Fieldset
Shelter. Water. Vaccination.

Today was a day for spontaneous applause. We achieved a non-food item (NFI) distribution for 25,000 people at KM18, the temporary site in which refugees fleeing the fighting in Blue Nile State, Sudan, have gathered.

Today was a day for spontaneous applause. We achieved a non-food item (NFI) distribution for 25,000 people at KM18, the temporary site in which refugees fleeing the fighting in Blue Nile State, Sudan, have gathered. They had to flee so quickly that they have nothing, just the clothes they stand in. The NFI items included plastic sheeting, a blanket, high-calorie biscuits, soap and a jerry can. Finally they have something to protect them from the rain, something to keep them warm at night, some food to sustain them, something to protect from diarrhoeal diseases and something for collecting drinking water from our water points.

And this brings me onto our next reason for applause, our fantastic water and sanitation team. They have been working so hard to not only maintain clean water supplies at KM18 and Jamam camp but to also search for other potential water sources. This has involved them scouring over satellite imagery I brought with me, visiting countless sites and even re-routing our MSF plane over reservoirs, wells and river beds so we could take photos. And the good news is that not only have they found a potential water source half-way between KM18 and Jamam in which we might be able to set up a refugee camp but they might have also found additional water for Jamam camp so that we could increase the very low daily water supply for the current refugees (5L per person per day which should be 15L). We might even be able to transfer refugees from KM18 to Jamam camp.

And our measles vaccination team got a round of applause for successfully vaccinating all the refugees at KM18 in 4 days. Measles is largely unknown in the West because we have such good vaccination coverage but it’s highly infectious and in refugee settings spreads rapidly due to proximity and vulnerability. It’s soul-destroying to watch children die of a disease that you know is so easily preventable, hence why MSF prioritises measles vaccination in refugee settings.

And even I got a bit of applause. I recruited and trained 43 outreach workers to carry out mortality surveillance. This involved two translators (English to Arabic and Arabic to other languages) but it was remarkably successful. Of course, we won’t really know until the surveillance starts tomorrow but fingers crossed. And none of this would have happened without a field epidemiologist by my side. I’m used to working on my own in outbreaks and emergencies but luckily Sandra has been able to join me much earlier so that I can train her and hand over. It’s been great bouncing ideas off each other and having someone else to support with the workload.

Today we had to visit the cemeteries in Jamam camp to count the graves. This gives us an initial idea of how many people have died in the camp. The last rains were a week ago so we could tell how many graves have been dug since then by the appearance of the soil. It’s a job I dread. I defy anyone not to be affected by the sight of so many tiny graves. Heart-breaking.