Yemen: Welcome to the humanitarian world

Welcome to the world of humanitarian aid, where the sky is way more often tinged with grey than with blue, let alone pink.

Ibrahim is the type of person who always has a kind word for others, a kind of natural warmth that increases when it comes to greeting strangers in his beloved native town of Hajjah. A man with a perfectly trimmed beard, an enchanting smile and a permanent elegance in the way he dresses, he is one year older than me and reminds me of the French actor Rochdy Zem. Ibrahim is Bea's assistant, and accompanies her everywhere, as she meets with various people, partly to provide translation. He is also responsible for regularly keeping us regularly updated with valuable information on the conflict and various security and cultural considerations.

 "Guess who this person is?" he says as I walk into the first office, after greeting my new colleagues. "I guess you're Aida!" I reply, addressing the person in front of me. "Yes! Your assistant! Welcome, Thomas," she replies cheerfully, in perfect English.  "When your face is covered, your eyes and voice prove that you don't have to have a smile on your face to guess what colour it is. We exchange our first words as she lets me choose the furniture I want, but I respond automatically, telling her that I will take whichever is free, not wanting to disrupt her regular way of doing things.  After walking the few steps to the entrance to our MSF building, I see that my new workspace is three meters over, on the right. Rather plain, about 4 x 6 meters in size, it contains our two desks facing the door. They are surrounded by light beige walls and two large windows with a view out onto the hospital courtyard. The natural light is a big plus. I then tour the rest of the building - one small meeting room, one larger room forming an open space where most of the teams are situated, and Bea’s and Ibrahim's office.

Aida offers to have me drop off my luggage in the house where the project’s five "permanent" expats are staying, accompanied by one of them, Shirley, our NAM (Nursing Activity Manager). Originally from Perth, Australia, where my love affair with the international scene began in 2009, our initial conversation brings back sweet memories of the Aussie accent. Shirley has been on the mission for three months, and this is also her first one. She struggled with leaving her husband and three daughters behind on her Pacific island for this experience after a long career in nursing and working on the family farm. If kindness and gentleness had a daughter, she would certainly look like Shirley.

It takes about two minutes to walk through the hospital to get to the house, which will be my commute, four times a day, for the next six months. Al-Jomhori Hospital is located in a square with an outdoor courtyard, in the middle of which there is a fenced-off area with a children's play area that was recently created by UNICEF. The courtyard also includes the parking lot for the two hospital ambulances for which we provide maintenance, along with our MSF Landcruiser.  This is also a central location for transferring and gathering patients and their attendants, all of which results in a space that is rarely quiet, something that is synonymous with safety for all its occupants. Upon seeing the stretchers, I soon realize that I would be at the heart of the action, which is an ideal way to learn about my new living environment, and above all to remind myself, on a daily basis, of the significance of our presence. But, like a shy child peering for the first time into the face of an unfamiliar adult, I don't dare dwell for too long on the patients, preferring to take cover in my discussion with Aida and Shirley. I avert my gaze from this frail old man lying there in the sun. Let's take it easy, as I am reminded that I can count on the fingers of four hands the number of times that I have ever set foot in a hospital in my lifetime.

A few days later I learn about the history of our presence in Al-Jomhori. Built in the 1950s, it is still owned by the Yemeni MoH (Ministry of Health). In 2015, as bombings and war intensify in the country, health care budgets evaporate, depriving all hospital employees of their salaries. Unsurprisingly, even though the need continue to grow, the hospital is completely disorganized and the lack of manpower makes it impossible to cope with the increasing flow of casualties. MSF, which has been working in Yemen for many years, decided to offer to help support the hospital's operations, and we continue to do that to this day. Through the payment of bonuses to its employees, the provision of medical and administrative expertise, the supply of medicines and food, renovations to several buildings, and the purchase and maintenance of equipment, MSF is helping the hospital to continue to exist and to treat more than 5,000 patients per month. From a structure that was severely reduced in 2015, suffering for its very survival, it has been able to move steadily forward, thanks to the crutches and rehabilitation services provided by our teams and, above all, our donors. Hopefully, it will soon be able to operate on its own. Inshallah.

We then cross a steep, rather dark corridor before going up two floors to access a part of the hospital that is under renovation, a project that is being paid for through a United Nations fund. We are now above the maternity ward. Suddenly, there is a brown metal painted to look like imitation wood. "Here we are," Aida informs me, the door in question looking nothing like the entrance to a house.

Upon entering, I come face to face with a small concrete inner courtyard, completely devoid of the slightest sign of greenery, in the heart of which there is a host of giant jumping grasshoppers that seem to have peacefully taken up residence. The courtyard leads to two main gates, which were once the entrances to two separate apartments. The one on the right is to be my bedroom, I am pleased to discover. Small (2.5 x 2 metres), it is what was once the apartment's former kitchen, as the walls covered with white earthenware tiles and bits of pipe sticking out of the wall remind me of. A wooden wardrobe, a carpet with short green pile, a board supported by four legs with a hard mattress make up the single bed, positioned at the foot of the double-winged window with traditional red and gold floral curtains.  This would not be anything special if it did not provide access to an absolutely magnificent view, looking out onto the mountains and the valley, as far as the eye can see, dotted with small villages. I am once again amazed by the beauty of what I see, and glad to know that I will be able to relax my mind simply by standing up on my bed, at least without looking at the lower part of the house, where the scattered garbage stands in stark contrast to the beauty of Mother Nature’s attractions. The rest of the house consists of a relatively clean bathroom with a hot-water shower (what luxury!), toilet and washing machine, plus three other bedrooms. On the other side of the house there are the common living quarters—the dining room with pistachio green walls and the small kitchen, owned by Suria, our cook, who exercises her talents there every day. The living room is quite spacious and contains a number of traditional sofas, arranged along the walls and windows, where I will be spending long hours, comfortably seated. For relaxation, there is a television, a treadmill and an exercise bike with a view to an even more breathtaking panorama than the one in my room.

Following this tour of my new living space, I happily conclude that comfort should not be part of any of the major personal hardships I may encounter over the long term.

I spend the rest of the day meeting with the teams, trying to gain a better understanding of how things work operate in this large hospital, and being briefed, this time much more concretely, such as visiting where we will be hibernating for weeks, if necessary, in the event of a major crisis. It's both reassuring and worrying that this exists, I tell myself.

We have just 22 national staff on the project, which is quite rare and makes this project atypical, far from MSF standards. They are divided among three main departments—medical (doctors, pharmacy, mental health, and infirmary workers), logistics (supply, maintenance, and guards) and administrative (HR and finance, of which I am in charge). More specifically, 230 hospital employees work every day in exchange for the "incentives" that we pay, to enable them to carry out their professions and still be paid. In my job, this is important, not only because we are in charge of making these payments, but also because the relationship with these employees is special, since they are being compensated by MSF but are not subject to our HR processes. The main advantage of this type of project is that we are able to pass on long-term expertise to all these people, and this is something that they will be able to benefit from after we eventually withdraw, which will happen sooner or later. This is always a difficult time, but because of the nature of our organization, which is crisis-related, it is something that is inevitable. Since everything involves prioritizing needs, closing one project down means opening another one up somewhere else in the world.

On the other hand, the downside is precisely that this is not our hospital, and I am quickly being made aware of what that means. Any actions we want to take must be approved by management or the local authorities, and the amount of energy needed to be able to convince them is sometimes huge. In a country at war, your attention and expenditures of energy are more focused on achieving the final victory than on saving the victims who have fallen along the way. And I wonder if the authorities do not sometimes confuse the terms “NGO” and “bank” with a bottomless well. The first signs of frustration appear when, soon enough, I realize that we are not welcomed with open arms because of our willingness to help, as I had naively thought. The challenges are going to be many and I am feeling ready to take them on.

Welcome to the world of humanitarian aid, where the sky is way more often tinged with grey than with blue, let alone pink.