When I told people that I was headed overseas with Doctors Without Borders (MSF) I would sometimes get a quizzical look, and the comment: “I know your wife is a pediatric nurse, I didn’t know you were a doctor?”
Yes, MSF is an international organization that provides assistance to populations in distress and MSF’s actions are guided by medical ethics and the principles of independence and impartiality. However, MSF needs more than doctors and nurses to do the work they do in the field. I am a field administrator for MSF.
MSF needs more than doctors and nurses to do the work they do in the field
To give you an idea of what a field administrator does, first, some perspective on how MSF organizes projects in the field. A typical MSF project has three teams led by a project coordinator (known as the 'PC'). The largest and most important is the medical team, made up primarily of doctors and nurses. They are the first thing people think of when MSF comes up. Rightfully so, as they are on the frontline, providing the urgently needed medical care.
The doctors and nurses are supported by two other teams, the first of which is Logistics. The “logs” have the responsibility for the mission’s physical plant (buildings, tents, etc.), security, transportation, and water and sanitation. These are the people that manage the drivers, cooks, cleaners, watchmen, etc. A lot of people think the strength of MSF is the expertise built up over time by the logs. They are real facilitators for getting anything physical done, or supplied to you, in an environment as demanding as South Sudan.
Russ at the project in Aweil. Photo: MSF.
The smallest team is Field Administration, and that is where I work. We take care of the finance and HR administration of the mission. In Aweil, which is in the country’s Greater Bahr El Ghazal region, MSF runs a hospital that is focused on maternity and child care. It is also an outreach to the local population for malaria which plagues the area during the rainy season (June-November).
This is a big operation for MSF; there are over 20 international staff members here (mostly doctors and nurses) and a local staff of around 440. Daily workers are also employed to help with projects and to fill in for employees on leave.
In Field Administration we pay the bills, keep track of the funds, handle all the HR issues, and do the financial and administrative reporting. Also, we are the focal point for pulling together a budget that reflects where the PC wants to drive the project within the larger organizational constraints. I think of it as keeping the back office running so that the medical people can focus on medical care, and the PC can focus on leading the project.
I think of it as keeping the back office running so that the medical people can focus on medical care
Our Field Administration team is five people, me and another member of international staff, plus three South Sudanese employees. As deputy field administrator, I focus on the financial side of things. The field administrator focuses on the HR issues and has overall responsibility for the group. We cross over and support each other.
We use a laptop-based HR/Personnel system, and a financial system that is primarily cash-based (remember single-entry accounting? Kind of like keeping track of a checking account, it's either money coming in, or money going out) with a lot of controls that have been established over time.
This morning, the power went out for half an hour (generator issue) but our laptops were just humming along in the no-lights-or-overhead-fans stuffiness. It's a cost-effective way to provide support in an environment where the infrastructure is unreliable. My back-up power supply is the battery in the laptop, and then our laptops are backed up to a portable hard drive at least once a month. There is a shared drive that the financial and HR system is backed up to every couple of days, but it doesn’t have to be operating for us to do our work.
Flashback: I was working in Manhattan when Hurricane Sandy hit the US East Coast in 2012. Power was knocked out across big swaths of the City. Our office building lost power so we could not occupy it. The UPS (uninterruptible power supply) allowed the IT guys to safely shut down the servers, however our work just stopped, because everything was networked. This morning no one batted and eyelash, the work kept going on, while the logs sorted out the power issue. We are working in a rough place, but with MSF’s years of experience there is the institutional knowledge of getting things done in an efficient way in a demanding environment.