To the Berlin headquarters

On Monday June 3rd I last wrote from Amtiman, Chad. Today is Friday June 7th and I am writing from Paris, France. I’m about to get on the plane for home in Toronto, Canada.

On Monday June 3rd I last wrote from Amtiman, Chad. Today is Friday June 7th and I am writing from Paris, France. I’m about to get on the plane for home in Toronto, Canada.

Amtiman now seems so far away from here in Europe. However, if I think of sand on the ground and heat on my skin, potholes in the dirt road, and a few pieces of garbage on the ground between the expat house and MSF office, I am taken back. Thinking of Amtiman is a powerful, spinning feeling. It’s a bit hard to write since I’m so tired right now. All I can mostly do is sleep and walk around in a bit of a daze. But let me try to write something.

MSF Chad

My tukul in Amtiman on my last day © Raghu Venugopal


On the way out, first the flight was from Amtiman to Abeche. Before Amtiman, the plane had first passed through Tissi and collected our MSF staff on their way out from this humanitarian emergency. They had stories of the difficulties in Tissi, serving the population who had fled in fear for their lives and who had little but what they could literally carry in their hands. As well, some staff were coming into Amtiman from the capital and getting off the plane to stay. On the tiny dusty airstrip we all said hello, goodbye, “bon courage” and thank you.

Papa Gadura, our Chadian head of the drivers, gave me a big hug. Luigi, from Italy, our project coordinator, came to the airstrip to say good-bye. Him and I had worked so closely together in this mission. It was really so incredible to work alongside Luigi and my medical coordinator, Cristina, from Spain on operational issues. This strategic work, alongside seeing many of the toughest patient cases encountered by the medical team, had really made my mission worth it. Ben, our logistician from Germany, was also there, since it is his job to manage the airstrip. I had given him my favorite shirt some months ago when he had said he liked it – what a wonderful man - I had always thought. And yet in minutes, the plane was in the air. It was over.

In the air, I thought about the last few months. Fatigue, exhaustion, satisfaction, and relief. I felt happy to have just survived. I felt just happy just to be alive. My biggest fear had been the heat, the job I had been given and the ill-deserved reputation of some of the local staff. All had turned out to be more or less fine. The heat – it was predictable – and was a struggle all the time, and I never really got used to it. The job I was given – well, I thought I had earned my keep and made some progress alongside the whole team. Lastly, our staff – had almost uniformly been lovely to work alongside. It had been hard on my girlfriend Maeve and I – but we grew stronger apart in some ways too – we decided to get married when I was in Chad. She was alone at home with her dog Daisy when I called from my tukul one night and asked her to marry me. I remember feeling a mix of nervousness and readiness as I paced in the confines of my tukul staring up at the thatched roof covered in dust and cobwebs. Even after Maeve said “yes”, I loved texting her many times “mm” (code for marry me) on my little Nokia cell phone that allowed a little link between us at all times.

On the flight out I sat beside Fabienne, from France. She has been a friend for many years. We had first met when she worked in human resources in the Toronto office of MSF and I served on the Board of Directors of MSF-Canada. Later she was my human resources coordinator in Goma, in eastern Congo. Staying with MSF-Holland these last four missions had meant seeing many old friends in far-flung places, and making new ones too. It is a good feeling. When we got to Abeche, we all spent the night at the MSF-Swiss compound. Those working in Tissi (Martine from Holland and Syed from India) went to the hospital where their sickest patients had been evacuated. They were thrilled to see their patients alive and so happy to see them. We sat in the thick, hot night air very pregnant with the expectant rain, which eventually fell in torrents. Martine, from the MSF-Holland emergency team, shared amazing stories from her many last missions – many of which had criss-crossed mine. She was on her way to Syria next. We all got updates from each other about friends. The mood was light.

I got up the next morning at 05:50. After a quick coffee we were in the air to the capital. In N’djamena I collected my precious passport and caught upon on email. I debriefed with a couple of colleagues, looking back at the lessons learned and way forward. I found a corner of a table and tried in vain to catch up on email. A huge bougainvillea amidst MSF generators and cars in our compound gave me more flowers to press and to give to Maeve. In the night we went to dinner at one of our favorite places – the Cote Jardin. I had just taken a shower but was drenched in sweat again. But the beer was cold at least. It was a good time.

The head of mission, Stefano, from Italy, was at his end of mission and was leaving along with me. We boarded the Air France plane at 11pm and were in the air. It was a good feeling but one of disbelief too. I could not sleep the entire flight and watched a movie instead. When I got to Berlin at 10am I went straight to the MSF-Germany office to debrief. There, again, I met many former colleagues and people who I knew by email and phone, but had never met in person. Christian, from Germany, an an operational manager, along with Adele, from the UK, a humanitarian affairs advisor – along with I – met first. Christian and I had done this before in 2010 after I had worked in the Central African Republic. Since that time I felt I had grown more experienced, more humble and a tad more wise. Catherine, from Canada, working in communications met with me next. Then I met David, from Spain, over logistics; Olivier, from France over human resources; and then two quick unplanned meetings with two people whose names I did not quite catch – but who manage our pools of nurses and midwives.

The Berlin office where our operations are based © Raghu Venugopal


I was wired on about five cups of coffee by the end of the day and had not slept enough in the past three days. But everyone in the office was friendly and welcoming and if felt good to share the experience from the field and hear about how Amtiman and Chad had been in the past. The time in Berlin was well spent.

Dr. Anja, from Germany who I had followed in both Congo and Chad, picked me up from the office. We’re about the same age and have about the same amount of experience in MSF. We sat in the warm German sun and reflected on the last period. She took me to a huge beergarden and we shared a mix of hopes and dreams, frustrations, and relief.

The next day I completed a few smaller meetings and then was asked to speak at the office staff meeting. A map of Chad was projected on the screen and I laid out our operations to the assembled staff from the human resources, finance and administration, fundraising, communications and operational departments. I talked about three patients to outline our operations to the headquarters. All three have been part of this blog. The first was a pregnant woman with triplets, then Ali, a young man with drug-resistant tuberculosis and lastly Mariam, a woman co-infected with both HIV and TB. I used this opportunity to bridge the field with the headquarters and share with our Berlin staff a sense of what makes our work in the field so special and what challenges our patients face. The staff asked friendly questions, and just when they started asking about the Tissi emergency, Stefano arrived from his debriefings in Amsterdam, and shed light on that situation.

It’s time go home. It was nice to debrief in Berlin but I’m longing for Canada. I’m going to see Maeve (and Daisy) very soon. The joy of no curfew, my own bed and the safety and security of Canada awaits. Ones rights and fortunes become crystal clear when you can come back home from the field. It is jarring for me every time. But Amtiman stays on my mind. Maybe I will return one day. I am ready if I am given the chance.

Farewell for now from the house-call….to Chad.