Soon back to France

I will be leaving Turkey in about 1 week.  I am very impressed by this country.  I have only seen a very small part, but the people are wonderful, it is a very developed country, the food is good, and it is part of the oldest civilizations in the world (the valley of the Tigris and Euphrates rivers).  The city where I am has a fort that dates more than 1300 BC.

We are not working in Turkey, however, but in Syria.  Syria was also a very developed country, but as we all know, has some problems now.  We work in the north of Syria, providing health care in the rebel-held zones.  We are the only non-governmental organization sending international staff into Syria   This is not without risk, but this is in our principles.  We do everything possible to assure the safety of these people, who are providing health care to people in need

My work just before here, in Jordan was related to the same conflict.  As stated before, I cannot say much more than that.  Only that I am proud to be part of this operation. It is stressful, and I will be happy to have some rest

When I return, I will be working in Paris for 10 days.  I will be working on our budget for 2014 for this project, plus reporting on our accomplishments through end of 2013.

During my stay in Paris, I will have dinner with a friend.  He is a gay Ugandan, who fled the country to escape death, because people found out that he is gay.  I met him just before leaving, and I am trying to help him to attain his refugee status in France.

After Paris I will return to Lyon, probably for a couple of weeks before going out again somewhere.  I might be in France for Christmas!  For the last 9 years, I have been in the field, in Africa.  I love Christmas in the field, but I have some good friends in Lyon also with whom I am sure I will have a good time.  Of course, if there is a disaster somewhere in the world at that time (as almost every year), I will go.

Thoughts on aging.

I just got this from a friend.

I was just lying around, pondering the problems of the world,
I realized that at my age I don't really give a rat's ass anymore.
.. If walking is good for your health, the postman would be immortal.
.. A whale swims all day, only eats fish, drinks water, but is still
fat.
.. A rabbit runs and hops and only lives 15 years, while
.. A tortoise doesn't run and does mostly nothing, yet it lives for 150
years.
And you tell me to exercise?? I don't think so.
Just grant me the senility to forget the people I never liked,
the good fortune to remember the ones I do, and the
eyesight to tell the difference.

Now that I'm older here's what I've discovered:
1. I started out with nothing, and I still have most of it.
2. My wild oats are mostly enjoyed with prunes and all-bran.
3. I finally got my head together, and now my body is falling apart.
4. Funny, I don't remember being absent-minded.
5. Funny, I don't remember being absent-minded.
6. If all is not lost, then where the hell is it ?
7. It was a whole lot easier to get older, than to get wiser.
8. Some days, you're the top dog, some days you're the hydrant.
9. I wish the buck really did stop here, I sure could use a few of them.
10. Kids in the back seat cause accidents.
11. Accidents in the back seat cause kids.
12. It's hard to make a comeback when you haven't been anywhere.
13. The world only beats a path to your door when you're in the
bathroom.
14. If God wanted me to touch my toes, he'd have put them on my knees.
15. When I'm finally holding all the right cards, everyone wants to
play chess.
16. It's not hard to meet expenses . . . they're everywhere.
17. The only difference between a rut and a grave is the depth.
18. These days, I spend a lot of time thinking about the hereafter . .
.I go somewhere to
       get something, and then wonder what I'm "here after".
19. Funny, I don't remember being absent-minded.
20. HAVE I SENT THIS MESSAGE TO YOU BEFORE..........? or did I get it
from you?

In Turkey

For several reasons, I will not be blogging about our activities in the region.  I will probably updating you soon about our move and the adventures associated with that event.  For now, here is a press release distributed a couple of days ago concerning our projects here:

Political will shown to work for chemical weapons access in Syria – same now needed urgently for humanitarian aid.

XXX, 15 October 2013 – The massive political mobilisation seen around the issue of chemical weapons in Syria, reemphasised by the award last Friday of the Nobel Peace Prize to the Organization for the Prohibition of Chemical Weapons (OPCW), must immediately be applied to humanitarian access, the aid organisation Médecins Sans Frontières/Doctors Without Borders (MSF) said today.

Many areas of Syria remain entirely under siege, sealed-off from life-saving humanitarian assistance, either because access is blocked by the Damascus authorities or due to the intensity of fighting. For example, in the East and West Ghouta suburbs of Damascus - areas visited by chemical weapons inspectors - medics are reporting desperate shortages of drugs and cases of malnutrition due to lack of food, but aid has been unable to reach them.

“Syrian people are now presented with the absurd situation of chemical weapons inspectors freely driving through areas in desperate need, while the ambulances, food and drug supplies organised by humanitarian organisations are blocked,” said Christopher Stokes, MSF General Director. “Influential countries gathered around a table, thrashed out an agreement on chemical weapons and put it into practice. They have shown it can be done, so where are the efforts to repeat this success with the burning question of access for humanitarian aid?”

The paralysis of humanitarian access is not limited to areas under siege. In Aleppo governorate, several days of intense bombing in As Safirah and Abu Djirin, as well as on camps of displaced people in the area, have forced 18,000 families to flee for their lives. MSF has treated 20 severely wounded, including many children, but access to displaced families was impossible because of the continued bombing.

Political will around the issue of chemical weapons led swiftly to a unanimously agreed UN Security Council Resolution and has seen inspectors being allowed to visit areas that have been under siege for months. In stark contrast, the lack of political mobilisation around humanitarian access leaves areas in Aleppo and the suburbs of Damascus cut-off from aid, and essential medical supplies are being systematically blocked from crossing frontlines.

The deployment of international staff, an issue which has been problematic for humanitarian organisations since the start of the conflict, has been relatively straightforward for the UN/OPCW team; in just a few weeks 50 to 100 chemical weapons inspectors have arrived in Syria. By comparison, after two and a half years of war the UN humanitarian office had to halve their 100 staff last March and has not yet been able to increase the number.

“MSF recognises the gravity of the use of chemical weapons and the utmost importance of the work of the OPCW inspectors. However the rapid deployment of chemical weapons inspectors has set a precedent and now the 2^nd October UN Security Council presidential statement on humanitarian assistance must be implemented with immediate effect,” said Stokes. “MSF calls on Damascus authorities, opposition groups and those countries who have any influence in the conflict to ensure that humanitarians can work safely and unimpeded, and that humanitarian assistance is immediately able to reach those parts of Syria in the greatest need.”

MSF Press Release of 5 September 2013

MSF surgeon killed in Syria

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5 September 2013

Barcelona, 5 September 2013 – A Syrian surgeon working for the international medical organisation Médecins Sans Frontières (MSF), Dr Muhammad Abyad, has been killed in northern Syria. His body was found on 3 September in Aleppo province. He was 28 years old.
MSF would like to express its sincere condolences to the family and friends of Dr Abyad, who was working in an MSF-run hospital in Aleppo province treating the victims of the conflict.
While the exact circumstances of Dr Abyad’s death remain unclear, MSF condemns the attack against a surgeon who was relentlessly working to alleviate a desperate humanitarian situation in the region while his own country was at war.
“His death is a terrible loss to his family, to the patients that he was treating, and to MSF,” says Joan Tubau, MSF’s general director. “We are outraged by this attack against a young and highly motivated surgeon who was working to save the lives of Syrians affected by the conflict.”
At such a tragic time, MSF would like to emphasise the obligation to ensure the protection of humanitarian workers. MSF is concerned that such attacks directly impact the ability of aid organisations to provide medical assistance.

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MSF teams made up of international and Syrian staff operate six hospitals and four health centres in the north of Syria. Between June 2012 and July 2013, MSF teams in Syria carried out more than 66,000 medical consultations and 3,400 surgical procedures and assisted 1,400 births. 

****************

I stayed at the apartment of the expatriate team who worked with this surgeon last night, before going off to my new assignment today.  They had just found out about this.  I offer my sincere condolenscences to his family.

Nearly Finished in Jordan

I am nearly finished with my 6 week stay in Jordan.  My replacement has arrived, and we are in the middle of our handover.  I leave during the very early morning Tuesday 4 September.  Although it is not so far, it is a 9 hour trip, including a very long layover between flights.

This mission has been great.  (OK, I know.  I say this every time.)  It is the first time I have worked on opening 2 big projects in 2 different countries in an emergency situation.  I have opened small projects in an emergency situation in the same time; but never in a country where the structure was not yet in place for emergencies.  Also, I love Africa, but the comfort level in the middle-east is much higher.  Amman is very comfortable.  On the other hand, as an emergency coordination team, we are currently 12 people living in two adjacent 3 bedroom apartments.  Do the numbers - let’s say that privacy is a little lacking.  We also routinely run out of water – these were meant to be single family apartments, not adult hippy communes, so the storage tanks are not proportioned accordingly.

In Turkey, everyone  with us enters on a 90 day tourist visa.  This visa cannot be extended, so I am going to replace a person whose 90 days are up.  And she is the one replacing me here.  I have worked with her before, and she is great.  I am very happy that she is replacing me, and I know that she is leaving me a situation there which is as clean as possible.  Her project has been in place for more than a year, so a lot has been done already.  I am leaving her with a lot to do still – we have just established our bank account but need to work on details, we are still negotiating with one hospital in which we will work, and there are lots of other pending tasks to tackle.   She is up to it.

I am going to Turkey at a time when our team is moving from one province to another.  That will entail a lot of work.  Also, upon arrival a taxi will whisk me away from the airport to go directly to a meeting attempting to register as a representative organization in the country.  I hope I don't fall asleep - that would be an embarassing introduction to the country.

I am excited that I will meet up with some other people with whom I worked previously.  The number of people who do more than 2 or 3 missions with our kind of organization is very small, but it makes up the core of our teams.  My replacement and I are joking that maybe when my 90 days is up in Turkey, we will switch again. I would rather go to Africa then, because winters in either Turkey or Jordan are on par with those of Europe or the United States.  I hate cold weather.  Anyway, I am on my second 1-year contract with the emergency department, so I am a slave – I go where I am told.  The sad part is that I like it!

Our work in Turkey is actually Syria – even more directly than here in Jordan, where we are focused on Syrian war refugees in both Jordan and Iraq.  I am really excited to go there now, with the threat of international intervention being the news topic of the day.  Our medical programs, which are already aimed at war injured, risk to change day by day.  We do good work today in this field, but we will have to stay reactive to the change in context to be of maximum assistance to a population in danger.  It will be really exciting.

Are you tired of me telling you that I love my job?  If so, you are jealous.  Tough titties.  Hehehehehe

Short stay in Jordan

My 3 week holidays in Lyon were wonderful.  As you probably remember, I am hosting a Tanzanian friend in my place, since I am never there.  He already knows more people in Lyon than I do, and we had a lot of visits in the place.  It was great.  He showed me some things I did not know about Lyon, and I did the same for him.  It was fun.  My last weekend in Lyon we saw the passage of the “Tour de France” bicycle race on Saturday, then the Bastille Day (the equivalent to the 14 July in the USA) fireworks on Sunday.  Perfect ending weekend to a perfect break.  During my break, I also visited a very interesting exhibition at the Lyon Museum of Art Contemporain  called “gray matter”(try to imagine a real-life-sized elephant suspended 4 feet from the floor, upside down, attached to the wall only by his trunk) and the construction site of an architecturally amazing museum the junction of the Rhone and Saone rivers.  I did, however, spend too much money during that time, so I will be recovering during my work months.  

I also had the pleasure of working in the vineyards of Beaujolais during my vacation.  My Tanzanian friend found out about a maker of bio wine there, and he had already started to help the guy.  This guy has been working in the family vineyards for a long time, and he has problems making ends meet.  So we and another friend helped him as much as we could a couple of days a week.  It was hard work, good times, and great wine.  I thoroughly enjoyed my time there.

I also had some quality time with a couple of friends, like my good friends Guy and Roby.  Guy is an old fart like me, and thoroughly enjoyable.  Roby is from Madagascar and a wonderful man.    I had the opportunity to spend a few days with him  and his sister and her children, who were visiting from the Reunion Islands. Wonderful.

And while in Paris for briefings, by hazard one evening, I met a man and a woman from Uganda who are seeking asylum in France (I already have another asylum-seeking friend from the Jamaica, in Holland).  Remember: I just returned from Uganda, so it was pretty amazing.  They are wonderful people, and I wish them the best of luck in their endeavours to stay in France.  I will stay in touch with them.

I left very early on Monday  the 15^th of July for briefings in Paris, leaving with 2 other members of our team on the 17^th of July.  Our departure was a disaster (late taxi, problems with extra luggage from MSF, long check-in, customs clearance of computers we brought, seat allocations, etc.), but once we arrived in Jordan, all was easy.

I have now been in Jordan for nearly 2 weeks.  This is my first time in 8 years with MSF outside of Africa. Even though Kampala Uganda was pretty nice, the difference is striking.  Amman, Jordan is a very comfortable city, even during the Muslim fasting period of Ramadan which lasts 1 month, ending with the Eid holiday around 10-11 August (depends on the moon).   We find all products (local, European, American) for a reasonable price.  This is already amazing.

The mission is really interesting.   All the Syrian activities in Jordan and Iraq have been grouped under our coordination.  We have a children’s clinic in a huge Syrian refugee camp (120 000 people) in Zaatari which has been running since March.  We are now opening a mother and child clinic in Irbid on the border for refugees not living in the camps, so they do not have access to health care in the country.  And after that (end of September at the same time that a new camp is opened) we will open an outpatient health care center in Iraqi Kurdistan.    

Our team is great.  We all live together in a 3 bedroom apartment - 4 ladies and 2 guys.  We don't yet have a cook, so I am cooking for everyone after coming home from work at 8:00pm.  We should have a cook/cleaner in a week, hopefully.

The muslim big prayer day is Friday, so this is the virtual Sunday.  The national staff do not come to work on Friday and Saturday.  I am having a hard speaking about the “weekend” of Friday and Saturday.  Besides, we expatriates always work on Saturday, which is sort of like a real Saturday., but the day after the “Sunday” and kind of like a “Monday”.  See what I mean?

Today we did interviews for an accounting/human resources/travel assistant for me.  They are all great, but they must give notice of 1 month in their old jobs before starting with us.  Our coordo team will be 5 international staff and 5 local staff in Amman.  Then we will have the 2 projects in Jordan and 1 in Iraqi Kurdistan for a total of 25 international staff and 200 national staff.

Our Paris headquarters has changed the plan for me, because of visa problems in Turkey.  I will only stay here until end of August.  Then I go to Turkey on the Syrian border for 3 months.  So I will not come back to Lyon before the end of November, inch’ Allah.  Since I am with the Emergency Department, it could change again several times before I go home.  I am happier than a pig in shit!

Back in Lyon

I just returned from my 3 weeks in Uganda.  It was very good, as always with MSF

When I left, it was not sure whether I go as support or as replacement of the person there.  And since I know that woman and respect her a lot, I was a little nervous,   It worked out good.  She left her mission early, but I did not replace her – she left just a couple of days before me and we had the opportunity to work well together.  I wish her all the best for the future with out organization.

I worked with her in South Sudan in 2007.  At that time, I also worked with another guy who was in Uganda this time with me.  And…….also a French friend with whom I worked in Nigeria.  He was the head of our mission, and then he replaced the lady I was supposed to.

So I already knew about half of the expatriates I worked with even before I arrived.  And the others I met there were also great.

And my job!  Wonderful!  Since I am on a one-year contract and I am paid whether I work or not, they did not really want me to sit around for 3 weeks without working (what a surprise) before they had a place for me in Syria.   So the idea was for me to come to Uganda to make a kit of policies and tools so that any administrator who arrives has what they need to get started.  I have done this before, but this time, this was my only responsibility.  Usually, I must do projects like this and at the same time to the day to day work, which is pretty big.  Only by having no other responsibilities could I finish the work in 3 weeks.   It was great to have this opportunity.

Now I am back in Lyon, probably until around middle of July.  I should leave for Amman, Jordan..  I should be working with one refugee camp of 120,000 people in Jordan, and another Syrian refugee camp in Kurdistan.  This will be my first time working with MSF outside of Africa.  I am looking forward to this new experience.

Here is a press release of a speech made by my old boss to the UN:

*************************************************************

Speech Delivered to the UN Donor Conference on Syria on June 7

Mego Terzian, President, MSF-France

June 6, 2013

Six months after the first international donor conference for Syria, humanitarian aid is failing. Security and living conditions have deteriorated dramatically. The population living in areas controlled by opposition groups have almost no access to official international aid. Across the country, there are enclaves surrounded by intense fighting, where virtually no aid is reaching the people trapped inside.
While international attention has focused on chemical weapons, our teams on the ground are seeing that it is above all the bombing, the consequent displacement of millions of people, and the targeting and collapse of the Syrian health system that are causing the largest number of deaths.
.
We can attest to the immense needs in the north of Syria, where MSF operates five health facilities in opposition-held areas. Already this year, in addition to carrying out thousands of surgical procedures, we have vaccinated nearly 70,000 children against measles and delivered almost a thousand babies, as women have lost access to maternal care. We are providing treatment for cutaneous leishmaniasis and typhoid, as well as other communicable diseases and chronic illnesses such as hypertension and diabetes.
Yet given the scale of need, what MSF is doing is extremely limited. Most aid in the country is coming through Syrian solidarity networks, but they are struggling in the face of massive medical needs. Their medical assistance is focusing primarily on providing treatment to the war wounded.
But what of the pregnant women? And the sick? The Syrian medical networks need more support.
The medical imperative is to meet critical health needs, wherever they may be.
We are doctors and nurses striving to fulfil that imperative impartially. But, under the current circumstances, we cannot work to our maximum capacity.
Medical assistance is being targeted; people in Syria today are risking their lives in seeking and providing healthcare.
We negotiate access with all parties, but we have yet to receive official authorisation to work in Syria.
Restrictions on the delivery of aid within the country are increasing. Humanitarian personnel who cross front lines risk being shot or kidnapped.
So if the aid arriving through neighbouring countries is stopped, a lifeline into Syria will be severed. Millions of Syrians will be left without medical services.
Neighbouring countries must continue to allow the flow of essential medicines, medical supplies, and medical personnel into Syria.
Borders must also remain open to allow refugees to escape. In Iraq, the last remaining open border crossing, at Rabi’a, is now closed. Thousands are stranded inside Syria, along a sealed border more than 800 kilometres long.
In countries bordering Syria, MSF teams are witnessing overcrowded hospitals and poor access to healthcare for refugees and a growing number of local residents. Official aid is dwindling in Lebanon, for example, yet tens of thousands of refugees have still not been registered by the United Nations. Without registration papers, these people are not eligible for most aid, including health services.
An immediate international financial effort is vital to support public health services in host countries and improve the living conditions of refugees.
All actors represented here today hold the key to increasing lifesaving assistance in Syria, wherever there is need, and to improving the living conditions of people fleeing to neighbouring countries. Yet the reality is that the official international aid system is not working.
We must—and we can—find other solutions.
Donors must increase funding through the aid channels that are able to provide effective humanitarian assistance, even if those channels are not part of the official aid system.
Neighbouring countries must lighten administrative procedures to facilitate the delivery of urgent aid.
Finally, we must reiterate that warring parties must refrain from attacking health structures and respect the safety of humanitarian convoys. Humanitarian aid must be allowed to access to all victims of the conflict, whether by crossing front lines or crossing borders. 

Dr. Mego Terzian was recently elected as the president of MSF-France. Born in Lebanon, he earned his medical degree in pediatrics from Yerevan State Medical University in Armenia in 1999. While still in medical school, he worked as a translator for MSF in Nagorno-Karabakh, and from 1999–2002, he worked as an MSF field doctor in Sierra Leone, Afghanistan, and Iran. In 2003, he became an emergency coordinator for MSF projects in Liberia, Ivory Coast, Niger, Pakistan, Central African Republic, Jordan, and other countries. From 2007 until being elected president, he served as the deputy and then the director of MSF’s Emergency Programming at MSF-France.

I say my old boss, because as you can see in the article, he was just elected to be president of MSF-France. Even though I am very happy that he is now our president, I am losing a great boss.  But from what I understand, the person that should replace him is a good guy also.

Going again

I have been on vacation for nearly 3 weeks.  Incredible!  But it ends with this weekend.

It was really nice to be back in Indiana to see my family. They are all doing great, as usual.  I saw everyone except my niece Sarah, who is living in the south. I am sorry that I missed her.  I was there at the same time as the prom of my youngest niece, and my brother and sister-in-law hosted a dinner before the event for about 40 kids, and after the dance they slept at the house.  It was a little crazy and a lot of fun.

After that, I arrived in Lyon, about 10 days ago.  Before I left, I invited a friend to live in my place because he needed some help.  So this time, I am sharing my place.  I know the guy from several years ago, but I was a bit worried about how I would find the place, but he took good care of it.  I am happy.  He knows more people in Lyon after only 4 months than I do after several years.

I have my next two work assignments now.  I leave Monday for 1 month in Uganda.  I know that I will be coordinator of finances and human resources, but I am not really sure a about the circumstances – replacement, coach, filling a hole?  Whatever.  After that month, I should come home for a week, then go to Syria for 3 months.  That will be my first assignment outside of Africa.  Syria should be a little rock and roll.  I am looking forward to it

Back from Congo, in the States, where next?

We finished our measles project in the Equateur Province of Democratic Republic of Congo (formerly Zaire).  We vaccinated in one 1 of the 4 health zones in the district of Mongala – 81 000 children in 11 days.  We probably should have vaccinated in another zone, but the rainy season had started, and the logistical issues (air delivery of the vaccines, ground transportation, site preparation) proved to be too much for us in this case.

We did, however do case management in all four zones, from end of January through 20 April.  We helped treat over 9 000 cases of measles in the 81 health centers in the district, and distributed over 11 000 treatments (covering cases after our departure.  We also helped treat severe or complicated cases in the hospitals in the area – 346 cases during this time.

It was a good intervention, but we left hoping that another partner can take over our work, as the epidemy is not yet completed.

Closing the project is always interesting.  We had very few staff ourselves, working with the Congolese government health system.  But we had a few, and I had to manage their layoffs.  I had several visits from the labor office, and the staff tried to get more layoff benefits, but finally, everyone realized that we had followed the legal procedures as we should.

Another consideration was Bob – the baby orphan chimpanzee adopted by the team.  What to do with him?  Fortunately, one of our drivers adopted him.

The last 8 of us all left on the same day on a plane operated by the International Red Cross and Doctors Without Borders in partnership.  The Bumba airstrip is a dirt runway, and this plane had already refused to land a couple of times because the runway was not in good shape.  It had rained the night before, so one of our logisticians who REALLY wanted to get home got up at 5:00 with a work crew to evacuate the water, fill holes and generally make sure that the plane would land.  Success!  They did.

We flew to the capital of Kinshasa for some meetings before the others left.  I stayed 4 days waiting for a flight to Goma on the east side, to hand over our documents and reports to the team there.  Then I was driven to Kigali in Rwanda to catch my flight back to France.

I have been in Congo too long!  While processing my departure with the migration office in Bumba, I had 2 people I had worked with on the east side of the country, who were on the same plane but from a different pick up point, who entered to greet me.  When we landed in Mbandaka, I was greeted by a Congolese lady whom I had met at a party during my arrival flights.  While in Kinshasa, I saw one of my close doctor friends who had just returned from Chad.  And while walking, I ran into a guardian who used to work with us there.  When I left Kinshasa for Goma, I found a Congolese doctor friend with whom I had worked many years ago, who now works for the Red Cross.  And of course, having stayed in Goma for 2 years, arriving there was like finding my family.  I was very fortunate to refind a friend with whom I had lost contact for several years, due to having my email account pirated.  I thought I would never be able to contact him again, but through a mutual friend, we got back in contact.  I only stayed 2 days there, but it was wonderful.

Upon arriving in Paris, I had my debriefings on a Friday afternoon.  Saturday, I did my laundry, because it was 9 days since we had closed the Bumba project and gotten on the first plane.  Then, Sunday I flew to Jeffersonville Indiana to be with my family.  It has been 3 years since I was here.  That is where I am now, and it is wonderful to see my brothers and their families again.  I left here when I started my studies 41 years ago, but I have already found a few people outside of the family that I know.  We will try to get the brothers and as much of their families as possible together this weekend.

Then Monday 13 May, I leave to return to my place in Lyon.  I should probably have about 1 week there before heading out again somewhere, although nothing is definite.  It will be interesting being there – I lent the apartment to a Tanzanian friend just before leaving, and we will be sharing the 170 square foot space while I am there.  It should be interesting!

February in Congo

Note:  This post was written 25/02/2013, but I could not connect to internet until today, 04 March.  Even now, I had to find an internet café to have a good enough connection.

I left Lyon for Paris on 21 January, 10 days after returning from South Sudan.  I arrived in Bumba on 28 January, where we are responding to a measles epidemy.  Case management started the same day I arrived at the local hospital and 16 health centers in the zone.  We are starting the first vaccinations today, 25 February (it takes some time to order and receive all the vaccines and logistics material necessary in this remote corner of the world) targeting 85 000 children between 6 months and 15 years old.  We may be vaccinating in 3 other zones with about the same target population in each zone.

Bumba is a small town situated on the Congo River, at the top of its course through the Democratic Republic of Congo.  I have been in country capitals the last few years, so it is refreshing to be in a small town again, although the choice of food and supplies is very limited.  Fortunately, in Congo, beer and bars - and churches (but this does not really affect me) - are rarely is short supply. 

We have taken over a small hotel with 12 rooms – with the last arrivals there will be 19 of us.  One of the big rooms serves us as an office.  The dining room is our pharmacy.  The commercial kiosks facing the street are our logistics store.  And the storeroom now houses the electrical generator.   We have arranged an indoor/outdoor kitchen and a covered outdoor dining room.  And as we have taken over the hotel, we have also taken over their 3 cleaners and 3 watchmen.

Most of our movements inside and outside of town are by chauffeur-driven motobikes.  As ot today, I have my own chauffeur – what class!  A lot of my time is spent changing US dollars for Congolese francs, and distributing both currencies for staff, purchases and rental contracts.  When not doing that, I am seeing the local authorities, revising our budget, recording the accounting, recruiting, and training.

I joined the emergency group in June, but this is really the first project opening I have done since then.  It is pretty exciting and very interesting.  Until now, I have been pretty much tied to the office.  But we just hired a cashier which should free me up to get out to the sites.  I am looking forward to seeing how a mass vaccination campaign works.

The organization of such a campaign is amazing.  First, we have to assess the gravity of the problem, start treating the cases, calculate the target population for vaccination, order the vaccines and other consumables, and find the freezers, icepacks, coolers, and refrigerators necessary to keep the vaccines at the correct temperature (some coming from our central supply in France).  There is also all the logistics material for the site circuits and the vehicles.  And then there is the personnel.  We have 3 supervision teams consisting of 1 nurse and 1 logistician each.  Each supervision team works with a circuit construction team of 1 carpenter and 1 laborer.  And each supervision team managers around 8 vaccination team a day during the 8 days of vaccination. For the vaccination teams, we are using staff provided by the local health center (each team consists of 14 people) so we don’t have to worry about recruiting these people, but we do pay them an incentive for their participation.  The vaccination kick-off was today.  It will be a very intense 8 days.

It is incredible the difference between here in Equator province and North Kivu, where I spent 2 missions (a total of 2 years and 9 months).  Equator is close to sea level, and as the name insinuates, on the equator.  Sun is up at 6:00am and down at 6:00pm all year round.   It is HOT – between 90° and 105° F each day.  If you read this blog regularly, you know that I am happy.  North Kivu is also on the Equator, but like Denver, it is very high, so it stays between 70 and 80° all year round (if there was peace in that district, it would be the perfect tourist spot, with animals and all – I would gladly take my retirement there.  But that is still not the case.)..  I can tell you that I suffered from the cold in France arriving in January.  I have spent 7 winters in central Africa.  I love this weather.

In Equator, this is the dry season.  That means it only rains 2 days a week rather than every day.  And when it rains, it pours.  In North Kivu, this is about the same.  For us that is good, because starting April the rainy season starts again and the roads (big word, because road means a dirt path – in some places less, where only the motorbikes can pass along a path or in a  creek) are impracticable.  If we have to vaccinate the other 3 zones, it must be very soon.

 I am once again in a country with a new language.   In the west of Congo, the language is Lingala (in the east it is Swahili).  Since I already have enough problems with written French, I doubt that I will be picking up a lot of Lingala.

Our MSF team is great.  By the time everyone arrives, we will have 15 international staff and 4 delocalised Congolese staff.  We have 12 local staff today (1 more to hire), the hotel staff, and godzillians of staff working for the Congolese ministry of health.

All in all, I am once again enjoying my new experiences.  EXCEL is still my best friend, for generating the payment frameworks, and creating automatic receipts.   And I still have contact with people from my previous missions, when I can.  The internet here is worse than terrible.  If I try 2 times a day, I am able to connect maybe 2 times a week, so contact is not great.  So please forgive me if I have not contacted you.  

Back to Congo (Hurray!)

I arrived in France on 9 January.  Winter.  Cold.  I have been in Africa for the last 7 winters, and I thought my balls were going to freeze and fall off (pardon my French)!  But I had a very good time!  I met up with a friend from the Netherlands while in Paris, and then I refound a great friend from Zanzibar while I was in Lyon (see below).

Now, I am going back to Congo !  And not too soon – this European winter weather is killing me.  Fortunately, it is the official time of “SALES” in France.  I found a winter coat for not too much money.

I received a call on Saturday telling me that the woman who was supposed to go to Congo for a measles epidemic could not get her visa, and so they wanted to send me.  Of course, I said yes, after about ½ second of reflection (okay, maybe not that much).

But this is not in the parts of Congo (Democratic Republic of Congo – DroC – Congo Kinshasa) that I know.  This in the province of Equateur – in the north west.  There are no security problems!  Well - no more that parts of Paris.  It is also in a district that MSF is not represented for the moment.  So we must start everything

MSF Belgium noticed that a measles epidemic has started in June 2012 in the neighbouring province.  They alerted MSF France (my section) in December that it might touch places that we did not know.  We sent out an exploration team and voila!  We found the need.

Measles means treating the cases found, especially less than 5 years old in which the disease can be most lethal.  It also means vaccination.  We have just decided to do both (it is complicated due to the politics of vaccination – I can’t go into that problem here).  So we will be working with the existing Congolese health organization for both treatment and vaccination.  But there is still a lot to do before we start the vaccination – it will be for 45000 and 90000 children.

Right now it is a small team – 8 people including me.  And I have already worked with half of them - and enjoyed it!  Since our section is new in the region, there is everything to do – how to get money (no banks where we are), what to pay people, hiring, how to bring in supplies and vaccines (probably charter a plane, because the only other way is by boat on the Congo river – loooooooong), and much more.  This will be my truly first start up mission since starting my contract with the Emergency Department in June.

I leave tomorrow at 5:30am from the hotel.  I arrive in the capital of Kinshasa tomorrow evening.  Then I take a flight on Thursday to the district capital of Mbandaka on Thursday.  Finally on Monday after, I take the flight to Bumba (I will rumba in Bumba!) directly on the Congo river, where I will be working.  Apparently the biggest difference with the North Kivu where I worked before it that it is in the lowlands (hotter) and it rains every evening (oh, well).

The other news it that my place is no longer empty!  While in Paris, I got a message from an old friend from Zanzibar from 7 years ago.  We have stayed in contact off and on.  He was living in Europe, and recently was aggressed where he was.  He no longer felt safe, and asked if I could help.  I had already offered my apartment to him and his wife a few years earlier.  (They have since parted ways for a couple of reasons, although they are still married and still see eacy other).  So he was able this time to come to visit.  And he will be staying now in my place for a while.  I feel a lot better with someone I trust in the place than when it is totally empty.

Once again, I must say that I have had much luck in my life.  Only problem – I must be awake at 4:30 in the morning!  Such sacrifices - hehehehe.

Again, to Cindy's mom (my most fidele blog follower) big hello. It was great to speak with you today.

Happy 2013

I am nearing the end of my time in South Sudan.  The guy I am replacing returns tomorrow afternoon, but there is no place available on departing flights until 9 January, so I will be leaving at that time.  I will fly into Paris for debriefings and to meet a Jamaican friend there for a day before returning to Lyon.  Then, I will head out again, although I am still not sure exactly when and where I will go.  I have been told that the break will be a short one.  Seeing how it will be very cold in France, this is ok.  Unless, of course, they send me to someplace even colder!

We had a wonderful holiday season here.  On the 24^th, I finished my work early and went home to make some Christmas breads – an Italian panettone and a German stollen, as well as a Linzer torte.  I had to start my panettone recipe 3 times before getting it right due to some ingredients problems.  Grhhhhh!  

 Having Christmas dinner outside under the mango trees in 90 degree weather is my idea of perfection.  The table was beautiful (thanks to the French contingent), and the wine was heavenly.  Almost everyone contributed to the cooking and we ate like kings.  We thought we might have too much food, but Christmas holiday is 3 days in South Sudan – 24-26 December – and we had no cook during that time.  So we finished everything by the end of the period. 

You might think we do nothing but party here.  Just to be clear, although we had no national staff in the office in Juba, our expatriate staff continued to work during this period, because our health centers operate 7 days a week / 24/24, and we need to support them.  The workload, however, was less than normal!

There were 15 of us in the house for Christmas dinner.  I am glad I planned large when buying small gifts while I was in France in November..  A couple of the other guys got together and did the same thing, buying small African crafts for everyone. It was a wonderful evening.

On New Year’s Eve we hosted a party at our house for the other sections of MSF.  This was also our housewarming party, since we moved into the house the new house the first week of December.  The organization was amazing, and we had a very good time, although there were a few pitiful faces the next morning!

I have enjoyed my 5 months in South Sudan.  I was originally slated to be here 2 months, but these things happen in MSF.  Tomorrow and the next day will be doing the handover with the financial controller, giving him back the work that I did during his absence.  Then I will be taking it a bit easy until my departure, since I am not sure how much time I will have before going out again.  I will miss a lot of the people here, both national staff as well as expatriates.  At least with the expatriates, I have a good chance of finding them somewhere else in the future.