Fieldset
An end in sight

The end of my mission is soon at hand. One week to go. I will not miss the horrible smell of plastic and medical waste burning just beside our office. I will not miss the piercing daily sound of children crying as they receive their sleeping sickness medications.

The end of my mission is soon at hand. One week to go. I will not miss the horrible smell of plastic and medical waste burning just beside our office. I will not miss the piercing daily sound of children crying as they receive their sleeping sickness medications. I will not miss the never-ending, relentless drone of the diesel generator twice a day, everyday. I will miss long walks in the woods along a tiny rural road. I will miss that feeling of taking off in the Red Cross plane. Fellow MSFers know it well - once in the air - with some distance between you and this work - you realize it was worth it all.

Thankfully, MSF has found a good replacement for me. An experienced doctor from Austria, with many missions under her belt, will take my place. I have been in contact by email with this new doctor in the past couple of weeks. I've sent her reports, emails and other key documents to give her a chance to come to Maitikoulou aware of the challenges and the opportunities. It is a good feeling to know experienced hands are following you.

No doubt there will be changes made by my replacement to the system that we've set up now to care for sleeping sickness and other patients. But that's good. A fresh set of eyes and new energy is always important in MSF. As for me, I'm tired, I'm looking to go home, I have done all I can. I have done my imperfect best.

There is a lot of change in the air in this bustling sub-base. Finally, a better expat compound is taking shape. Thank goodness the new expats will have better living and working conditions than we have seen here so far.  Maybe in a week, logistics will have finished the common area and the kitchen. I wish it had been there for me to enjoy earlier. It would have made the mission a lot easier. The foundations for a real in-patient facility are also laid, and they're building the walls now. It's gorgeous. It'll sure beat doing patient care out of our urine-smelling, musty tents. You drop your pen in the tents right now and you wash your hands a few extra minutes at the end of the round.

And the medical work, it goes on. Lots of malnutrition, malaria, childhood sepsis, skin and soft tissue infections, traumatic injuries and respiratory illness cases fill the tents. Today I did a training for the staff on the approach to a patient with convulsions, as that is a common and serious problem here. The staff loves any opportunity to learn and interact. At the end of the training, Timothy, one of our nurses' aides asked if I could spare a notebook so he could keep better notes. I'll have to check on that one - maybe we have some small notebooks to spare somewhere in the stock.

Simon our logistician is signing-off on Monday. He's finished his mission after 5 tough months. He has worked hard and long (very often 7 days a week), and today was his last meeting as our team-leader. I gave a long speech to thank him, but also give a thankful nod to the whole logistics team that works with him. The logistics and administration teams in MSF make practicing medicine possible here, in the middle of nowhere in this central African country. It takes a lot more than doctors to deliver good medicine.

I took a long walk to finish today. Usually I take walks with Kathryn, the American nurse, but she's at our base this weekend. It had rained and the air was cool and fresh. One the way back I saw a man walking very slowly, shuffling and wondered what he was up to. As I passed the man, I recognized it was our staff Timothy who was reading what looked like a letter from a far-off relative. I asked him what he was reading. To my surprise, it was the notes he had taken today during the training on convulsions. Hmm, I thought to myself. That sure makes you feel like the effort was worth it that someone would re-read the notes they had taken alone on a lonely small country road in the middle of nowhere, here.

Warm wishes from the Central African Republic,

Raghu Venugopal