my plans...

Yep. Another set of busy weeks. First off, Claire, if you're reading this, I hope you're feeling much better, and please know that the whole team is concerned about you and hope to see you back soon!

 

So, what sort of things have I been up to? Well, our new surgeon, Claire (from UK) had to be evacuated back to Europe. She'd been here about 4 weeks and got sick. They couldn't figure out what was wrong with her here, so the HoM decided to fly her back to Europe to a 'real' hospital where they can hopefully get her all better. She started getting sick last weekend and then was really bad on Monday. The team all pulled together to take care of her on Monday night. Between that and my two big trucks (maybe 10-tonners) that arrived from Monrovia carrying 400 bags of cement plus nails, steel wire, twisted bar, and other sundry building materials at 2:30AM, we didn't get a lot of sleep to start the week. I'm very happy that my supplies came in (it will help a lot with the clinic to actually have material _on hand_) but the timing wasn't great. I was already pretty bushed from the day (and evening)…in fact, I had just given up hope that the trucks were actually coming, when…trundle trundle trundle here they come through the gate. So Tuesday we sent Claire and Annette (as caretaker) down to Monrovia to see if the MSF hospital in the capital could get her healthy, so I ended up acting PC again for a couple days (busy days!). They ran a bunch of tests but couldn't figure things out and the MSF doctor ended up advising that Claire return to Europe immediately. Much to Claire's displeasure, I imagine, although I wasn't there. She ended up flying to England on Thursday. Get well soon!

 

Compared to the flurry of activity that is medevac'ing, much of the rest of the week seemed benign, and I'm having a hard time remembering what happened the week before last. But, that's only by comparison. In fact, my clinic ("my" clinic) is coming along very well, we've got ¾ of the foundation down, a 250 gallon water tank built, warehouse finished, well dug down to 25 feet (6 more to go), and they're building doorframes and windows. Hopefully we'll have the foundation finished and slab laid down by mid-next week and can start on the walls. That would be really nice. I'd like to get the slab down before the rains start in earnest (another three weeks). I'd also like to get the waste compound underway – sharps, placenta, and burning pits built, plus latrines and maybe an incinerator. And the roof on the existing clinic will need some patching. But I digress…

 

In other news, as I referred to previously, our email died. That was a pain. Then (now) the email computer died. Hopefully I didn't lose all my photos, but they're all on it which is why there's not pictures with this post.

 

Other news from the last two weeks…On Thursday (barring any security incidents) I'll be journeying with Dr. Daniel to Ivory Coast. We (MSF-H) has a project in Danane, which should be about 4 hours away, and when Daniel was in Monrovia for an HIV conference, the medco extended an invitation which, when I heard about, I happily decided to tag along.

 

I'm quite excited about seeing another MSF-H project. I think it'll be really good for me. Hopefully, I'll get to talk with their log and we can share thoughts, ideas, and probably problems…as well as solutions. Also I'd love to get to see how another team operates, really, just see a bit how things work outside of what I know. I imagine that every team and project has its differences and I look forward to getting some new ideas.

 

Also over the course of the last two weeks Daniel and I have decided where we're going on holiday. For those who aren't "in the know" as it were, MSF requires that all expats take holidays every few months to get you out of the project, away from the environment, and generally take a break. Daniel ended up delaying his holiday a bit and it just so happens we can take approximately the same time off.

 

So, come June 11, we'll be headed back to Monrovia. From there, we'll (hopefully) fly to Dakar, Senegal. Then we'll immediately get on a minibus or taxi and take it to the border at Mauritania, where we'll cross and head up the coast and inland, probably as far as Chinguetti. Once we reach Chinguetti, we'll relax and start slowly working our way back down, through Mauritania and ideally fly back out of Dakar around the 24 of June.

 

"Mauritania?" I hear you ask? Yep. Why? I have no idea. Seems like a good idea. Neither of us have ever been there. It's hot, but that's about as much I know about it. Flipping through the Lonely Planet (ca. 2003) looking at chapter after chapter on West African countries I know nothing about, a few jumped out at me…Mali, Guinea Bissau, and Mauritania. Mali was neat just because it would be fun to say I'd been to Timbuktu. But also it's quite touristy, and supposedly a bit pricey. I'm not making much bank with MSF, so cost is an issue…Guinea Bissau just didn't ultimately grab me, so when we were talking about it, Mauritania seemed the best balance: reasonable prices, reasonable distance, and neither of us know anything about it. That sounds to me like a good place for a holiday.

 

What do we know? Well, we know that neither of us speaks any of their languages (Arabic, French, or tribal). We know that it has two seasons: the hot season and the very hot season. We'll be traveling during the "very hot" season.

 

We know that it is home to the longest train in the world. Or, at least, it was 3 years ago. There's an iron ore train that's over 2km long…runs through the middle of the desert, with one passenger car at the end that you can ride in for a small fee. Alternatively, you can ride on the roof for free. That's what we're hoping to do…It may be cold, but I have to imagine in would be damn cool to ride on the roof of a train through the Sahara at night, nothing but the desert around you and the stars above. Unless it rains.

 

Also, there's a holy Islamic city in Mauritania, founded in the 12^th century. There are ruins from the 10^th through 15^th century west African empires. Salt caravans. A huge bird sanctuary (which we may or may not get to…). Probably some people. Oh, and lots of sand.

 

I'm intrigued by the whole thing, in large part because it's so far out of my context, and I really have no idea what to expect. I think it'll be neat. Here's to hoping.

 

BUT, that said, if _anyone_ has some ideas on things we shouldn't miss, or things we should miss, please advise? That'd be true for Dakar as well (we'd like to get a day in there), but especially Mauritania as neither of us have a clue what we're in for. Whee!

 

ciao for now...

taj

Things I've learned in three months.

 

1. It's possible to fall asleep in the back of a Landcruiser on a REALLY bumpy road when driving for 7 hours without bashing the back of my head on the window.
2. You can buy 20 mangoes for about a dollar, when the season is right. But, regardless of the season, a coke costs a dollar.
3. Instant coffee isn't so bad, once you've drunk it every morning for three months.
4. Lentils are good. If you're so inclined, you can easily eat them twice a day. Similarly, pineapple is good three (or more!) times a day.
5. You don't ever "get used to" the heat. What you "get used to" is sweating all the time. After a while, you stop noticing.
6. Trees are dangerous. They bite, you bleed, and then you get infected.
7. Always wash your hands after meeting (and shaking hands with) 30 villagers in the bush.
8. If you stop paying attention, it's easy to wear the same pair of shorts for a full week. Of course, someone else on the team may remind you.
9. It's a bad thing to run out of deodorant in the tropics.
10. Don't pick the bathroom that's furthest from the water tank. Especially if there are 8 expats in the compound. You're practically guaranteed to not finish your shower and end up covered in soap.
11. Germans aren't actually that bad. Usually.
12. Those landcruisers, they're really hard to tip over.
13. Having _two_ spare tires is a good idea.
14. Not all mosquitoes make that nice buzzing noise to let you know they're coming. Some of them, especially those that carry malaria, are notorious for making no noise at all. That's not playing fair, in my book.
15. When cockroaches die, somehow they always end up on their backs. How, I have no idea.
16. Just when you think you have enough bandages, you don't.
17. Just when you think you have enough needles, you don't.
18. You will _never_ have enough ampicillan.
19. Phenobarbitol? Forget it.
20. It's entirely possible to move 100 50kg bags of cement wearing flip-flops. Even if it's raining. But you have to be careful.
21. Apparently, it's possible to play soccer in flip-flops. I haven't learned how, though. It defies physics.
22. Even with a scary-chemical treated bed-net, you will wake up in the morning with bug bites.
23. When it's going to rain, the wind will let you know first, possibly by ripping pieces of roofing off the building.
24. In some bars, it's not so bad to hear the same song seven times. In a row.
25. Every surgeon will inevitably disdain whatever the previous surgeon thought was required to get the job done. They will need something else. Probably something you can't get.
26. Just because you're both speaking English does not mean you will understand each other. You may, in fact, have an easier time understanding each other if you're speaking different languages.
27. It's easy to carry a goat by its hind legs. Not so easy by its front legs. And don't ever try to carry a goat by its tail.
28. If you don't watch the construction yourself, you're asking for it to be done wrong.
29. All UN compounds have satellite television. Lucky buggers.
30. If ever anyone runs out of anything – whether that be drugs, electricity, water, seating, food, etc. – their solution is to ask the logistician. Apparently.
31. If you want to get a ride in the helicopter, you'll need to break your leg.
32. You probably won't get to ride in the tank. Even if you ask nice.
33. If you buy 50 pens, your odds are about fifty-fifty that one of them will last more than an hour.
34. Always carry toilet paper in your bag. Then, don't forget to carry your bag.
35. ALWAYS ride in the first vehicle in the convoy if you're traveling on dusty roads.
36. And, most importantly, stay relaxed, don't stress out unnecessarily, and have a good time whatever you're doing.

...and we're back!

Hi all-

Just to let you know, I've been without any access to internet for, oh, since the last time I posted. Our satellite service died.

I've got actually quite a backlog of email in the last week and a half, please bear with me while I try to get through it.

 

Not so much feedback on the dancing, I see...I expected more pithy comments from everyone!

 

ciao

taj

ramblings of a workin' man

I just realized it’s been about 2 weeks since I’ve posted anything here. Huh. I just think maybe I’m not cut out for this type of journaling, at least not while I’m here. I’ll try to post every two weeks max, but I think the odds of posting every day (every other day, every week) may be slim.

In part I’m crediting this to the fact that the ‘new-ness’ has worn off a bit. Things feel remarkably normal for me now, and as such I don’t find I have as much to comment on – that gloss of difference for me is much diminished.

The Happy Spot…Stopped here for cold soft drinks, stopped nearby for bush meat out of a, well, vat. The bush meat didn’t turn out so good on the picture, so you get to see the Happy Spot. The owner was quite proud of her new establishment, and when asked about the name, she said, “Liberia is rebuilding! Jobs are coming back! Things are looking up! Why not the Happy Spot?” Fair enough!

I’m definitely busy, there’s a whole ton of stuff to do, but a lot of it’s work – and I try not to focus too much on it when I’m supposed to be “off” (like now). Plusses in work in the last couple weeks:
o No new massive cholera outbreaks
o No major car (“mobile”) troubles
o We’ve got water
o We’ve got electricity
o Construction of the clinic is proceeding well in hand (foundation trench completed, warehouse almost done, foundation to be poured next week!) (pictured: guys working on the warehouse
o We received a big drug shipment which means we’re not in rupture for a lot of medical items


Minuses? Yeah, a few of those:
o Small mobile trouble which left me on the side of the road in the bush. (hidden plus: I got to spend a night in Monrovia and have PIZZA! Yeah!)
o Still having ruptures in some medical items.
o 4M report is due May 5th … blech
o Found out the construction on the annex for SGBV leaks like a sieve…which is not good since the rains will be starting soon. I’m going to have to rebuild the whole thing.
o Also found out that the ‘examination tables’ that we requested be built were in fact built as…dining room tables. Which just isn’t that helpful for the midwife.

In twelve days, I’ll have been working for MSF for 3 months. Yikes!

We had kittens. Four of ‘em. We haven’t named them yet, but I think they should be: Gertrude, Bessie, Esther, and Matt Damon. We watched the Bourne Supremacy the night the kittens were born.

Got to play Settlers of Cataan the other night. That was really nice. I’ve been feeling a bit restless in the evenings after dinner. I’m trying not to go back to work once dinner is over, which then leaves me sort of milling about. On Wednesday we played settlers (Christian, Susanne and myself)) and it was a really nice way to unwind at the end of the day. The alternative is usually to go into one’s room by oneself and read or what-not, or sit on the front stoop and have a drink, or go to town and sit and have a drink. Since it would be really nice not to come back an alcoholic, I’m limiting myself to one night a week (beer). Of course, this means I’m becoming addicted to soft drink.

Let’s see…last week I got stuck in the bush. Yeppers. We were heading down to Kakata to buy some special bricks for this incinerator I’m building and had purchased our bricks and were headed back (it’s about a 4-5 hours drive). Driving along minding our own business when Yaah (the mobile) just up and stops. Huh. So we’re out and poking around, trying to figure out what the problem is.
The Landcruisers we use have two tanks for diesel. Front tank and rear tank. Each holds 90L. If you ask the drivers who have experience, they say this is from during the war. It seems it was quite common for rebels to ram your truck to damage the fuel tank so that you would run out of gas and then they could take what they wanted from you. With one tank up front, even if they damaged your rear tank you could still get away. Also for this reason, we’re always supposed to use the rear tank first, then switch to the front one when it’s empty.

We had known full well that the front tank was going to be empty for the trip back, but we should only use about half the rear tank – plenty to spare.

Well, except for one pesky fact: the rear tank didn’t work. Try as we might, we couldn’t get the engine to take diesel from the rear tank. We must have fiddled around with the damn thing for an hour before finally throwing up our hands and calling for rescue. All we needed to keep moving was a three foot length of tubing to siphon from the rear tank to the front. Could we find one? Nope. Not in any neighboring villages, not in the nearby refugee camp, nada. So we had to wait. And wait. And wait. Oh, yeah – and it was raining. Of course.

But, in the end, we made it to Monrovia by 2130, I spent the next day in Monrovia while Yaah was repaired (serious leak in the fuel tank combined with faulty relay for engaging the rear tank pump). And, the next evening, I got to have PIZZA! And it was GOOD! And I was EXCITED! about that. The pizza appropriately balanced the fact that I had to wear the same clothes for three days in a row.

Last weekend we went back to the mines in Yekepa so that our visitors (Christian – Head of Mission, and Anne – Procurement Officer for Liberia from Amsterdam) could get a bit of the great outdoors under their belts. It’s still nice, and this time I’m going to include some pictures here (I hope – if blogger and my pokey internet connection let me). It’s quite neat, and it was nice to get out and stretch our legs. However, I think I’m going to take a few weeks off from the mines – I’ve now been there twice in a month, and it’s nice and all but not _that_ nice. It’s a pleasant walk, and not too hard a drive, but there’s not so much to see that I need to go too many more times.

For the most part, since the newness has worn off, things are becoming a bit status quo, honestly. I’ve yet to figure out how to schedule my day, really, but it’s getting better. I’ve just accepted the fact that the first two hours of my day will be spent in chaos control as we try to get all the mobiles out to their various locations…including drug supplies, expats, national staff, patients, and other cargoes. The balance of my day tends to be spent putting out fires, which I don’t especially like but am slowly working on shifting to PROACTIVELY taking care of situations and not waiting for them to become emergencies…a chronic problem here. It means shifting an awful lot of how we (MSF staff, both national and expat) plan…or not, as is usually the case.

I’m struggling with my evenings a bit, as far as what to do with my time. By and large, once dinner is over the team sort of spreads off to their own activities. Which is perfectly reasonable, especially given the length of the day and the intensity of the activities we find ourselves in. For me, who (some of you may be surprised by this, but it’s true) is quite a social person, I do find it hard at times. I just need to get a little more motivated and organized, and come up with some solo activities that work for me. I think it’s especially hard as the logistician – I pretty much stay on base and don’t see many people all day, particularly the expats. The hospital staff are inundated with people all day and just need a break when they get back. It was really nice to play Settlers the other night, and I’ve been watching movies on occasion, and of course my old stand-by: reading; but I am also working on finding some ‘constructive’ activities to engage in if I’m by myself. Haven’t figured out which, yet, but I’ll get there. Any ideas would be welcome.

Last minute addition: Yesterday (Sunday) we made another day-trip. We went to a waterfall near Gbedin, about 45 minutes south-west of us. I was a little hesitant, after the last journey I made to a waterfall (near duotiayee) not only wasn’t much of a waterfall (small brook, really) but also as I got so dehydrated by the walk that I couldn’t eat anything or drink anything for 2 days except for Oral Re-hydration Salts – which, trust me, aren’t that tasty. Any time I tried to drink water or eat anything, it would just come right back up again. Whee!

But, in this case, it was about 1.5 hours each way, and on Saturday we had gotten quite some rain. And the waterfall was an _actual_ waterfall, not a tiny facsimile thereof. It was quite a nice hike (walk), although it was still bloody hot and humid, and I still managed to be dehydrated, just not so badly as the previous time. Pictured here: Beryl in front of the waterfall. We had two (three) guides who were quite nice and did a good job finding the place. I understand that the expats had tried to find this waterfall once before but ended up with unreliable guides…which meant they walked around in the bush for 4 hours.

A neat sight: people making cane juice in the bush. They’ve got these whole setups going there…some of them have motors, but mostly they’re hand-pushed cane mills that squish the sugar cane to get the juice. Then they boil the juice and distill it into something that’s an awful lot like really raw rum. Actually, it probably is raw rum. And it’s good.

I’ve found I quite like it, except for the smell. If you mix it in a drink and don’t take a big whiff before you try, it’s quite good. If you take a smell first, well, then it maybe doesn’t seem so good.

If anyone has any ideas on where I should go for my first holiday (coming up in May or June) in East Africa…please tell me! I have not a clue about most of this part of the world, so I don’t really have any ideas as to what I may want to do or go see…

Ciao for now…if anybody has any requests on topics they’d like me to expound upon, please advise…
taj

Watch me dance!

OK, I'll admit that it's not the most graceful dance I've ever done,
but I don't feel too bad about it. The backpack was really heavy and
awkward, and there were 500 people watching, so I think I did pretty
good!
Also, I think my dance was better at the beginning, before the camera
started rolling. Ah, well...

Thanks to Christian, my head of mission, for putting it up on the web.

This is from my first visit to Lugbeye with the two head-of-missions
and the goat.

So...drum roll please...and...watch me dance!
YouTube