it a road is being generous, the drivers do an amazing job, negotiating the huge ruts and crevasses, balancing the car perfectly over narrow log bridges, creeping slowly up steep inclines. In the dry season progress is ok, but once the rains come the job is even harder. For starters each movement needs two cars so that when you inevitably get stuck you have someone to pull you out.
I had a briefing from the project coordinator on radio use, when to call, the basics of what to say etc, and I felt reasonably happy. The first time I had to check-in I instantly forgot everything. I rehearsed in my head exactly what I needed to say, but as soon as I pressed the button to speak my mind went completely blank. My improving, but still very limited, grasp of French didn’t help matters.
We stopped for a comfort break at one stage and I announced to the base our distance from the base and that everything was ok, the guys then told me to say ‘escale’. This confused me no end – all I could think of was escalader, to climb, but we weren’t on a hill. When we got going again everyone was then looking at me, before the driver eventually thrust me the radio – I had no idea what I was meant to be reporting!! I later found out that out escale means stop and I’d forgotten to let the base know we were back on the move again.
As we got further away from Shamwana we switched to the less familiar HF radio. This created another problem. Every hour we update the radio room on our distance travelled. I called and informed them we’d made it 17km. The reply I got was ‘Too far! Too far!’ Again this confused me no end. We’d only been going for an hour, how can we be too far from the base?! I repeated my message, thinking maybe I’d misunderstood.
The reply again came back ‘TOO FAR’! I looked around the car for some help, the team were finding my radio shortcomings quite funny. After a good chuckle the driver came to my rescue and completed the call. It turned out that we weren’t too far from the base, but that I was in fact holding the radio too far from my mouth and they couldn’t hear what I was saying. I sank back into my seat and began counting down the next 60 minutes til the next dreaded check-in.
The scenery we were driving through was truly stunning. It was a shame I was so preoccupied with the radio that I didn’t completely appreciate it. We passed through thick forests, accompanied by the loud buzz of whatever bugs were living there, we came across several small villages full of kids fascinated by the ‘mzungu*’ driving through. The road weaved around huge hills, with some breathtaking panoramic views. The only traffic we encountered were bicycles overloaded with wooden planks, charcoal and giant cooking pots.
After a couple more successful calls we made it to our destination. This was unfortunately not to be the end of my radio woes.
The time spent at the health centre was very productive. I spent most of the time in the pharmacy helping to prepare the monthly order and working together to improve their dispensing practices.
The following morning I sat in on consultations with the lead nurse, reviewing their prescribing and advising where I could. About half way through the morning I nipped out to the car to grab something from my bag. Big mistake. I opened the passenger door and as I reached for my bag I heard: “T75 for the base”. Our car was number 75. I knew there was also a 74 and a 71 – maybe I’d misheard. Again, “T75 for the base”.
I anxiously looked around, no one was in sight. I responded and was then met with: “Sierra Tango”. I had no clue. I asked them to repeat. The project coordinator hadn’t mentioned Sierra Tango in her briefing. Sure enough, Sierra Tango came back at me again.
I paused, hoping for a moment of inspiration. It was so clear I couldn’t possibly ask them to repeat it again, could I? The third time they repeated the request it was slightly louder and slower, they obviously knew it was the new recruit on the other end with no idea what was going on. I managed to get the attention of someone inside who took great pleasure in explaining to me Sierra Tango is the routine situation check-in, and the response is easy… Oscar Kilo… everything is ok.
The whole team were in stiches when they finally appeared from wherever they’d been hiding in my moment of need.
The journey back was ok thankfully. The radio operator at the base was waiting to greet me – he’d been laughing just as much as the guys in the car. I’m looking forward to my next outreach visit, hopefully without any radio worries.
*mzungi is Swahili for foreigner