Day 30 - leaving South Sudan

Randra or Suby? The team are trying to decide what acronym they should use for me and Sandra, along the lines of Brangelina and Tomkat. Sandra and I have been inseparable. We work together, we share the same tent, we’re basically with each other 24/7.

Randra or Suby? The team are trying to decide what acronym they should use for me and Sandra, along the lines of Brangelina and Tomkat. Sandra and I have been inseparable. We work together, we share the same tent, we’re basically with each other 24/7. I find myself looking for her when she’s not around. And I’m going to miss her now that I’m leaving. It’s been great working with her. She cares about the refugees and our outreach teams just as much as me. She could discuss the challenges, debate the limitations and problem-solve our activities and although we have very different styles (she’s much more patient, gentle and diplomatic than me), I think our combination worked well for our outreach workers too. I feel a bit out of sorts.

Leaving a mission is always hard but this is particularly difficult. There’s so much more to do. This crisis is far from over. We’re just starting to scratch the surface of the true extent of health morbidities in this population, we’re starting to identify patients before its too late and we’re catching patients before they drop out of our programmes. But there’s still more that we could do.

We had to remove the pregnant women component of the MUAC surveillance due to the staff strike. We still need to investigate the main diseases affecting this population and we need to do more qualitative research (semi-structured interviews, focus groups and non-participant observation) to understand the refugees’ attitudes, perceptions and behaviours around water and hygiene. So maybe it’s appropriate that my boss is coming to replace me. I am joking with Tara, the emergency coordinator, also leaving the mission (and with whom I would work again in a heartbeat), about how we’re both being replaced by our bosses. Clearly we’ve set the bar so high only the highest level of MSF is qualified to take over (ignoring the fact that it’s the summer so finding staff is a lot more difficult!). But Phil is an infectious disease expert with years of field experience in MSF. I’m relieved to be handing the project over to someone that can move it on to the next level.

And I leave behind a team of fantastic people. The large Kenyan contingent like Johnstone the WatSan technician and all-round flirt, Janet the shy midwife, Soloman and Steven the supply logisticians that never complained about my demands and Peter my favourite OPD nurse who never looked phased when we brought in lots of patients from the camp and always prioritised their care. And the Sierre Leone posy; Daniel the outreach nurse that would travel through hell and high water to get to his patients, John the passionate nutrition nurse who was just as determined as us to trace every defaulter from the nutrition programme to ensure they were not forgotten and Sheik, the medical team leader with a gentle but determined approach who has been without his luggage for almost a month and hasn’t complained once. And the rest of the team; Richard, Andrew, Neil and Robin, the dependable logisticians; Estoban and Joachim, the coordinators that I last met in Haiti, shortly after the devastating earthquake of January 2010; Laura, Sabrina, Katherine and Erna, the medical staff that care about every patient. And Martha, Matt and Rink, our formidable WatSan team, still battling to supply enough water to the camp.

I put my bags in the car and suddenly Jilail appears at my shoulder. Jilail is the eldest of the Outreach team and I’ve always looked out for him, worried that all this walking might be too much for him, making sure his team support him. He lost six members of his family in the Blue Nile bombings. Six. I think he’s telling me to hurry back, in his quiet gentle way. I don’t know how to tell him I’m not coming back so I nod OK and quickly turn away. A huge lump in my throat.

And as our car pulls away Vanessa, our medical coordinator, suddenly appears, running after the car. I feel the most guilt about leaving her. I’ve known her remotely for a few years, supporting her from my office desk in London. But this is the first time we’ve worked alongside each other and I’ve loved watching this dynamic woman motivate her teams, having advice and an opinion on everything. We have used each other as sounding boards, bouncing ideas off each other to address the health needs of this population. It’s a bad time to leave but she gives me the biggest hug and I know I’m forgiven.

And then I see Rink, our star WatSan technician, running after the car. We arrived together. He was the one that re-routed the MSF plane over river beds and unused runways, igniting the adrenalin in all of us for our important missions. We became fast friends and I’m sad that I might never see him again. And then Anur comes running after the car, one of our lovely translators. We’ve decided to make him and Timoty outreach supervisors. They’ve accompanied me and Sandra every step of the way and know exactly what needs to be done to maintain a robust community surveillance system. The project is in safe hands until Phil arrives. And hopefully the small increase in salary means they can go back and complete college one day.

I’m now a blubbering wreck and the journalists and other expats leaving the mission are tired of stopping the car, keen to get out of this camp. But I see it differently. As we drive away in the morning light I only see the beauty of the Ingassana, a proud mountain people suddenly finding themselves living in a swamp. The change must be such a shock, but they are stoic, and determined to survive this hideous chapter in their lives.

And our MSF team, living beside them, demanding that their voices are heard, and doing what we do best, mounting a response in that critical early phase of an emergency while others debate what to do and providing medical care to people at their most vulnerable. I can’t think of anything more worthy.

MSF plane

The MSF plane Photo ©Ruby Siddiqui/MSF