Mali: MSF maintains its presence in Timbuktu

This is a press release issued yesterday by MSF to Agence France-Presse, concerning the project on which I am working:

Date Published: 12/07/2012 10:15
A Médecins Sans Frontières/Doctors Without Borders (MSF) team is providing health care in Timbuktu despite the destabilising, ongoing violence in the north of the country which has displaced thousands in recent months.
Since the beginning of April, Timbuktu has been in the hands of Tuareg rebels and armed Islamist groups. The city is the scene of pillaging and has rapidly lost a large share of its population: two-thirds of its approximately 40,000 inhabitants have fled toward other regions of Mali, or to neighbouring countries.

Health centres pillaged

An armed rebellion took hold of northern Mali in early 2012, leading to the displacement of large groups of people. © Foura Sassou Madi/MSF

In the surrounding villages, some health centres have been pillaged. Since then, a latent tension has pervaded the city. Sporadic fighting has flared up among armed groups and, recently, sacred sites around the city have been destroyed.
“Bringing aid to this destabilised region is a challenge, but it’s also a necessity,” says Dr Mego Terzian, MSF Emergency Desk Manager.
“The instability impedes the access of humanitarians, and the north of Mali remains blocked to westerners. Nonetheless, because the situation remains volatile and could deteriorate at any time, we are maintaining our presence in Timbuktu’s hospital and in the surrounding villages.”
MSF is one of the few humanitarian organisations present in the region. Five expat volunteers along with the remaining local staff are providing medical care in the city hospital’s departments of paediatrics, medicine, gynaecology and, since mid-May, in the department of surgery.

Fuel shortages

Like the city's inhabitants, some of the medical personnel have fled, and those who remain are not paid regularly. Sporadic fuel shortages disrupt the supply of water and electricity, which in turn impedes the hospital’s operations.
Furthermore, the hospital lacks medicines. In two months, more than 300 patients have been admitted to the hospital and over 1,500 consultations have been performed by our teams.
In recent days, restrictions have been placed on vehicle movement within Timbuktu as well as movement out of the city. Nonetheless, MSF teams continue to provide medical care in Niafounké, Goundam, and Gourma-Rharous outside of the city, and limit medical referrals to the Timbuktu hospital.

Malnutrition

Over the past two months, more than 6,300 consultations have been performed. The primary diseases observed are respiratory infections, diarrhoea, and skin conditions, often related to a lack of water and poor sanitary conditions. 
MSF teams are also paying close attention to the nutritional situation since they have observed pockets of malnutrition in the region. Malnutrition is a chronic problem, and one that becomes more critical each year at the onset of the “hunger gap” – the lean period that falls between two harvests.
Nearly 800 malnourished children have already been treated by MSF. However, due to the security situation, which is having a detrimental effect on the economy, the nutritional crisis is in the region is likely to become worse.
MSF is also working in the country's south. Teams are providing nutritional treatment and pediatric care in five health centers and in the Koutiala hospital.

Bamako

Things are good in Bamako.

The budget for our project has been submitted and reviewed in Paris.  Most of the accounting has been entered, up through the 27 June.  I have developed my expense follow-up template.  Our employees are entered into the database, and they were paid for the month. We are getting the expatriates we need for the program.  And we have made a proposition for additional staffing to improve the medical care for our patients and are now negotiating with headquarters for the approval to hire them..

But the situation in northern Mali is still tense.  The Ansar Dine and the Mujao, the more extreme factions in the occupation of the north, have taken control from the Touaregs of all the main cities, including Gao and Timbuktu.  The Malian government, which is still in a transitory stage after the latest coup, is not in a good position now to try to recover the north.  The Ramadan fasting period starts in a couple of weeks, and we are watching to see if anything will happen before that.

Mali has been, until recently, a very touristic country, but with the current troubles this important source of income has dried up.  Hotels and restaurants which were thriving before are now closed.  This reduction in income, as well as the conflict and the instability in the government, are making it very hard on the population, both north and south.

The hospital in which we are working in Timbuktu is functioning, but we are currently not going out to our ambulatory sites because of the insecurity.  This hospital and two other health centers are running because we can provide the drugs necessary and can pay the staff, most of whom are no longer receiving salaries from the Malian health system.   Insecurity is rife.  Vehicles are frequently requisitioned, including one which was carrying one of our staff – he was left alone, but he lost all his luggage and papers which were in the car.  We are still able to move people and medical supplies, but only with extreme caution and careful planning.

Bamako is calm and very wet.  The rainy season has started, and it rains some nearly every day.  Last weekend it poured!  I spent my Sunday afternoon in the Mali National Museum.  It is in the national park, which is beautiful.  They have some interesting artefacts, including some incredible wooden carvings.  There is also a very interesting exhibition of Malian textiles.   

The park is old, so there are some big trees there, but apparently it was in ruins until recently.  It was restored in the last few years.  It is adjacent to the zoo, which is closed now for extensive renovation, to make a better living environment for its inhabitants.

Saturday, I took a long walk of about 3 hours round trip.  We are on one extremity of the city - I did not make it into the center.  But it was good.  I get a better feel of a place on foot than in a car.   It was a good experience, and I will be doing it again.   

Over the last couple of weeks I have been into town quite a bit, to set up flights, get visas, and take care of other business.  I am getting a better feel of the city.  Bamako straddles the Niger River, with 3 bridges linking the 2 sides.  There are a few big streets to get around, but the traffic in the center of town in incredible – cars, trucks, minibus taxis, motorbikes, pushcarts, horses, donkeys, and more.  We don’t drive here – as in most places where we work.  We use either the MSF cars and drivers, or taxis already qualified by the logistics group.  Moto-taxis are forbidden to us. Arghhhhh.

I went to a bar for a beer one evening this past week.  Like a lot of African bars, it is in a courtyard with an enclosed building, but most of the bar is roofed, open sections of the courtyard.  This set up is really agreeable.  I was sitting at the outside bar when the owner came in.  He is a great fellow.  He offered me a beer, and I think it surprised him when I afterwards offered him and his 2 employees something to drink.  We talked for a while.  And before I left he offered me 2 bronze statues, each about 3 inches high, a man and a woman.  I was really surprised.  He says he has thousands of them, but I was still touched by his gesture.  From what I have seen so far, this generosity is typical of the Malians.

Mali is known for its music.  It is a very vital part of the western Africa music scene.  This very bar I mentioned has live music 3-4 times a week.  I hope to go one evening soon.  But the music starts late, and I get up early.  I will have to find a way to have the experience without upsetting my work schedule.

A car just arrived from our regular program in the south, bringing back our chef de mission and assistant medical coordinator who were consulting with the team there last week.  I missed them – it is good to have them back.  And to my surprise, two of my old colleagues from previous projects arrived in the car also – a logistician from Congo-DRC and a doctor from Ivory Coast.  It is great to catch up with both of them again.  The logistician is going home on break, and the doctor is going for briefings in Paris.  I have two more former colleagues working in the regular programs here that I have not yet seen. 

The only frustrating part of my time here is that I cannot go to our project, because of a fear of kidnappings of whites$$$.  Working at a distance complicates things a lot.  But all in all, I am really pleased to be here.  I am happy that we can provide health care to the population of Timbuktu and the surrounding area, who would have no access to it if we were not there.  And I enjoy my life here in Bamako.   

For those of you following this blog, you probably remember that this is my first assignment in a 1-year contract with the Emergency Pool of Médecins Sans Frontières (Doctors Without Borders) – French section.  It is a whole new ballgame as compared to the “regular”, longer term projects in which I have worked.  I have now been here for a month, and will be here at least one more month.  Then, who knows?  Maybe more time here, maybe some other hotspot in the world.  All depends on the situation of the world.  And with the world as it is, I am pretty sure to have a job in the humanitarian field for a long time.

Now in Mali

I arrived in Mali a week ago, and I have been pretty busy since arriving.

My first big task has been to take the budget which was developed by my predecessor (hurray!) and update it with the newest info, then to transpose this budget into another format, breaking down the figures into 7 activities.  I just sent the results off this evening.  It is usually tough to try to understand someone else’s work, but the lady before me was crystal clear in her explanations.  It still took 1 week though; seeing how there were day-to-day activities to perform at the same time.

Next week, I must get the emergency program employees into the human resources database along with the correct salary scales, and also assign them to the correct activity within the program.

The staff here is great – both the expatriates and the national staff.  I have worked with a few of the expatriates before elsewhere.

I have been into the center of Bamako a couple of times for work, but have not yet had time to wander around our immediate area.  I live in the house which is just above the office.  Last Saturday, just after I arrived, we were invited to dinner at the house of the Belgian section of MSF, which is really close to our place.  I buy bread for the house every morning in a kiosk about 10 yards/meters from our front gate.  There is a great grocery store a 5 minute walk from the house.  And apparently there are some bars and restaurants in the same area. 

On Monday evening, I noticed that the place just across the street from us had a sign for Flag beer outside.  I asked if that bar was open, and one of the drivers told me yes, 24 hours a day.  This seemed kind of strange, but I decided to give it a try.  I went with a lady who had also just arrived.  We were on the terrace and the place was pretty dark – only light from the TV.  Then we noticed that there were a LOT of women standing around.  We finally figured out that it is a brothel.  What the hell.  The waiter was pretty funny, and we drank our 66cl beers without being hassled.  I went back a couple of evenings ago, without the lady, and one of the women DID ask me if I was going to reserve a room.  I told her I was there only to drink a beer and she left me alone, although she stayed at my table and pouted because I didn’t offer her anything.  I will probably go back, now that they have gotten used to me.

Bamako is a really nice city.  It is very green with a lot of trees lining the streets and in the house compounds.  I am looking forward to getting to know it better.  Next Sunday, I hope I will have time to walk around some, in safe areas, of course.   

Next stop: Mali

I just got the news. I will be going to Mali for a couple of months.

I go first to Paris to get to know the emergency coordination (I know most of the team, but now I will be working with them) and train on some of their tools. I go Monday morning 4 June, going down to Bordeaux for the day Thursday and returning to Paris for Friday. Then I leave for Mali directly from Paris Saturday 9 June. I will be replacing someone I know there. There are quite a few people working there that I also know from previous assignments. We already had a program there, but in March, a couple of rebel groups took over the north of the country to set up a sharia law state. This means that there are quite a few displaced people and no functioning medical system in place, so we are providing medical aid to those people. Mali is already over 90% muslim, but of a moderate persuasion. Right now, the 2 rebel groups are arguing over what interpretation of sharia law to install. The one of them wants the stricter form. Here is a news report on the situation: http://www.youtube.com/watch?v=WdDOJzXGdig. I will not be able to visit the project itself - no whites allowed by MSF up north for security reasons. I will be staying in the capital of Bamako, working from there with the project in Timbuktu. For now, I should be staying 2 months - it could be more, it could be less. I just found out Wednesday evening, so I am now running around getting my papers in order, booking my train to Paris, doing laundry, arranging for my mail to be forwarded to MSF in Paris, packing my bag, and preparing to close up the apartment again. I’m happy! After 1 month of vacation, I was starting to get bored.

In Lyon

Our human relations policy changes went down very well. We succeeded to announce the changes to all the sites and the reactions were positive. Then we had about 10 days to get the new contracts prepared and signed, and everything else implemented into the rules and regulations, the personnel database, and the payroll calculations. It was speed, but it worked. We got everything entered, including a lot of changes for each employee in the data base as well as the general parameters. And the payroll was prepared and sent to their accounts on time. I had 1 error I had to correct in the payroll calculation, and this was done the weekend just before I left Nigeria. So I think I left everything complete for the guy who replaced me. I also prepared a 24 page handover report for his, since he was not arriving before I left.

My going away party was the Friday evening before my Tuesday departure. It was a lot of fun, and by chance, we had representatives from all of the projects there. They all had some presentations to make which were kind, funny and very sweet. I received an aquarelle portrait of myself as a going away gift! Not exactly the easiest thing to carry home – it is pretty big – but it worked. I arrived in Paris for debriefings on the evening of 1st of May – Labor Day in Europe. I really felt back in France arriving at Place Bastille just as all of the labor union manifestations were showing up there. Then on Tuesday, I had about 4 hours with the person replacing me in Nigeria to go over some things with him. And I got to see a lot of old friends, before taking the train back to Lyon the same evening. Since then, I am back in my own little nest. I knew that I was tired, but I have been sleeping about 10 hours a day. And that is almost all besides eating great food and drinking wonderful wines. I have renewed some ties with my bar buddies here, renewed my wardrobe a bit (I haven’t done this in a few years, and my clothes were a bit embarrassing), bought a new camera, done some reading, downloaded a new set of films, and filed my French and American tax returns. And most importantly, I renewed my French residence visa, which expired on 29 February. This was much easier than I thought. After waiting in line for 2 hours (a record – usually 3-4 hours), I was received by a young, polite civil servant who loves the United States. I had all the papers that she needed and more, and I was out of the office by 10:00am with my temporary visa. The permanent one, good for 10 years, will be ready by the end of July. I am no longer an illegal alien. I should return to Paris around 4 June to start my new contract with Emergencies. I am pretty excited about this. This is a core of mainly experienced people who are available to leave anywhere in the world on 24 hour notice to help victims of war, epidemics, or natural disasters. There are 3 of us on contract as Coordinators of Finance and Human Resources – I worked with one of them in Niger. I will go to Paris to learn about their specific way of working and the tools that they use. I really have no idea of when and where I will be going – it depends on the situation of the world and where I will be needed. The biggest change for me will be that these are usually 2-3 month missions, hopefully with a bit of time at home before going out again. Until now, my shortest mission has been 8 months. It will be interesting to see the difference. My contract is for 1 year, renewable. Afterwards, I would still like to move into a field coordinator position, being responsible for an entire project. We will see.

The HR Roadshow has begun

We have started the MSF-France Nigeria Human Resources Roadshow. We are announcing a lot of changes: payscale, job function grid, a new tax law, seniority system, terms and conditions of employment, retirement plan, work hours, work schedules, maternity leave, annual leave planning and counting method, and more! Most of these changes are positive, but there are a few that are less pleasing. It took a lot of work, and it was very difficult to get approval for the package from the Paris headquarters.

Last Monday we announced the new policies to the Abuja coordination staff. Then, we took the 8 hour drive up to the Jahun project on Tuesday, informing the expatriates of what we would be presenting. The big general meeting took place with all the staff on Wednesday morning. Starting Wednesday at 11:30am, we had a series of small group meetings to inform them of the specific changes for their group (salaries, work hours) as well as to answer their questions. These continued all day Thursday.

The reaction has been very positive. The employees are pretty happy overall. I was worried about some of the lower level staffs in Abuja who receive a rather small increase. I was also worried about the staffs in Jahun, who are being asked to work 20% more hours than before. But we were prepared to answer their questions on these issues, and they accepted our arguments.

Today has been dedicated to implementation. I generated contract amendments for everyone, and made some good progress on calculating the correct number of months for the new seniority system. I am waiting on some info from Paris, which I do not think that I will be receiving before leaving tomorrow morning (another 8 hour drive) back to Abuja.

We stay in Abuja for Easter weekend and then leave again on Tuesday to do the same thing in Port Harcourt, returning on Saturday. One group in particular in Port Harcourt risks to be disappointed that we could not get an increase in their function level. And since we have already made the announcements in Abuja and Jahun, everyone will have already heard most of the stuff through their network of friends in the other projects even before we get there.

We may have to split up to have 1 person in each site the week after that to get all the contract signatures, finalize the database parameters, and enter all the changed personal variables into the database. Then we generate the new payslips under the new policies and sent out the money! I am sure that when everyone sees his/her payslip, there will be more questions.

And then I leave Nigeria! I am really happy I am able to see this thing all the way through implementation. I think a lot of information would have been lost if I had had to handover to someone else during the process. And since I had to be the bad guy when I arrived at the end of 2010, introducing the first tax scheme and then announcing that there would be no pay raises in 2011, it is rewarding to be able to announce good news before my departure.

I have a new job!

The person replacing me in my job in Nigeria arrives in about 1 week. I have heard some very good things about her. We will have a handover of about 10 days, and she will take over as the Coordinator of Finance and Human Resources for the country. I will stay here until the end of April, to finish implementing some new policies that we have been working on for more than 6 months. That will make 18 months that I have worked and lived in Nigeria.

Then I go back to Lyon in France for about 1 month. I must return to renew my residence visa. I have been living in France for 27 years, but I am still not a citizen.

And I just accepted my new job. I will continue with Medecins Sans Frontieres (MSF, or in English, Doctors Without Borders), still doing administrative work in the field, but I will be on a 1 year renewable contract with the Emergency department. That means that I will have short missions (2-3 months) in which I go somewhere where there is a natural disaster, war and displaced populations, epidemies, or some other crisis, to do the administrative things necessary so that our doctors and nurses can help the people. This is what MSF does best and what we are known for. It will be very exciting.

I have now been working with MSF for 7 years, mainly doing administrative work, but for long times in the same place - 8 months to 2 years. I have had to deal with emergencies in the past (displaced populations because of violence, cholera, vaccination campaigns) but on a small scale within a long term project. Now for at least 1 year I will be doing exclusively emergencies. Between assignments I will be at home in Lyon, but I commit to be ready to leave within a 48 hour notice period. At most I will have about 2 weeks off every 3 months. If some miracle happens that everything is right with the world, they use us to fill gaps in the long-term projects, or have us work in headquarters. That doesn’t happen a whole lot.

When I have finished this assignment, I want to move to project management, being responsible for a long term project for 6 months at a time. This emergency job will be very good to help me to prepare for the change of positions.

Hurray!

February 2012

Hi all

Nothing much has happened since my last posting. The violence in the North continues, so the flights to and from Kano are almost always shut down. That means that we send people back and forth from our Northern projects with a 9 hour car movement. The roads are good, and the scenery is rocky, rough desert so it is interesting but still tiring.

One of my contacts from our New York office is here for a couple of weeks, and I am going down to Port Harcourt with her this week. Our trauma hospital there has been severely space limited for quite a while, and we have a project to build and rent some space close by to give us breathing room. Another guy from New York is already there working on the plan. They will be the ones to try to sell this project to our operations people in Paris, so it is very important that they are involved in the finalization of the project, and the rational behind it. We were really lucky to find some space near the hospital, so I hope we get final approval on the plan. It will really make the work environment much better and will improve the quality of care that we can give.

Our big human resources policy review is moving along. The pay scale and function scale report has been issued, but apparently, the cost involved has already raised a panic in Paris. It is going to be a hard sell. So we are looking at justifications, alternatives, and our presentation strategy. The implementation of this review is why I have postponed my departure from Nigeria. It is really important to me to clean up a lot of things discrepancies in policy and fix some things, as well as to pay our staff correctly so that we can hire new ones and keep the ones we have. The presentation of this program in Paris has been pushed back 1 week. Once we get approval (or not) we have to prepare our presentation strategy for the staff, explain the thing to the project managers, have meetings with the staff in each site to explain the new policies, work on changes to our pay plan to implement the new policies, and then distribute new work contracts to all the staff and get them signed. Most of the work within Nigeria falls on me. I cannot stay longer than the end of April, and I think we can have all of this done by then, but not if we have more delays.

I have now been in Nigeria 15 months. I am starting to feel it. But recently, I have been able to get some work out of the way that had been lingering for a while. If we can get our HR review approved, that will give me a surge of energy which will help me up to the end.

Happy 2012

Happy New Year!

Ok I am a bit late. I am still just as bad at keeping this thing up to date. It has been 2 months!

I travelled a lot in December. I was back in France the first week of December. The idea was to renew my residence visa, which expires 29 February 2012. And when I got back to France, and had stood in line in the freezing cold for 1 ½ hours, they told me that I could not renew my visa before the last months of validity (totally different from what the person told me in the French embassy here in Nigeria). But they also told me that since I have a long term visa (10 years) I could renew it up to 3 months after expiration. That is good news, because my work here in Nigeria is not finished. We are still in the process of a huge human resources policy review, I feel that I must be here to explain the results to the staff and make any changes for the implementation. I am the only one who is still here when we started the thing, and knows the history of the project. So now I know that I can finish. That is great

But if I had known I could not renew my visa, I would have gone somewhere warm, like Ghana. I hate cold! At least, I was able to change my dead water heater and a couple other small maintenance projects in the condo. And my trip home was during the time of the Festival of Lights in Lyon. This is a very Lyonnaise festival, and it has grown in amplitude in the last 20 years. It started I think in the late 18th century to thank the Virgin Mary for the fact that the last big plague passed over Lyon. The archiveque at the time asked people to put candles in their windows as a sign of thanks. This still happens, but now, there are splendid light-and-sounds shows also. It now goes over 3 days. It was great.

While I was there, there was also the chocolate conference. Yummy.

So I was able to bring back to Nigeria many decorations, gifts and French Christmas food. Of course I ruined myself. What the hell.

I must tell you. I had a surprise Christmas gift from my wonderful friend from HP Martha, and her sister who she was visiting in Turkey. They made a donation to MSF in my name! Wow.

I spent Christmas in Abuja with our team here. We have a wonderful meal – I was not the only one who had thought of food. We had a cheap gift exchange for which we had exchanged Secret Santa names. And I had brought gifts for everyone also. It was fun.

Then, for New Year’s, I was in the project up north in Kazaure. This is the project that we are closing at the end of February, for operational reasons. The team there is wonderful, and there are some great cooks. We ate like pigs, and drank like that also. Apparently, the logistician had to carry me to my room, and my ass hurt like hell for 3 days, because I fell somewhere. The admin the next day apologized, because she said (she doesn’t know how) but she made one cocktail for me of gin, tequila and whisky – that’s all. Oops


The beginning of the year has been intense. The government announced the total cancellation of the gasoline subsidy, which doubled the price of this fuel. Obviously, that made everything else goes up – public transportation, food prices, nearly everything. (Some weird things also – the price of fuel went up by 100% but the price of public transportation sometimes went up 150-200%???) A general strike was declared to start on the 8 January, and it went on for 8 days. Internal airports shut down even before that, so I had to spend a lot of time arranging for car movements between the capital and the projects for expats arriving or departing. It actually went pretty well

So the strike is over, but there has recently been some violence in the city into which we fly expats for the 2 northern projects. This again has made my life a bit more difficult
But the government here is very reactive, so I think that things will go well next week.

We also have a new head of mission since end of December, as well as a lot of other changes. This of course means changes in operating procedures, and sometimes directions. I worked with the guy also in Congo, so I know how he works. He is great, and does things that are necessary, but he wants everything done in the first month of his arrival. I am tired – I have been here since November 2010. But I still am so happy to be with this organization.

I have asked to change functions for my next mission. I have been doing administration now for 7 years. I feel good in the post now, and want to expand into other things. The next time, I would love to leave coordination and go back to the projects as project coordinator. For the moment my old head of mission, and also the new one support me in this request! I will of course do whatever MSF needs at the time. We have so many problems to find people that I don’t want to be difficult. As long as I can continue to grow and learn new things.

November post

I have been very bad about keeping this blog updated. I apologize. I have let a lot of things slide, like family birthdays, since having lost my original email address to hackers. I will try to do better.

Things here continue to be busy. I have been out of Abuja a lot. Since my last posting, I have replaced the project coordinators in both Port Harcourt and Kazaure, each place for a week. So I have done this now in each of our 3 permanent projects. I am really thankful to my head of mission to have put this trust in me. This has really opened up new horizons for me. I find the work was very interesting, and I hope to move out of administration and into this post for my next mission, if the powers that be agree.

After this, I returned to Kazaure nutrition project to announce to the ministry of health and our own staff that that project would be closing (and our staff will thus be out of jobs) in early 2012. I have done this at least 5 times in MSF – we are an emergency organization – not a development organization. They were pretty much aware of this, so it was not really a surprise to them. I think that they were relieved that it has finally become official. Anyway the meeting went well, and we will now be doing what we can to help them find new jobs and keep them in our files for future interventions.

We have also been working very closely with the Nigerian Ministry of Health to contain a couple of cholera outbreaks. The cooperation went very well, and so we have completed our work in each of those interventions. We are now planning a vaccination campaign in another state to contain a small outbreak of a rather rare disease.

My human resources administration manager left near the end of September, so I am trying to cover her post. We have found her replacement, but he is working in another project, so I will not steal him until they have recruited his replacement and he has trained that person. And my dear deputy has finished her mission and returned to the States about a week ago. Her replacement arrives at the end of this week.

Of course, this all falls during the time for preparation of the 2012 budget! I just prepared the budget files for the field and got them all out on Friday evening, so that they have a week to work on them. This was especially difficult, because the communications software between here and the headquarters did not work! I had to re-install it 3 times. But finally after 5 hours of rather intense swearing (my team is now starting to talk as badly as I do – this is worrying!), it is working, with the poor internet connections that we have. Nigeria has some good connections, but MSF-France is a bit cheap concerning internet.

This is a big country for MSF-France. Our total budget is over 8.4 million euros, and we have around 650 employees including around 35 expatriates, local staff, some daily workers, and Ministry of Health employees for whom we give an incentive. We are receiving 50% funding on our Jahun emergency obstetrics program from EuropeAid. The rest comes from donators in France, U.S.A., Australia and Japan who give donations directly to MSF. Thanks to all of you!!!!!


Now, I must also prepare our budget for the coordination. This will be a bit of work, because we are splitting out our Emergency Team from the general coordination. Next Friday, when we (hopefully) receive the field work, we must control everything and consolidate it, then send it (via this software which I hope will continue to work) to headquarters.

I think I will be returning to France for a week in December, just after submitting our budgets. My residence visa there expires in February, and I may have to extend my time here until after that. So I plan on returning to start the process, then come back here with a temporary French residence visa, picking up my 10 year one when I return. I am not completely thrilled about returning to France in December. I haven’t experienced a winter in 6 years. I don’t even own a winter coat anymore. Plus my water heater died during my last trip. So that will be another thing to work on very quickly during that week. Until then, I will have to heat water on the stove and take bucket showers, like when I am in the field in some countries! I was really hoping to take my vacation in Benin, but what the hell. The good thing is that I will be able to buy lots of small gifts and French Christmas food (heavenly) to bring back with me. Aieaieaie, it is going to cost me dearly! But since I am a very large, old kid at heart, I am happy.

The reason that I might have to extend here is that we are doing a complete human resource policy review with the help of 2 people from Paris headquarters. Our implementation plan is very tight, and I cannot leave with a good conscience before having gone out to the projects to announce and implement the plan. Certain changes will be very good for the staff, but certain others will be more difficult to accept.

It is not difficult for me to extend here for a few weeks. This is a good country. Yes, there are problems, especially right now for security, but the government is handling it well, and the people here are wonderful. This is the most developed country that I have worked in yet. I have now been here 1 year! We will see where I go next, and in which position.

I go now. It is Sunday night. We have no cook on Sundays, so tonight we prepared barbeque with 3 different salads and a pineapple and watermelon fruit salad for desert. Yum-yum

Busy, busy, busy

Things haven’t stopped since I came back from my break.

A friend of mine visited me here in Abuja. He is Nigerian. His family lives in Lagos, but he is doing his studies in the Ukraine. He came up from Lagos to get renew his passport here. We had a great weekend together.

We are now preparing for our semi-annual “Mise a Plat”. This is a French expression pretty much meaning “Taking things back to the beginning”. It is where we look at the objectives we have for each country and each project, what this year’s objectives were and where we are, what have we accomplished, are the objectives the same for the next 6 months, and what resources do we need to obtain the new objectives. The project teams really put a lot of thought into their presentations, and we were impressed with the quality of work. Now, we will be consolidating the work to decide what we will ask for in Paris at the end of October for 2012.

In conjunction with this meeting here this weekend, we had 15 people in the house, including some visitors and people coming and going from their assignments. I was in charge of the physical arrangements: audiovisual, rooming, meals, and cooperation with the logisticians for the cars. All considered, this went pretty well. We managed to have a good meeting and some quality time together during and after the workday.

We are also recruiting for 3 posts in our coordination team. We have between 15 and 75 candidatures for each post – quite a bit of work to screen them and choose who we hire.

I also have a lawyer and a human resources specialist who just arrived, staying here for several months to do an in-depth review of our human resources policy. We have been waiting for this team for several months, and I am very happy that they have arrived. I know both of them, and I have great confidence that they will produce a good proposition for the future policies for our national staff.

At the same time, we have had someone from Paris to help us with a funding contract. We have the help of EuropeAid for our Jahun Emergency Obstetrics program. This is great. They are funding about 50% of the project. It is the first time we have worked with this organization, and as we do not have so many of these cooperations with donor institutions, we are in need of help to make sure we comply with their reporting specifications.

Also during the next 10 days, we are going into our last budget revision of the year, analyzing where we are in our projected expenditures and seeing if we need to make any changes to the budget through the end of the year.

Besides that, my deputy has done an outstanding job of working on a new form for our monthly cash requests from Paris, which incorporates a budget expenditure follow-up. She has just finished the work, to be incorporated this month for next months request.

Finally, I am leaving tonight to stand in for the project coordinator in our Kazaure Nutrition Project. He has just left for his home country for a week. I will enjoy working with the team there, while managing the other tasks from afar.

Never a dull moment!

Abuja Bomb

You may have heard. A bomb went off in the U.N. building here in the Nigerian capital of Abuja on Friday 26 August at 10:20 in the morning. The building houses around 400 employees, and currently there are around 18 dead and at least 50 were injured.

We deplore the victims of this bombing, and our hearts go out the injured and the families of the victims.

The emergency services and hospitals of Abuja have responded very well to the situation. Our organization has donated some medical supplies and the time of a couple of nurses, but the Nigerian health system could easily manage without our assistance.

The U.N building is in the central area of Abuja. To reassure you, the MSF-France office and house are outside of this area, and none of our staff were affected by the incident.

The group claiming to be responsible for this suicide bombing, Boko Haram, has been active in Nigeria for a couple of years now. But up until this moment the group, which is demanding Sharia law in the north of the country, has targeted mainly military / police / drinking establishments. This is the first time they have attacked an international target. We are reviewing our security rules accordingly.

Again, my sincere condolences to the families of the victims of this tragedy.

Vacation in Lagos

I am currently on vacation in Lagos Nigeria. Usually we must take our vacation outside of the country, because this is not considered a restful place. The only situation where a vacation in the country is authorized is if we have no re-entry visa. This is my case for the moment – my passport is still in immigration for the processing of my residence visa.
I am happy to be here. Lagos is a huge, vibrant city – it recently surpassed Cairo as the largest city in Africa. I am staying in the hotel we use for transit passengers here. It is a small African hotel – a bit shabby – but inexpensive (45 dollars a night – the average hotel price here is 250 dollars!) with a very friendly staff. It is also relatively well situated in the city. It is in Ogudu, right on the central expressway which turns into the 3rd mainland bridge (at 5 km, the longest bridge in Africa), which crosses over into Lagos Island. Ogudu itself is a small area with a lot of small markets and shops, some local bars and quite a few fastfood places, as well as internet access (where I am now). There is even a good pizza place!
I have been trying to get around some, but not hurrying about it. One day, I went to the Lekki Conservation Area. It is basically a preserved swamp. It was donated by a couple of big oil companies and is just across the street from the huge Chevron complex in Lekki. It is surrounded by suburban sprawl, but once inside, you are lost in a jungle. There is a footpath meandering throughout it – a raised wooden walkway in the swamp part, and a sand path in the savannah part. Apparently, there are some crocodiles, exotic birds, etc, but all I saw were a few monkeys in the big treehouse. The entire walk takes about 1 hour, and it is a very peaceful experience.
The next day, I was a bit more urban. I went to Alowolo Road in Ikoyi, next to Lagos Island. This is the biggest road for shops, restaurants and bars. I had a good time just wandering around and seeing what is being offered for the rich in this city. I visited a wonderful art gallery with some incredible contemporary African art. And just across the road is the “Jazzhole”, a shop with CD’s, books, coffee shop and concert hall. It was great. And in the same area is a HUGE market, with small stalls selling everything you could think of.
After a while I went into the Protea hotel for a drink. This is a prestige South African chain which has been cited as one of the first to bring down the hotel prices here. I enjoyed my time sitting in the luxurious lounge, drinking a Star beer and looking out over the water at one of the biggest yachts I have ever seen.
I love good food, and I had earlier spotted a restaurant called Chardonnay. I splurged and I am happy I did. I ordered prawns in a white wine, cream and garlic sauce. Calling what was on my plate prawns is like calling Moby Dick a fish – they were huge. There were two of them, but that was definitely enough, and it was so good. My meal of prawns, potatoes, apple crumble, 2 glasses of a crisp white wine and a bottle of water cost around 75 dollars. But it was very good, in a very classy atmosphere, and with a wonderful staff. (OK, maybe I have lived in France too long and picked some bad habits.)
Today I wentto Onikan in Lagos Island. This is really the center of the city, with the National Museum, the city stadium, the Camus cultural center, and a large shopping mall with a great grocery store named Goodies. The National Museum had a temporary exhibition concerning Nigerian lace and embroidery, most of the raw lace coming from Austria, and most of the African printed cloth coming from the Netherlands or England, purely for export to Africa. The permanent collection included some interesting stones carved with faces, from the Port Harcourt area.
Although it may not sound it, I am also relaxing a lot. I was very tired, and my last 2 days before leaving, I had to visit one of our projects to resolve some nasty staff problems. We ended up dealing with it, but it was pretty strenuous. With my siteseeing, I have also been averaging 10-12 hours of sleep a day, and had a great deal of time reading. I am starting to feel human again.
I fly back to Abuja tomorrow evening, Tuesday 2 August. On Wednesday 3 August I have a couple of specialists from Paris arriving who will be with us for a couple of months to overhaul our internal regulations, function scale, salary scale, and an overall audit of the HR set-up. So I will be thrown immediately into the grinder. But now I feel up to it.

June in Nigeria

It’s June and the elections in Nigeria are over. Hallelujah! No more weekends blocked at home, and a calm atmosphere.

My trip to Jigawa state went well. It is always good to be out of coordination in the projects to get back in touch with what we really do. I spent most of my time in Jahun, where we have our women’s emergency obstetrics project. I watched another fistula operation, which is always fascinating – each rupture is different and requires a special solution. Dr Said, the Nigerian surgeon who does these repairs, is really good and he loves an audience.

Jahun is one of the places in which we had some tensions the day of the announcement of Goodluck Jonathan as the new president. Since, it has been tough to get the people from different regions on the team to trust each other. So we had a general staff meeting with our MSF staff and the public health staff to try to iron out some issues. The director of the hospital and the head nurse, both from the public health system, participated in the meeting, and they were really a big help. I wish all of our collaborations with the public health system were as good as this one. Overall, I think we made some progress.

I also visited the tax board in the state capital of Dutse with our tax consultant. We explained our method of calculating withholding taxes, and worked out what we owed them from last year. It was a successful meeting.

While I was there, we had some human resources problems in our other Jigawa state project in Kazaure. This is a nutrition program, treating children who have no other complications than malnutrition at home with a special weight-gain product which was developed especially for this. But some of the kids have other problems and must be hospitalized while undergoing treatment. It was in this in-patient department where our problems came up. I made a 1 day trip up there to help the admin re-establish order. She had already done most of the work – I was only there to back her up in front of the staff and confirm what she had already said. I think we solved a lot of problems, and the staff appreciated our efforts.

So overall, I spent a lot of time in the car while in Jigawa, and got to see a lot more territory than expected.

Remember that I have a new deputy to help me out on the finance side of my work? Well, I don’t anymore! There has been a new outbreak of cholera in Haiti, and MSF had a hard time finding an experienced administrator for this emergency project. So I graciously (grrrrrrrr) accepted that she go there for a month while they try to find someone more permanent.

Emily is not the only one gone from our coordination team. The MSF France Mise-a-Plat (it basically means putting back to the basics) is going on now in Paris. This happens twice a year. Each country presents their program: objectives, method of implementation, results, directions, and needs. The directions are determined for the immediate and long term future. Our Head of Mission and our Medical Director are there for that meeting. The Medical Coordinator is leaving us soon after his return to continue his studies, and his replacement will be arriving at the end of this month. Our Assistant Medical Director will be leaving Tuesday to be the Nigerian staff representative to the MSF France General Assembly. Our Logistics Coordinator will be leaving on Tuesday also, because the immigration department refused to renew his stay visa for the 3rd time. We have scrambled to find a replacement for him, and this person will hopefully arrive at the beginning of next week. And our Deputy Logistics Coordinator will be finishing at the end of the month. With my deputy gone also, the Supply Logistician and I are feeling kind of lonely.

At the same time I am revising the budget for our mission in Nigeria. This is a rather huge task, looking at our expenditures since the beginning of the year and trying to decide if we need to adjust the budget requirements or not. And we have to build in provisions for the directional changes decided since the beginning of the year, including those from the meeting in Paris. I got a lot done yesterday, and I SHOULD be working on it right now, but I am having a hard time getting motivated today.

I had dinner at the house of another organization Thursday evening – Action Against Hunger. The lady who is the country administrator for them used to work for MSF France before switching over, and we have been in contact for quite a few things. Thursday evening was a working dinner. We got quite a bit accomplished, and then she, I and another lady in their house had a delicious dinner (their cook is even better than ours!), with a few beers and a couple of bottles of chilled white wine. It was a good evening.

I have recently become very attached to a person I met on the internet. He is a guy from Morocco, and we have been speaking together a lot in the evenings and on weekends. He will probably be joining me in Lyon when I return at the beginning of next year, and we will see where it goes from there. Being a confirmed single person, I am a little apprehensive about this, but I am also excited by the prospect. Stay tuned……….

May in Nigeria

The elections did not go quite as smoothly as hoped, although they were the most quiet and fair elections ever seen here.

The problems started upon the announcement that the incumbent, Goodluck Jonathan, had won the presidency. Goodluck is a Christian from the south. His main rival, General Buhari, is a Muslim from the north. As the results were announced, Buhari made allegations of rigging of the elections, and things went bad in the north. It did not last long, but it was pretty violent. Some buildings were burnt, some people were killed, and as a result curfews and travel restrictions were put in place. By the time that gubernatorial elections took place the next week, though, things had calmed down.

One of the places which got pretty hot was Kano, where we usually fly in our expatriates going to the 2 northern projects. This airport pretty much shut down starting Easter weekend for about 10 days. So we “stockpiled” people here in Abuja for a while. Finally, we HAD to get some people in and out of those projects. I spent quite a bit of time changing flights to another airport quite a bit farther. That was on a long weekend again, so my staff was not at work – it was just me and our travel agent, who did a marvellous job. In the end, everyone got where they needed to go when they needed to be there (after 1, 2, or 3 changes in schedule).

This situation made for an Easter weekend with a full house – around 10 or 11 people. I made Easter dinner, and it was pretty good – chicken, beef, salad, cooked vegetables and dessert. We finished with a panettone, an Italian bread/cake. Here’s the recipe: http://allrecipes.com/recipe/panettone-i/. Well, it was sort of a panettone, because I had to do quite a few substitutions and I had just enough flour to complete the thing. It was pretty good though.

Last Sunday, I was invited by a couple of the waiters in the bar near the house to visit their village. The village is in Abuja, but it is a settlement with small ramshackle houses which will probably be torn down when the city planners ever get to that area. It was a lot of fun. They took me to their local bar, where I think I bought beers for the whole village. I got home later in the afternoon, promptly fell into my bed and didn’t get up until the next morning.

The past 2 days we have had an intense meeting here with all our project coordinators, to plan our actions for the next 6 months. It is always interesting to go through this exercise, and this time was no exception. It also made for a lot of people in the house again – 10 to 12 people for about 3 days. We now have a month to prepare this info for the worldwide planning session in Paris. The biggest discussion was concerning the Port Harcourt trauma center, our oldest and biggest project in Nigeria. They do around 20 orthopedic interventions (broken bones for the lay audience) a day. These are due to gunshots, machete wounds, traffic accidents, etc. We are severely space-limited in this project, and there are very few options to expand, as we are located in a very dense intercity location. We have committed to at 3 more years there (this is rare for our medical emergency organization), which gives us a small amount of leeway in financial commitment. And we have 4 options for expansion, but we really need a lot more info before the Paris meeting to make a cohesive recommendation. It will be a busy month.

I leave here in a couple of hours to go to our Jahun project for a couple of weeks. This is the women’s’ emergency obstetrics project. I fly into Kano this evening (the airport which was shut down a couple of weeks ago for violence), spend the night there, and then one of their drivers picks me up early the next morning to drive to Jahun. The project coordinator there, a very experienced nurse from Malawi, has just left for an MSF training course in Paris and I will be replacing her. This is my first time as an acting project coordinator. I hope I don’t screw up too much. The project coordinator is the person head of the project and must manage the project itself, the security situation, relations with the community, squabbles between the staff, and the relations with the ministry of health in whose hospital we carry out our program. The administrator is also gone for my first week there, so I will be doing her job too, as well as my own. We’re having fun now!

Middle of the Elections

The elections are now going on here in Nigeria, although there has been a change in schedule. They are really making an effort to have clean elections here for the first time. They are doing everything to avoid the rampant corruption in all the previous elections (thugs stealing ballot boxes, buying of votes, etc.). The first weekend of votes did not get off to a stellar start – voting materials did not make it to all the polling stations in time. So they made the courageous (and not easy) decision to postpone for 1 week. National assembly elections were pushed back to Saturday 9 April, presidential elections are today the 16th, and state and governor elections will be on Tuesday, the 26th of April, after Easter weekend. So far, so good. Last week’s elections went relatively calmly – only 1 bomb thrown into a polling station the night before the national assembly elections (killing 9 volonteers). And this morning a bomb was thrown at a polling station in the northeast – it missed the polling station and no one was killed, although a few shops were destroyed. I hope it stays this quiet and that Nigeria has clean elections. Everyone here really hopes so!

I had a VERY busy couple of days at the beginning of the month. I must always order money from Paris at the beginning of each month for our needs. And once every 3 months I must update our annual budget with the real expenses made so far and any changes in the programs since the last revision. This time, the results of both of these time-consuming events had to be sent to headquarters on the same day. Thanks to the great work by our field admins, the cash request was done in time, and the quality of the work was good. As for the budget revision, our admins in Jahun (hurray Kristin!) and Kazaure (hurray Cindy!) did an outstanding job. Unfortunately, the Port Harcourt budget needed a lot of work before I could consolidate it with all the others, so I was a day late sending it off.

Along with this, headquarters has just changed the system for budget consolidation. It is a database product from IBM in which I have a local database on my computer. The central database for all the mission budgets is in Paris. Once my budgets are ready, I must synchronize my database with the database in Paris. All fine and good when you have a great internet connection, but that is not the case here. The system we usually use is not compatible with the new software. I managed to find a system which IS compatible just the Friday before I needed to synchronize. Then on Monday when I sent off most of the info, it took 5 hours of connection to get everything sent off! It kept cutting out after some of the info went off, so I had to start over again several times. I was really relieved when everything was sent. Then on Tuesday when I sent off my final revisions, the connection only took about 1 hour. Ahhhhhhhhh.

In the end, it worked out well. I sent off almost everything on Monday, so that our financial controller could look it over before presenting it on Thursday. He got the rest on Tuesday. And on Thursday, all the revisions were accepted by the powers that be!

My new deputy Emily will be arriving here the 3rd or 4th of May. We will have some meetings with the project coordinators on the 5th and 6th of May to plan directions/changes for the 2nd half of the year, so this will give her a good opportunity to get a good sense of our programs. Then, the evening of the 6th I will fly up to Jahun to replace the project coordinator there while that person goes to Paris for a training course. I am looking forward to it – there are a lot of things I need to do which are related to that project. (By the way, here is a recent article which explains what we do in that project: http://www.globalpost.com/dispatch/news/regions/africa/nigeria/110325/clinic-fistula-women?page=0%2C0%2C0%2C4. It explains our work very well, and it is well written – a positive article concerning a women’s health problem and how it can be helped.) I have some human resource issues that need to be resolved, I will be replacing the field admin while she is on break, I will be visiting the state tax office with our tax consultant to explain our new method of tax calculations, and I need to get to know the national staff assistant admin better – all at the same time of managing the project. I am REALLY glad that Emily will be here to replace me in Abuja while I am gone. I will need to travel to Port Harcourt also, but that will probably be later.

Let me now make a publicity announcement for a new website developed by a friend of mine: http://www.getmedias.com/. He has worked REALLY hard on this site to make something that people all over the world can use to download films, music, lyrics, software, games, etc. I am impressed – he learned most of the stuff he needed to develop the site on his own. And it is free. If you scroll down to the bottom, you will see a face and an address that everyone reading this already knows. Thanks, Denis! And thanks for this site.

During the elections, the country borders are closed from Friday through Saturday, there are no flights in or out of the country on Saturday, and there are even no car movements from 8:00am to 6:00pm on the voting days, to make sure people do not drive around to vote in multiple places. (The independent election committee AND the government have taken this reform very seriously!) People are supposed to register within walking distance of their homes. That means that our cook and housecleaner cannot come to work. Last Saturday, I did the meal. But tonight we are going to a restaurant/bar within walking distance. They have great catfish, grilled in foil with a very spicy mixture of tomatoes, onions, plantain and spices. I love it. A couple of 60cl Star beers helps to extinguish the fire while eating it, although it burns me a new a-hole the next morning when it leaves my system. Just wanted to share this with you. (The devil made me write it.)

Next week is a LONGGGGGGGGG weekend. In Nigeria, both Good Friday and the Monday after Easter are holidays. Add to that the state election day of Tuesday 26th of April. Seriously, I will be happy when the elections are over, because my group is responsible for the international and domestic movements of the expatriates and national staff. Of course, the day of the elections nothing moves either in the airport or even on the roads. Plus, the evening before and the morning after, the airports are a disaster – high level officials must return to their polling places and then come back to the capital, tying up the airports with their private flights to and from. We have done all we can to avoid flights at this time which is really not easy – when you have surgeons and anesthetists coming in for a 3 week stay (and in total we have 4 of these teams), you take them when you can get them. Yesterday (Friday) we had one guy returning from training in Europe, and another guy returning from Lagos for a freight clearance (a donation of therapeutic food for undernourished children from the Clinton Foundation). They were both delayed by several hours. We had the same problem last week with a lady leaving Jahun to return home to Port Harcourt after replacing an expatriate surgical nurse who became ill during her stay here and had to return to Austria. We usually have at least 2 international arrivals/departures EVERY DAY. You can imagine what 3 days of no travel can do to our schedules.

Anyway, I will enjoy the long weekend next weekend. Happy Easter to everyone.

Back from France

March has flown by.

Our new Head of Mission has arrived. I have already worked with her and it is good that we will continue with this mission in good hands.

And headquarters has agreed to split my post! I will be the Coordinator of Finances and Human Resources, with a Deputy. The lady who will be my deputy has just finished an emergency project here and will come back at the beginning of May. I will do mainly human resources and coordination of the budget, and she will concentrate on accounting and other financial issues. Of course, we will replace each other when travelling in the field. This is a big load off my shoulders, and I can work on some long term projects now.

Long term residence visas for Nigeria are only issued in one’s country of residence. So I had to return to France in the middle of March for this procedure. I arrived in Lyon on Sunday 13 March, and took a train to Paris the same night. Monday I ran all over Paris getting all the papers necessary for the visa, and took a train back again to Lyon Monday evening. Then I had a week at my place on break, before returning to Paris the next Monday to pick up the passport with the visa again, flying back to Nigeria on Tuesday 22 March. Now the final steps in obtaining this visa will be done here, and it will be VERY long.

The week at home, after 4 months in Nigeria, was nice, although I had a few adventures. My water heater broke during the week. I am glad it happened while I was there so I could at least shut it down to avoid damage. But I did not have time to buy and install a new one, so 3 days of very cold showers from a bucket reminded me of being out on mission. And one night while dancing in a club, my glasses flew off my head and were crushed underfoot before I could retrieve them. Finally, my last day in Paris, my shoes exploded (I have already repaired them at least 5 times) and I had just enough time to buy a new pair before the stores closed.

Otherwise, it was nice. I slept a lot. I ate a lot of French cheese and drank quite a bit of wine. I saw a few friends. And I treated myself to a 90 minute massage – heaven.

I’ve been back a week, and the work rhythm continues at its usually hectic pace. At least I don’t have time to get bored. We have had a LOT of people coming through the house, as we have just ended a measles outbreak surveillance program.

I am working less on the weekends here – I work from the house on Saturdays, and work very little on Sundays. Of course, I still prepare the Sunday evening meals for the people in the house, since on Sundays we don’t have a cook. It is nice to have some more time on the weekends, but I still have no time to attack the big, interesting projects. That will change with the arrival of the deputy.

The next 3 weekends are election weekends in Nigeria. April 2 is for the National Assembly. April 9 is for the president. April 16 is for state offices. Everyone must stay in their own neighborhoods on these Saturdays, only moving about to vote, so it will probably be pretty quiet. At least we hope so.

February

Last weekend, we had a going away party for our head of mission and our supply logistician. It was my first going away party in Nigeria, and it was just as good as the other countries. Africans know how to party – great food, great music, great dancing. Our office cleaner – his name is Thankgod – spent the whole day in preparation. They had purchased a goat and slaughtered it the very morning. He served all of us in the office what they call pepper soup at noon. This is the intestines in a spicy soup, although he was gentle on us, knowing that the expatriates in the team cannot support TOO much spice. It was great. And all afternoon, he did the barbeque for the evening.

This country is wonderful. One of the most interesting things is the mix of religions. In the south, it is 90% Christian. In the north, it is 90% Muslim. In the middle it is very mixed, the percentage depending on how north or how south. So you get names like Thankgod, or Love, or Sunday, Monday, Tuesday. Then you get Abdul-Azeez, Zainab, Salisu, Mohammed, and Adamu. Normally everyone lives in peace. But for the moment there are a few flare-ups. It is often attributed to religious conflicts, but that is too simple. These conflicts can come from a combination of religious, political, economic, tribal and MONETARY influences, all together. Have no doubt about it – this is a developed country based on the American capitalistic system.

This week I have had two people here from headquarters.

One, Soumia, is the person who is responsible for the accounting and budget software. We have implemented a new system for work on the budget which is based on a local and plus a centralized database. Basically, I have all my budget data in a database on my computer. From time to time, I synchronize with the central database in Paris to upload my revised data and retrieve centralized parameters from that one. I had installed the software on my system, but I made a few errors in the configuration (oops) so it was not working. Thankfully Soumia had already planned a trip in Africa, and she corrected the error. But it still did not work! So we went to a cybercafé to try another connection – voila, it worked. So now we will have to find a new internet supplier, at least for my work. I will need to talk with the Spanish and Dutch sections of MSF who are also here working with such software, to see what systems they are using. It was really a relief to get this going – the next budget revision is at the end of March, and it would have been impossible to do without this new software.

The other visitor is a finance support person, a Ugandan with the lovely name of Emmarine, who goes all over the world to fill gaps or work on special projects. She spent 5 years in south Sudan so she is obviously a tough lady, but she is always smiling. She is a great lady, and has given us some good help already. She will be going into the field with my accounting manager on Monday.

We had crises this week with a couple of our expatriates. An anaesthetist in Port Harcourt has been supporting back problems for a number of days, and it finally got too bad – he had to leave early. The other one is more serious. Our operating theatre nurse in Jahun had some serious heart problems on Wednesday morning. We were able to fly her back here Wednesday afternoon and we took her to the clinic we use for our national staff. We then contacted our international medical evacuation company, who worked with the clinic and spoke with her over the phone. Our medical coordinator, Dr. Chris, did all the work on this, really making my job a lot easier. She has had no more incidents since the first one, and she feels comfortable flying back by herself to Vienna, leaving here this evening. It really gave us all a scare. Besides, she is a little younger than me, so I need to prepare myself for this sort of thing.

I have just been informed that things are not so good for MSF-France on the east side of Democratic Republic of Congo, where I just finished 2 years. They have had 7 rather violent security incidents in the last 4 months. It has become so bad that we are abandoning our projects there, although 2 high-level people from Paris will be going shortly to discuss the situation with government officials to see what can be done to insure our safety in case we return. This breaks my heart. Congo is a wonderful place and our projects (like all of our projects in the world) are really helping the people in need.

Here in Nigeria, we are greatly relieved. We have had a number of people finishing their missions, and there were no replacements for them, especially the coordination positions – project coordinators and the head of mission. Our New York office has done a great job of finding replacements for all these posts at the last minute! I have already worked with the incoming head of mission while I was in Congo. She is great. And all the new project coordinators also seem good. We attract good people, but it is more and more difficult to find people willing to do long missions – 6 months or more. For these key posts, this continuity is essential.

The dry cold season has just ended. Cold means that in the north it can be down to around 50 degrees Fahrenheit – 10 degrees Celsius in the mornings (in Jahun, I even slept with a blanket!), although it is still hot in the afternoons. The first rainy season should start about now. We had a fantastic thunderstorm about 10 days ago. They say after this short rainy season it will get HOT, getting up to about 95 degrees Fahrenheit most days – 35 degrees Celsius. Then there is a longer rainy season (still hot), then dry hot, then the cold season again. It’s about the same as when I was in Niger.

I will probably be returning to France around the middle of March for around a week, to get my Nigerian residence visa (I am now on a business visa, and the residence visa must be issued by the Nigerian embassy in the country of residence) and to take my break while waiting for the visa processing. It will be good to be in my place again for a while.

Anyway, it is the weekend. This morning I took a 2 ½ hour walk in the neighbourhood. It was good. I stopped into a local market to buy some dates, got some money out of the ONLY ATM we are allowed to use (because of scams), and bought some great bread from a new bakery near the house. It was great but HOT – I was sweating pretty profusely when I got back around 11:00am. I have worked some this afternoon (Saturday) and will probably work a bit tomorrow, but not too much. The rest of the day will be dedicated to naps, films, a book and preparing dinner for the house. We are 6 tomorrow – being the capital, we always have people coming and going from the projects as they begin, end or go on their break. The photo here is our house. It is as good as the house in Congo.

January in the field

First off, I want to say hello to one of my readers – Cindy’s mom. I am happy to know that someone out there is following me. Cindy says hi from Kazaure.

Yes, I just returned from another 2 weeks in the field. I was accompanying my human resources officer from New York, and one of the reasons for the visit was to explain that there would be no net pay increase in 2011 – not one of the most fun things to do. In fact, we had to recalibrate our income tax calculations to be in accordance with the tax laws, and to make sure this did not eat into their net incomes, we were obliged to increase their gross salaries quite a bit. This increase already took out a big bite of our budget, and the MSF-France budget committee did not deem it necessary to add on again to their net. No one is very happy. But we did commit to doing a thorough study of the entire salary scale during this year to have a sound proposition for 2012.

While I was in the field, I was able to observe a fistula operation in our emergency obstetrics program in Jahun. A fistula is a tear in the walls between one or more membranes in the woman’s pelvic area, often caused by a long, difficult child birth. In this case, a 50-something-year-old woman’s urethra had disappeared because of such a child birth. That means that there was urine leakage in her vagina. I watched the surgeon actually create a new urethra, snipping the skin of her vagina around the opening into the bladder, then sewing it up into a tube. It was fascinating. Nigeria is one of the few countries which has a successful program for this type of problem, and the program in the Jahun hospital is the only one in the world in which MSF-France participates.

On a lighter note, in Kazaure I was able to see our ambulatory nutrition program soccer team beat the pants off the ministry of health team! It was a Sunday afternoon in a dust storm, but it was a lot of fun for everyone.

I also went to the Jigawa state capital, Dutse, with our administrator to visit the health commissioner and the tax office, as well as to buy some logistics material and some “white people” food for the expats in a big grocery store there. While there, I got my first taste of authentic Nigerian staples – pounded yams with a pumpkin seed (aguzi) and tomato sauce. It was delicious and VERY filling.

My flight back to Abuja was cancelled, so I made the trip back by car yesterday, one day later than planned. We left Jahun at 8:30 am and arrived at the office at 5:45 pm. It was what we call a “kiss” movement – one car is sent from each site, we meet in the middle (hence the cars “kiss”) and each car returns to its home site. In this way, each driver and car is home for the evening. In this case, the car coming from Abuja was delayed, so we waited for a little over an hour at the half-way point. There was a big outdoor market where we were waiting, so I was able to do some serious people-watching.

Most times we travel by air, so I really enjoyed being able to see the countryside this time. There are some places where huge rocks appear to have been spit out by the earth and have tumbled back onto each other. And there are other places where really huge bare rock formations have been pushed up through the surface by seismic eruptions.

Nigeria has the best road system I have seen in Africa. There are very good highways, and the building of them continues. There are an incredible number of car cadavers along these highways, though. Once a car is totalled in an accident, it stays where it is. Of course, all usable pieces are scrounged quickly, giving these cars the look of a skeleton. It makes a pretty good advertisement for safe driving, but the message seems to be lost on the Nigerian drivers.

I just received a Christmas package! As my recruitment into MSF was done through the satellite office in Lyon France, I am still associated with them. (In September before coming here, I did a presentation in Lyon to a meeting for hopeful recruits.) Each year, the volunteers in this office put together a box for each of their expatriates in the field, including sausage, coffee, tea, chestnut spread, French sauces, candy, Christmas decorations, and music on a CD. That really warms the heart. Of course, if we don’t share with people from other satellite offices, we risk our lives. To all of you in the Lyon office - thank you, thank you, thank you.

It's Christmas

I had a great Christmas, like always on mission . But this year, I think I have never been so late in planning and preparing it. I went to a crafts market not far from our office on the 23 Dec to buy around 15 small gifts. I wrapped all of them the same night in photos from magazines. The same evening I went to buy some spices and other ¨white people¨ food products in a place in town called Park ‘n Shop. The evening of the 24th I met William, our head of mission; Chris, our medical coordinator; and Wodage, our supply logistician after work for a beer in a hotel just next to the office. Afterwards, we ate at home with William (his wife and daughter are out of the country for the holidays). Then Wodage and I took what was left to eat to the house guards and we stayed talking with them for about ½ an hour. They were very happy and us too. Before going to sleep, I put out the gifts for everyone in the house, as if Santa Clause passed

The 25th, we were invited to our medical coordinator’s house for dinner. There were 7 of us. I made a chocolate cake and an apple pie in the morning and we brought these with us. The food, drink and conversation were all good. Chris and his wife also have a 3 month old son, and he added to the entertainment.

My predecessor in this job, Nathalia, is leaving today. She has been working really hard to finish up some things before leaving. I appreciate that. I have been doing the day to day tasks in the job for a little over 2 weeks now, and it was good to have her here to answer questions. Now I will be on my own.

It looks like we will be doing a measles vaccination campaign, vaccinating 1,200,000 children between 6 months and 15 years in 2 northern states. With 30 vaccination teams we can do this in about 30 days. It is a huge effort. We will need about 630 people, 70 cars, the vaccines themselves and generators, refrigerators, and freezers to keep the vaccines cold. We plan on a month of preparation, a month of vaccination and a month to wrap up. It will be exciting.

And my financial controller and human resources officer from our office in New York will be arriving soon. They arrive the 6 January and will be visiting all our programs here. I will be accompanying them on these visits. So I will be very, very busy.