Sunday, November 02, 2008

Back in Town

I am back in Goma - Anne, a logistician, and I arrived yesterday, leaving two other people on the other side of the border. The town is pretty quiet - not as much circulation as usual and most of the commerces are still closed. We will keep the staff at a minimum for a while.

With the displacement of the population, there is a lot of work to do, but we are bringing people back slowly and cautiously because the conflict is far from over. There will be a lot of movement of people between projects, and some people will be returning home early because their profiles no longer fit the program. We had a two-hour meeting yesterday evening to plan the movement of the expats and the relocated staff - that's about 56 people.

We have started a new project, trucking water to the 20,000 displaced above Goma at Kibati, because this is the biggest need there. We are also doing mobile medical clinics for these people who have no access to medical care. Other actors are involved in distribution of non-food items, distribution of food, etc. It is important to coordinate between all the Non-Governmental Organization (NGO's) to maximize the aid provided to these people and to avoid wasted or duplicated efforts.

I am a lot more involved in the strategy for covering this crisis than I was in 2006 when we had a mini-version of the same type of conflict. It's a very interesting experience.

Friday, October 31, 2008

Hot time in Congo

Things have heated up here in Congo. The fighting between the government troops and the CNDP (the major rebel group here) have intensified, and even the UN Monuc troops (who are usually only in an observer role) has gotten involved.

The combat arrived at the doors of Goma, where I am, Wednesday. We wanted to do a partial evacuation then but we were caught a little too late. We closed down the office early and all the expats and relocated staff went together to our first house. With the police gone, and the military having fled, it was a night of looting, vendettas, and general mayhem everywhere. We heard shooting all evening, starting around 6:00pm. Around 9:00pm when a round of machinegun fire was heard VERY close, all 10 of us at the house fled to the “safe room”, one of the bedrooms with no windows exposed to the outside, metal doors which bolt from the inside, a stock of food and a ham radio. Since the room is about 10 ft x 10 ft, let’s say that the night for the 10 of us together was very intimate!

Thursday morning, we did a partial evacuation of 5 of us (yes, I am in the group). We didn’t go far – just across the border into Rwanda – about 7 miles. But the border crossing (exit stamp, entrance visa, payment of an exit visa for the car and customs of a lot of baggage – including a case of sensitive documents we brought with us) took about 1 ½ hours. We are pretty worried about our colleagues still in Goma because apparently there was heavy artillery fire there this afternoon. We’re not sure how long we will be here, but we can still work and communicate with the other sites, some of which are also in evacuation, now that we have found an internet café close to our guest house.
We are not sure how this will end. The CNDP said Wednesday evening that they wouldn’t attack Goma. Then Thursday evening Laurent Nkunda, head of the CNDP announced that no one would keep him from taking Goma. No one knows if they have the capacity to hold onto the positions they have already taken. No one knows either if the Congolese government has the power to retake those position. At any rate, whatever happens, MSF will have a lot of work waiting for us as soon as we can put all our people back into place.

Sunday, October 26, 2008

26 October 2008

Happy DSD reunion for the Californians!

I sent off my quarterly budget review Wednesday, asking for a 7% increase to finish the year. This is always a traumatic exercise – it took me about 3 weeks to put the whole thing together, while dealing with the usual stuff (already a 12 hour a day job) plus an outbreak of cholera.

It has been pretty quiet for a couple of weeks, but fighting broke out again early this morning about 40 kilometers from here – the objective is a government military camp, which was taken by a rebel group this afternoon. It is on the road between Goma, the district capital where I am, and Rutshuru where our biggest project is. This is also the route we use to supply all our projects in terms of medical supplies, logistics supplies, money, etc. So we hope that the situation is the same as a month ago – the rebels took the camp, stole all the arms and left quickly.

If all goes well, I should go to Kabizo on Tuesday for a couple of nights. This is a site which we evacuated at the end of September. The objective of the visit is to see if we can return the expats and non-local national staff. Apparently, even 90% of the local population left the area, leaving only the refugee camp full - they have no where else to go. We have been back a couple of times for day trips, but this time we had hoped that the logistician, Anne, and I could spend a couple of nights there to evaluate the security situation, see what the needs are to put the program back into regular running order, and pay the few local staff who are still there. With the fighting, which is much closer to Kabizo (which is a rebel enclave) than here, our trip is very uncertain


Never a dull moment.

Tuesday, October 07, 2008

Explanations of North Kivu Facts Sheet & Press Release

The two preceding postings concern a press release sent to the world press by MSF yesterday. The first explains the involvement of MSF - all operational sections (France, Belgium, Holland, Spain, Switzerland) - in this region of Congo. The preceding one is the press release explaining the current events here and our concerns.

Anne Taylor, mentioned in the article is my boss.

North Kivu Facts Sheet - MSF

MSF ACTIVITIES IN NORTH KIVU - FACTSHEET

MSF provides primary and secondary healthcare in North Kivu in and around Rutshuru, Masisi, and Lubero districts. MSF supports hospitals in Rutshuru, Mweso, Masisi and Kitchanga as well as surrounding health centres, and runs a network of mobile clinics. MSF teams also provide medical care to victims of violent trauma and of sexual violence and treats children for malnutrition. In some areas MSF has opened new health posts to provide care for the increasing number of people fleeing the violence. Mobile teams are doing assessments and providing medical assistance in new areas, including Ngungu in North Kivu and Minova, in South Kivu. MSF teams are also monitoring the situation in the camps to prevent outbreaks. MSF teams respond to potential cholera epidemics and carry out vaccination campaigns against measles. MSF has been continuously present in the North Kivu since 1981.

RUTSHURU DISTRICT

Rutshuru town area

MSF has been working in the Rutshuru reference hospital since August 2005 providing secondary health care, including surgical, medical, paediatric care and specialised care to victims of sexual violence. The hospital capacity has been increased to 220 beds. The number of surgical interventions per day during the first nine months of the year has increased in comparison with previous years to an average of 12 per day (3 in 2006). Between January and September, MSF teams have performed 2,777 surgical interventions and 7,359 emergency room consultations. In June, 832 patients have been admitted to hospital. Between January and June, an average of 87 victims of sexual violence have been treated each month. Between January and September, MSF has treated 158 war wounded at the Rutshuru hospital; 36 in September alone. Between January and September, MSF has also treated 1,469 people for cholera.

In Nyanzale, MSF conducted 2,320 consultations in June. From January until June, MSF treated more than 1,300 malnourished children (776 treated in ambulatories and 585 hospitalised). Between January and June, an average of 450 victims of sexual violence have been treated each month.

In Kabizo, MSF is normally conducting medical consultations (1,590 in June), and hospitalises IDPs and residents in a 16-bed centre. MSF teams also treat victims of sexual violence and malnourished children.

LUBERO DISTRICT

In Kayna and Kanyabayonga, MSF is providing assistance to thousands of people fleeing the conflict since the 20th of September. During the first ten days of activity, MSF teams already treated 140 victims of sexual violence and 15 war wounded.

With thousands of displaced persons constantly on the move, from all these sites, MSF also supports a network of health centres, has set up a system of mobile clinics and has regularly conducted measles vaccination.



MASISI DISTRICT

Masisi town area

Since August last year, MSF has been supporting the hospital in Masisi, whose capacity has been increased from 70 to 120 beds. MSF medical teams provide secondary healthcare in the hospital, including life-saving surgery, and support a health centre in town, where they provide primary healthcare. MSF has also set up a 25-bed structure that welcomes pregnant women before they give birth.

To respond to the needs of the displaced population in the area, MSF has set up a system of four mobile clinics with an adequate referral system. MSF raises awareness about the need to provide medical and psychological care to victims of sexual violence in seven locations.

During the month of September, 55 victims of sexual violence have been treated. During the same month, MSF also treated 25 people for violent trauma.

Mweso and Kitchanga area

MSF supports the St. Benoit hospital in Kitchanga since 2007, and the hospital in Mweso since April 2008.

MSF also supports a network of health centres and, since January of this year, has significantly extended the programme to provide assistance to people affected by the conflict in the Masisi districts. MSF supports health centres in Kirolirwe, Bukama, Kachuga and Kalembe since 2007. Since January 2008, MSF supports the health centre in Pinga and Mpeti and, since April, Kanyatsi. Mobile clinics go weekly to Malemo and Busihe.

During the first eight months of the year, 2,703 people have been hospitalised, 2,069 women have given birth and 11,698 women have received antenatal care. MSF medical teams have conducted 94,094 external consultations (30,239 for children under 5 years), and have treated 18,103 cases of malaria. MSF surgical teams have conducted 384 operations, 306 of them urgent. MSF has also treated 2,354 malnourished children, and 377 have been hospitalized.

GOMA DISTRICT

Tens of thousands of people are thought to be living in camps outside Goma, with several thousand more finding accommodation with host families. MSF is working with the Ministry of Health to treat and contain cholera. Cholera is endemic in DRC and MSF teams will normally see a number of cases in North Kivu every year. MSF has treated 1,480 cases of cholera from January until September.

MSF has 62 international staff and 716 national staff currently working in North Kivu.
MSF has been working in the Democratic Republic of Congo since 1981.

MSF press release

War in North Kivu (DRC)
The international community is failing to provide adequate assistance and protection to the population

Goma, 6 October 2008 – In the most volatile parts of DRC’s North Kivu province, violence has reached its highest levels in years, while assistance is hardly reaching those most in need, the international medical organisation Médecins Sans Frontières (MSF) said on Monday. Hundreds of thousands of people have been forced to flee their homes since full-scale war resumed at the end of August and are living in fear, without the means to meet their most basic needs.

The international community has failed to address the on-going conflict in the region as a priority. Even though one of the largest peacekeeping forces in the world is currently deployed in DRC, the United Nations peacekeeping force (MONUC) is clearly failing to fulfil its mandate to protect the civilian population in North Kivu.

Most UN agencies and NGOs are also failing to provide an adequate humanitarian response whereas the already disastrous humanitarian situation is dramatically deteriorating. Despite the presence of a large number of humanitarian organisations in Goma, the province’s capital, few are active in the areas most affected by the war.

Many people who now need assistance have been forced to flee several times. They have repeatedly lost their homes and belongings – often as a result of looting – and are losing their capacity to cope. In addition to the extensive needs of the population – food, shelter, access to water, medical care and protection – the risk of epidemics is high, and many health clinics have been looted.

Some of the people who flee reach relatively established camps, while others gather in isolated pockets of calm or with host families. Still others have become ‘invisible’ – hiding in the bush, trapped between armed groups. "We were assisting over 100,000 displaced persons in Nyanzale and Kabizo. We have no idea where they have fled in the past few weeks”, says Anne Taylor, MSF Head of Mission in Goma. “Only 25,000 people arrived in Kayna and Kanyabayonga. Where are the others? We are extremely worried about their fate."

In other areas, MSF found groups of newly displaced people. In Ngungu, thousands are living in terrible conditions, without any health care. Thousands of people also arrived in Kitchanga during the last weeks. “Reaching these people is extremely difficult because of the volatile security context and because they are constantly on the move,” says Anne Taylor. “But it is not impossible. We just keep trying and trying until we can find them and provide some vital assistance. But we are aware that we are only dealing with a small part of this humanitarian catastrophe: hundreds of thousands are out of reach.”

In North Kivu, MSF teams are currently working in and around Rutshuru, Nyanzale, Kayna, Kanyabayonga, Kitchanga, Mweso and Masisi. Mobile teams are doing assessments and providing medical assistance in new areas, including Ngungu in North Kivu and Minova, in South Kivu. MSF has 62 international staff and 716 national staff working in North Kivu.


For further information, please contact:
Andrea Pontiroli, MSF communication officer in North Kivu
+243 817100003 / +88216 50360889

Saturday, October 04, 2008

October Posting

Since my last message, we had to evacuate all our expatriates and non-local staff from 2 of our 4 projects in North Kivu. But they haven’t been idle – they are following the status of the population fleeing the combat. We have set up mobile clinics in 4 new sites to treat these people medically. Three of these clinics are in the same sites in which we set up under the same circumstances when I was here in 2006!

In fact, last Friday I was on my way to our Nyanzalé project, but during the 4 hour car trip Nyanzalé evacuated. Instead of returning to Goma, we decided that I should continue to Kayna, where we have set up a base to follow the population movements and treat the displaced people just south of there. Kayna is where I spent my first mission of 8 months in 2005-2006. It felt like going home! I did a lot of set-up work for the project, but I also had the opportunity to renew friendships with people I hadn’t seen in 2 ½ years.

The fighting has calmed down temporarily in most spots, but the situation is far from stable. In Rutshuru the full team is back in place since last Monday, the team from Nyanzalé returned to that site yesterday, but the Kabizo team (in accordance with our neutrality policy, this project is in the heart of one of the rebel zones) is split between Kayna and a new mobile clinic for the displaced not far from us here in Goma.
We just finished a measles vaccination campaign in the southeast of the country (vaccinating around 25000 children before the beginning of the rainy season) this past week, which has freed up some resources (personnel, cars). This is fortunate because they were sorely needed to help with the activities listed above.

Monday, September 08, 2008

It's Hot!

It’s been a busy week here in North Kivu. On Monday, fighting broke out between the government forces and one of the principle rebel groups fairly close to our biggest project, Rutshuru. So we reduced the expatriate and relocated national staff by half, bringing 14 people south here to Goma. This makes it easier to perform a total evacuation if necessary, but allows to keep the project going – we treated about 20 wounded there (both military and civil) since the fighting broke out. Later in the week, the conflict zone enlarged and we had to evacuate all the expatriates and relocated staff in the other 2 projects to a more secure area up north. (FYI: Following our policy of total neutrality, one of those projects is in a government-controlled area and the other is in a rebel-controlled area.) That makes 30 more people evacuated.

The local population is moving to get out of the fighting zone as well. Apparently they have also fled north, but not as far as our staff. So today and tomorrow, we have sent out a small exploration team from the evacuated group to evaluate the situation of this displaced population. If they find a need for health care or water supply or distribution of basic non-food items, we will probably set up an emergency project, using the team that just evacuated. Our plans change hourly.

But today is calm – not much we can do until the explo team has evaluated the situation. We should know more tomorrow. I worked a hard yesterday so that I could take this Sunday off. For the first time since I arrived here, I took a discovery tour of the town by foot. Goma is a secure place, but still, our security rules only allow us to walk along the 2 biggest streets. I visited Kivu Market, a grocery store which caters to the white humanitarian organization clientele. I was amazed at the selection – you can find a lot of French and American products (Pillsbury cake mixes?) Tonight, Claudia (our medical coordinator) and I are making dinner for the 11 people in the house – beef barbeque, vegetables, rice and apple pie.

And tomorrow the work starts again. We will know more about the situation of the displaced people tomorrow evening. Then we can decide whether to put the evacuated team on standby in a really secure area (like Uganda) until things calm down or, if there is the need, to put them to work. I will be going to Rutshuru (where we did the team reduction last Monday) tomorrow for a week. I will be replacing the administrator who was evacuated and is now on break and working on some big human resources problems that we have there. Between that work, following the situation of the evacuated group and the situation of the displaced population, it risks to be a busy week again.

That’s what we do! And I am as happy as a pig in shit! Yes, it is a pretty intense situation, but right now, I have to start making my apple pie!

Sunday, August 24, 2008

Posting end of August


I arrived Goma three weeks ago. After being in the desert for 2 years, the green of North Kivu in the Democratic Republic of Congo (formerly Zaire) is beautiful. Our house is right on Lake Kivu, which is enormous. On a clear day, we can see the volcano Nyragongo, which is still active (it destroyed the town about 12 years ago).

A week after arriving, I did a tour of our 3 projects. It took 10 days. I think that I know about 1/3 of the staff already from my first stay in the region (2005-2006). It is wonderful to see them again. Since the project in which I worked has closed, they have found jobs in the other sites and here in Goma. Some are working with other organizations, and some are unemployed. It is a bit disconcerting for a few of the other expats when we are in the middle of nowhere and someone calls out my name and then hugs me!

There has been quite a turnover of administrators here the last year, and it shows. I have a lot of work to do to get things back into order. Fortunately, I have a great staff here, in Goma and in the field. And our expat coordination team is great. It is going to be good to work here.

I am already overwhelmed with work. My head of mission has already told me that I work too much. (For those of you who know me, this probably comes as no surprise.) But at the same time, she added to the list of critical things to work on! Right now, the big items are
· a complete overhaul of the payroll supplement we pay the state health system employees who work with us (around 90 people)
· a revision of the job function scale for the local staff (around 400 people)
· a study of the “fundamental needs basket” on which the salaries are based
· implementation of analytical axes in the accounting, so that we can track expenses by activity
· implementation of a more complete budget follow-up system

The day-to-day human resources problems also take up a huge amount of time, as it did also in my last 2 missions. Keeping track of all the expats coming and going and the reference visits from Paris is also a nightmare. Part of my grunt work is to assign rooms to all the expats and délocalized (I can’t remember the English word for this – yes, this is a French-language mission again) staff here in Goma, as well as the visitors. For the moment, we are 6 expats (+ the daughter of one), 5 délocalized staff, plus transit and visitors. This weekend, for example, we are 13 and next weekend we are 15. There are 9 bedrooms in the house! Fortunately, we are renting a second house starting in September.

Ahh! We don’t get paid a lot, but we sure have a lot of fun! At least there is beer and wine in Congo, which already beats Sudan!

Tuesday, July 22, 2008

Leaving soon

Yes. I will be leaving Lyon for my briefings in Paris on Sunday the 27th of July. Then I leave for Goma in the North Kivu region of Democratic Republic of Congo (also known as Congo - Kinshasa) on the 29th. My flight arrives in Kigali, Rwanda and then it is a short drive across the border to Goma.


The good news is that my apartment is finished and I should finish moving my stuff from Savoie tomorrow.

I am very happy with the place, although it took me longer to finish the plaster and painting than I had anticipated. Anyway, it will be ready for me when I return in a year.

I have enjoyed my time back in France going to concerts, other spectacles, bars and restaurants. I have gained back some weight and am ready to attack my time in Congo. Actually, I am thrilled to be going back there.

Apparently, there is a lot of work to do on the "big" topics: staff follow-up, salary scale, budget follow-up and analysis. Fortunately, my Paris contacts for human resources and finance are the same ones I had for Darfur. So we are used to working together.

We are about 30 international staff and 700 national staff, bigger than Darfur. Our programs in 3 sites include war injuries (including surgery), cooperation with a district hospital, victims of sexual violence, malnutrition, and mobile clinics. There should be enough to do!

Sunday, July 06, 2008

July Posting

The admin training course went really well. There are some really good people in the class. Most of them will be leaving very soon on mission, or they have already left. It was a pleasure to help out with the course, and I learned a few new things too.

And the party in Italy the 21st of June was great! Emanuela has some interesting friends. Apparently, most of them were in the communist movement in the 70’s. Some had prison terms to serve because of this, including a doctor and a researcher for the Pasteur Institute. They were all interesting people, and I was able to communicate with quite a few of them in English or French. Emanuela has about 40 people living on her property (her great-grandfather both the village at the end of the 18th century). It’s not a commune, but almost. The big party was the 21st, but I stayed 3 days and was not the last to leave!

Since then – WORK! I have just finished painting and varnishing. Yesterday, I installed some of the bathroom fixtures (one drill bit for each 2 holes) and the blinds for my one window. I moved a few items yesterday, including a huge painting I bought 3 years ago that has been in storage since – the place already looks more lived in. I cleaned the place today because there was dust and other crado (is this French slang?) stuff on all the surfaces. And I washed the chandelier today – something exploded just afterwards. I changed all the bulbs and verified the wiring inside and the circuit breaker didn’t even shut off. I have no idea what the problem is, but I have an idea that I will have to change the dimmer switch. We’ll see that tomorrow. I would like to make a couple of shelves for the bar, and I have to move my stuff from Savoie. But we are getting there. I won’t have too much time to enjoy the place before leaving, but I will be finished, I hope.

I am also trying to get reacquainted with Lyon the evenings. There are a lot of really nice restaurants and bars near my place. That’s one of the reasons that I chose this location. It is, however, difficult to meet people here. I’m not great at starting conversations, or even keeping them up, but I’m starting to break the ice with a few people.

And I am still psyched about going back to Congo. I have been studying the hand-painted map they gave me of the region before leaving in 2006 – trying to get re-acquainted with the area. I’ve also been studying their plan for the next 6 months. Apparently, all the capital admins they have had this year have been for a very short time, for one reason or another. So it is good that I am staying for a year. I should be leaving before the end of July (around the 28th?) because I would like to have a last briefing with the lady who is in charge of all the field admins (and who is also a very dear friend) – she leaves on vacation with her new daughter the 3rd of August. I will leave Paris, for Bruxelles, then Kigali in Rwanda and then going by car to Goma in North Kivu in the Democratic Republic of Congo (formerly Zaire, also known as Congo - Kinshasa to differentiate it from Congo – Brazzaville).

Tonight I am going to Jazz a Vienne Blues Night with a new acquaintance. I will also be going Thursday evening for “A Tribute to Frank Zappa”, an evening with Jean-Luc Ponty, a jazz violinist whom I adore.

So life is fine. All is well with the world

Sunday, June 08, 2008

Paris in June

I am writing from Paris again. We have been preparing the course for the future group of 17 admins this past week, and the course starts tomorrow. I hope they are all good, because we need all of them in the field as soon as possible.

The general assembly for MSF-France was last weekend. The election of the president and administrative council was pretty important this year – there were a lot of absences. Most people, including me, are very pleased with the outcome. For the first time, we have a woman president – Marie-Pierre Allie, who is excellent. And I now have two very good friends on the administrative council.

I’ve crossed paths with a lot of old colleagues this past week in headquarters, including some old national staff members who have become expatriates. It’s great that MSF is improving here: the people who started as local staff have great experience and motivation to bring to our programs in the other countries where we work.

My next assignment is now official. I will be leaving at the beginning of August for a year in the Democratic Republic of Congo, also known as Congo Kinshasa to different it from Congo Brazzaville. I will be the coordination admin in Goma, on the eastern border next to Rwanda.

I’m really excited to be returning to the same area where I did my first mission in 2005-2006. The site where I worked, Kayna, has closed, but apparently quite a few of the people from that program are still in the area working with our other programs. The assistant admins in Goma are the same ones that were there when I was in Kayna, and they are great!

The programs are also interesting. There’s still a lot of conflict in the area, so response to displaced populations is often an issue. We are also working in a hospital which receives a lot of combat wounds, and there is a big nutritional program. An agreement has been signed recently to incorporate the old Rwandese rebels into the Congolese army or repatriate them to Rwanda, but the implementation of these plan will be tricky and will probably incite some more fighting.

I will have a lot of work to do. On one hand, the assistants are in place and well trained. On the other hand, there is a lot of work to do on the salary scale and the internal regulations for the staff. The program is expanding. And the field teams still have to evacuate from their sites from time to time. It won’t be busier that Darfur was, but it will be pretty close to the same level.

I wasn’t planning to work in Paris for three weeks, and the work on my condo is going a bit slower than expected, so I don’t think that I will be getting back to the States this time. I will try to finish the apartment by the end of June so that I can relax a bit during July, so that I can concentrate my full energy on Congo for a year.

Thursday, May 08, 2008

I'm back

I arrived in Paris on Monday afternoon and started my debriefings immediately. I still don't understand it, but everyone is really happy with my work. It doesn't seem to me that I have done better than an average job. Anyway, I just finished my debriefings on Wednesday. I have already met up with several of my collegues from previous missions who are passing through Paris to or from missions, or who are working in headquarters.

I will be leaving Paris for the Savoie on Friday afternoon. I have already begun eating and drinking like a wildman. Tuesday evening, I had already drunk enough, when the owner of the restaurant where I was announced that it was his birthday and brought out the champagne and cognac. The walk home was difficult!

The weather in Paris is gorgeous! Today is a public holiday - celebrating the signing of the peace treaty for one of the wars - so everyone is out, sitting on the terrasse of cafés watching the world go by, which is one of the favorite passtimes of the French.

I will be returning to Paris at the beginning of June. The financial director and her deputy, both of whom are good friends of mine, offered me a 3 week job to teach the course for future admins here. I'm really looking forward to it. The course ends on the 20th of June - just in time for me to catch an overnight train to the Lac du Gard in Italy for a party on the 21st of June at the home of our Medical Coordinator from Darfur, who will be finishing her mission shortly.. And the head of our "desk" (management of a cluster of countries) has put me down on the list of candidates for the context and environment training (training course for future field coordinators) in September in New York. I'm pretty excited about that, too.

But for right now, I look forward to finishing my apartment in Lyon and living in it.

Sunday, May 04, 2008

Khartoum

I arrived in Khartoum yesterday evening from Nyala. I got a lot of presents just before leaving - quite a few clothes. I think that they were telling me that I dress like a bum, which is true. Anyway, the pair of pants fits me like a glove! The local shoes also. The hat, too. I don't know how they did it!

The only problem with last minute gifts is that you have to enter them into your baggage! So I did some ruthless last-minute sorting again. I threw away some of my really old, torn T-shirts (the ones in which I dressed as a bum) and got rid of some of the papers that I no longer need. Everything fits in, and I have all my baggage from my 9 months, old and new, in a dufflebag and a small backpack at around 16 kg.

Speaking of kg, I scared myself today. I spent the night in the MSF transit apartment here in Khartoum last night. There is a scale in the house, so I got on it. I weigh 65 kg, or 142 pounds. I don't think I have weighed so little since I was 14 years old. It's true that I look like one of those skinny old men from a concentration camp - I don't have a muscle anywhere. But in fact, I feel fine - I have already started to recover some sleep-time. I hope working on the apartment in Lyon, eating everything that one does not find in Darfur, and drinking a few beers will get me back into shape.

I leave Khartoum this afternoon, arriving in Dubai a little after midnight. Then I leave Dubai around 8:20am. This is fine, because Dubai is one of the world's largest duty-free shopping centers in the world - I have a few electronics goodies I want to purchase. My credit card, which hasn't been used since my break in Zanzibar, is going to start smoking!

I will arrive in the Paris airport tomorrow at 1:30pm. I'll be there for 2-3 days for MSF debriefings, a trip to the embassy for an extension of visa space to my passport, etc. before going back to Savoie/Lyon.

It is just now registering in my little mind that I am leaving Sudan!

Friday, May 02, 2008

I'm going home

I leave Darfur tomorrow. It does not seem possible that it has been 9 months already. I have pretty much finished the handover to my replacement (who is another American), I have given away a few of my electronics goodies to some of the national staff, my bags are pretty much packed, and we had a small going away party at the house last night. So it is pretty much the end.

This was my first time in coordination, and I miss the direct contact with the beneficiaries of the programs in the field. But once again, I learned a lot.

My last month was probably the most interesting one. The highlight was going to Adila, where there was no set-up at all and creating a program in 10 days. The first day we made our purchases for the base in the biggest town in the area. The next day we took the 2 1/2 hour drive to Adila and found a place to rent as the base (office, two housing areas and the place for a warehouse). The next day we opened the recruiting process and began to take the applicant files. After that, the newly recruited medical staff from Khartoum (people who had already worked with MSF elsewhere) arrived and we filled them in on the project, They helped us to recruit the other 54 people the next day, Before leaving, I set up the accounting system, started the human resources data base, made all the work contracts and wrote the car and property rental contracts. All this under pretty primitive conditions. I have already had the experience of reducing programs, but this was the first time to be involved in a set-up starting from nothing,


I’m really happy to have been here. I think that I left the admin stuff in pretty good shape, although I left a list of pending issues of 4 pages - tt is never less than this! There’s quite a few things going on right now – receiving international drug orders for all the sites, the start up of the Adila program and the PlumpyDoz distribution program, a NEW water distribution program in a NEW site, some problems of dry wells in our existing water distribution program, a lot of hiring of medical staff, some personnel problems, and a few others.

I don’t think that I have ever worked so hard for so long as I have here over the last 9 months. And that is saying something! I am looking forward to 3 to 4 months of break. It will take about a month of work on the new apartment, but after that, I hope to relax, eat, drink (I'm dreaming of wine and beer - alcohol is forbidden here),travel a bit and sleep.

And I am looking to finally having a small place to myself in Lyon.

Friday, March 28, 2008

End-of-March Posting

I’m starting my last month. It doesn’t at all seem like 8 months have passed since I arrived. But I am getting tired more often.

This promises to be a very busy month. Our Head of Mission just came back from an exploration in the eastern portion of South Darfur. It is an area that was ravaged by rebel/government fighting in 2007, during what should have been the planting season. They have no food, little water, very little health care and few humanitarian actors to aid them. We have found around 45% of the kids under 5 to be in the “danger” levels of malnutrition. And the next harvest won’t be until October.

So we are planning to go into the local rural hospital in Adila to run the pediatric ward and a therapeutic feeding center. Along with this, we will have 2 or 3 outlying outpatient therapeutic feeding centers, to help those who can take their treatment at home and to find the ones who need to come to the hospital. We expect to treat about 10 000 children under 5 (the age group most likely to die from complications brought about by malnutrition). This will be a short-term project, starting mid-April up through the end of October. This is the kind of project that we do very well.

If all goes well (this is a very big “if”), we could have government approval Sunday or Monday. In that case, I will probably go to the area next week to start the recruiting process – we will need about 70 staff.

At the same time, we are starting a targeted supplemental feeding program in Zalingei, where we already work in the district hospital. This program is aimed at preventing severe malnutrition by distributing a therapeutic supplement to all the children between 6 months and 3 years in the area (15000) for 6 months. It is an experimental program, based on what we did in Niger last year, to prove to other humanitarian groups and governments that malnutrition can be prevented at a small cost which is later compensated by a healthier population (more productive with less health-care expenses).

We have also begun a 3-month vaccination program with 8 antigens in the Jebel Marra area (partially government controlled, partially rebel controlled).

All of this will be going on along with our normal programs (which are no less worthy – running 1 hospital and 3 outpatient clinics by ourselves, and working with the health ministry in the aforementioned Zalingei district hospital, all of which are treating internally displaced populations), while all my administrative staff is changing or taking vacation! And my replacement will be arriving mid-month. I will need to prepare my handover with him before he arrives, then start working on my end-of-mission reports and evaluations of my staff during the time that he is taking over.

As always, this is the time when I start asking myself if I accomplished anything during my stay here. Certainly, just keeping things running is an accomplishment, but there have been administrators before me (we are in Darfur since late 2003) and there will be others after. I would like to think that I put some systems into place which will be continue to be useful after I leave, but when one starts looking back, it’s not always easy to find the added value. This will be my theme of reflection while preparing my end-of-mission report.

Sunday, March 16, 2008

March Posting


I just got word today that the work on my apartment is finished. I will have a place to live when I return to Lyon! The guy who did all the work sent pictures, and it looks great. It’s all oak, dark beige tile, light beige marble and stainless steel/chrome. I will still need to arrange the inside of the big closet, brush the old beamed ceiling, sand and finish the plaster, and paint, but I enjoy that. Besides, it is so small that it should go pretty rapidly. And the only ceilings to paint are in the bathroom and kitchen.

I will be leaving here at the beginning of May. My replacement has already been in contact. It’s another American, who has been with MSF about the same amount of time that I have. He arrives around mid-April, so we should have a couple of weeks of handover, then he can take a quick tour of the projects (about a week) before I go.

In the meantime, I will be busy. My financial assistant is moving to Khartoum to work with MSF there. He will be replaced by someone from one of our other sites, but I will need to do some training. My human resources assistant is finally moving here from our old coordination site in El Geneina (plus I loaned him to the Khartoum office for the last month) next week and we will have to get him installed. And my transit assistant will be taking some long-postponed vacation time after training his new short-term replacement.

I am trying to get some additional procedures in place before I go. The human resources side is getting into shape. I go to Bulbul Abu Jazou to recruit some staff on Monday. I have just put into place a system for financial analysis, which should help me keep better track of our expenses. It will also help me with the quarterly budget revision, which should be done before the end of March. Then I will need to do the personnel evaluations for my staff and prepare my handover reports and end-of-mission reports.

I hope to stay in France 3-4 months this time, to finish up the apartment, get back for a short visit to Indiana, and RELAX A BIT. But you never know with MSF – it’s better to stay flexible.

Tuesday, February 05, 2008

February Posting

I just returned from Khartoum. It’s really a capitol. We went out to eat every night: Italian, American, Thai. And I brought back some strawberries, one of the fruits we don’t see here (as if bananas, oranges, grapefruits lemons, apples, mangoes, and guavas didn’t suffice).

That was not, however, the objective of the trip – it was for work. I had two good days with my collaborators in finance and in human resources in the Sudan coordination office. We got a lot done, but as usual I came away with a huge list of things to do. Fortunately, I have already made a big dent in it.

I was pretty tired at the beginning of the year, but I’ve gotten my second wind. Getting out of Nyala to El Geneina, Niertiti and Khartoum helped. And we finally have a stable coordination team in Darfur - the changes here were also pretty tiring. Unfortunately, my human resources assistant will be going to Khartoum to replace someone who is leaving there, and my finance assistant will probably be hired for a position there. And my two closest collaborators in Paris have just moved from supporting our region to another. The only thing that is constant is change!

Politically, things keep changing, too. For the moment, the rebel activity in neighboring Chad is pretty heavy (their conflicts and those in Sudan intermingle). Today, the Chadian leader seems to have routed the rebels from the capitol of N’jamena. We thought that if all the rebels who are hiding here left for Chad to join the fight, that the Sudanese government would take the opportunity to go after their own rebel groups. For us in MSF, it means that we would need to get set up quickly on the rebel/government frontiers to treat the wounded. It’s something that we are looking at very seriously.

I just received a Christmas package from the MSF-Lyon office, which is the regional office where I applied to work for MSF. Of all the regional offices in France, they are the only one who sends out a Christmas package (coffee, tea, sausage, paté, and candy) to their affiliates, so I share with everyone in the house. Otherwise, they would kill me.

I also received news from Indiana, Savoie, Congo and Zanzibar. It’s always nice to hear from family and friends. That’s an unsubtle hint.

The work on my apartment is progressing. My builder sent me an email telling me that a lighting system I want will cost more than expected. I’m going for it anyway, it’s not THAT expensive. He should also put in the kitchen and some built-in furniture in February and March.
It’s hard to believe that I have already been here 6 months.

Wednesday, January 23, 2008

January Update

I was just in Niertiti, our eastern-most project in Western Darfur. It’s an interesting place, because of the politics. Niertiti is very near the border between West and South Darfur. It is also very near to the Jebel Marra, which is controlled by the Sudanese Liberation Army (SLA).

Niertiti itself was a tiny town of about 5000 people which became host to two camps of internally displaced populations of 30,000. There was just one small government outpatient clinic here before the camps. So we now work in that alongside the government health workers and we built a 50 bed hospital also, with a 40 bed feeding center for undernourished kids. This is a pretty unstable area, and gunshot wounds are a fairly frequent thing to treat in the hospital.

From here, we run a mobile clinic (meaning that we go there in the morning and return with the team in the evening) twice a week in Thur, right on the border between West and South Darfur. This clinic gets a lot of patients from the South Darfur side, the local government controlled areas, and the rebel controlled areas. About 10 days ago, 3 trucks full of food from the UN’s World Food Program were stolen near here by the rebels and taken into the Jebel Marra. This was kind of embarassing for the local government. Afterwards, the town of Thur was sacked, and there was quite a bit of gender-based sexual violence. We aren’t able to go back to our clinic in Thur until we can assure the safety of our team. It should be fairly soon.

We also run a clinic in the Jebel Marra, the rebel controlled zone, in Kutrum. This is maybe one of the most peaceful regions of Darfur! The government can’t dislodge the SLA from this mountainous area, and the SLA is in control so it’s not moving. Therefore, no fighting (although we do treat some gunshot wounds from the border zones). We see about 200 outpatients a day and have a 10 bed hospital there. Three people (a doctor, a translator and a driver/logistician) leave from here on Saturday morning to work with the local staff during the week, returning to Niertiti every Thursday evening. I was there today, and got to meet 3 SLA commanders. They seemed like pretty nice guys.

In Bulbul, our water distribution project is starting up nicely. This is a village in which a nomad tribe has decided to settle, to avoid continued conflict between them and the farming communities in which they grazed before. Between 15,000 and 25,000 (real figures are hard to get) have arrived in the village since July, and the water supply was not up to the volume. We now have 4 wells installed and pumping, and we are now getting the distribution system in place. We will also be distributing non-food items (jerricans for carrying water, soap and blankets) to the families. If we end up working in the hospital in a larger village nearby (Kass, another possible new project), we could operate a mobile clinic here.


I still have way too much to do, but it’s better than at the end of the year. We have the layoff in El Geneina, hiring in Nyala, finalizing 2007 accounting, putting in place a system to track expenses by activity, getting everyone into our human resources data base, and a host of smaller items.


It rained here the last few evenings! This may not be surprising to you, but it's about the equivalent of snow in Indiana in August.

I am heading up to the big city, Khartoum, on Monday for a few days to work with our country-wide Human Resources coordinator on some issues. I didn't move at all for quite a while, but now I'm making up for lost time.

Friday, January 04, 2008

Happy NewYear

Things in Darfur are pretty tense for the start of 2008. A group of Arabic soldiers who were loyal to the government are now calling themselves “the neglected soldiers” and are siding with some of the rebel movements. El Geneina is pretty much surrounded by this group and the town itself is being defended by some fighters who recently fled Chad! Zalingei as well is circled by the neglected soldiers in conjunction with some other groups. Different and interesting alliances are springing up. Although there is no more fighting than usual, everyone seems to be preparing their positions. Right now, it doesn’t look like 2008 will be the year for peace here, unless this new positioning forces the government to make some concessions that they wouldn't otherwise.

I finished my 2008 budget preparation on the 30th of December. It was a long and laborious process. I always underestimate the amount of work involved. From what I have calculated, our projects in Darfur should run around 3.8 million euros this year.

I haven’t had a slow moment since I came back from my break in Zanzibar, and the tempo finally caught up with me.
I went to bed at 9:00 pm on the 31st and was not feeling very well for around 36 hours. Now I feel better, and the pace should go back to normal, too. The budget is in, all the assistant admins should be coming back from annual leave soon, and the coordination team is becoming more stable.

Of course, a normal pace is not slow either. We are starting a new water distribution system and distributing non-food items in Bulbul, the layoff plan in El Geneina has to be put in place, we have to do permanent recruiting here in Nyala, I have to close the 2007 accounting, etc. Never a dull moment!

We celebrated the new year here in Nyala with the staff. There were about 25 people at the house. We had received a sheep from the community of Bulbul, and we bought another. The guards slaughtered the two in the morning and did the main butchering. A special cook came in to prepare the meat. The liver was prepared raw, marinated in lemon and hot peppers. The ribs and most of the meat was grilled. The most tender cuts were breaded in a special mix and then cooked over an open fire as well. It was all accompanied by green onions and pita-style bread. The meal was great and the company was good too.

Most of the guards, cooks and cleaners don’t speak French or English, only Arabic or Fur, so conversation is difficult. But it gave us an opportunity to get to know each other better than in a work situation. We ate, drank tea, danced, laughed, and communicated as well as we could. It was a very nice day (even though I was still sick).

As I mentioned, we are finally getting a stable coordination team together. We have a new Head of Mission coming in mid-February to stay for 9 months, and he will be preceded and accompanied by Fred Meylan who has already been here last year. This is really good. After 5 months here I am right now on my 4th Head of Mission, my 4th Log Coordinator, and 3nd Medical Coordinator. At the same time, Paris headquarters has been in turmoil. All these changes call for a lot of explanations, produce a lot of direction changes, and create a lot of fatigue. Maybe now we can move ahead in ONE direction and spend less time and effort CHANGING directions.

I recently received photos of my apartment made by the builder. It’s getting together. The sound-proofing and plasterboard are up, the tile and hardwood floors are down, the mezzanine is about done, the stairway up to it is installed, and the bathroom is pretty much finished.
He should come back in February and March to do the rest: kitchen installation, a built in desk and bookcase, and some finishing work. I will have a place to live when I return to Lyon at the beginning of May! But I will need to install the closet shelving, and do all the surface sanding, varnishing and painting when I arrive.

Have a very good 2008!

Friday, December 07, 2007

Back to Work

At the same time that I was writing my last posting to this blog, I did one of the more stupid things in my life. I had arrived in Stonetown from White Sands Beach with a taxi, and I had an hour and a half before needing to go to the airport. I decided to write my blog entry and buy some small Christmas presents to distribute here. So I told the taxi driver to keep my bag and come back around 12:00 noon.

About 1:00pm, although I had not yet seen the taxi, I really had to go check in to the airport, even without my bag: goodby to my earlier purchases, goodby underwear, goodby toilettries. When I returned here two and a half days later, I discovered that the taxi driver had understood 12:00 Swahili time (6:00pm). Upon realizing that something was wrong, he had taken my bag back to the hotel, an hour away. The hotel has sent my bag, transporting it to the airport, which is again an hour away from them. The bag is now in Khartoum awaiting cargo transit back to me here in Nyala. I am looking forward to having underwear and a razor again. (Yes, I have been going without underwear for a week. You can call me “tubeless”.)

I am really impressed by the honesty and helpfulness of the people of Zanzibar. (Somewhere, also, there is a god who looks out for fools.) I had already decided to return there on vacation, even when I thought that my bag was lost forever, but now it’s certain that I will be returning.

Upon arriving here in Darfur, I was thrown back into the fray of things. My financial boss in Paris and my human resources boss from Khartoum were here, ready to get to work. I haven’t had a slow moment yet. But things are good. My work with Laurence and Denis was fruitful. And locally, we have taken some decisions to consolidate the coordination, which will reduce costs and facilitate decision making. Even more - we are making some successful explorations into new communities in South Darfur (where we want to establish a presence) in which we can take a foothold and do some important work for the displaced populations. We should be able to take some action quickly.

At the same time, we have a lot of turnover for the moment; a lot of people wanting to get back home before the holidays. Our turnover in coordination has been about once every 6 weeks for a long time now. This makes it tough to get new programs up and running. Fortunately, our Head of Mission, who is leaving in 10 days, knows Sudan inside out. He’s been in and out of Darfur several times. This guy is amazing. He can converse intelligently on about any subject one can think of – in French, English or Arabic! And apparently, he is being replaced by someone just a good. Damn! I DO work in a good organization!

Fortunately, even though the turnover is high, we don’t have the gaps we did a couple of weeks ago. I definitely have enough to fill my plate: payment of the annual bonus to the local staff, continuing to define the job roles of our new local staff here in Nyala, development and government approval of a layoff plan in another site, trying to cope with staffing of the medical operations during the 7 days (!) of holidays for Eid and Christmas, replacement of one of our admins during the same period in Niertiti, helping to break in the new arrivals to coordination, 2008 budget preparation, and closing the accounts before the end of the year.

But since I am still a big kid at heart, you can be sure that I will be taking the day off at Christmas, distributing gifts, making food, and generally being a big slobbering idiot. That’s what Christmas is all about!

Wednesday, November 28, 2007

Zanzibar

I'm writing this from Zanzibar. Sound exotic? It's even better than that.

My first three days were spent in Stonetown. It's the old quarter of Zanzibar town. It has beautiful architecture, a very interesting history, and lots of very friendly people. There are also a lot of "beach boys" - hawkers who want to sell you something, or show you around, or beg money off you. And I think that I have the word "sucker" written on my forehead. The first day, I just walked around town, waiting formy duffel bag to arrive - my luggage ALWAYS gets lost. Unfortunately, my comfortable shoes were in the bag and I totally destroyed my feet.

The second day I visited the tourist spots in town: the museum which explains the history of the island during the rule of the Sultan of Oman and Zanzibar, the old arab fort, Freddy Mercury's house and others.

The third day I took a spice tour. The spice farm grows cinnamon, cardamon, cloves, tumeric, lemon grass, nutmeg, vanilla, and others. It was interesting to see how each of these grows, and how they can be used in cooking and for medicinal purposes. We visited a cave where slaves were hidden (slaving was a big business here until the 1890's). Most of the people went down, looked, and came back out. A few of us had the bright idea of going down the end and then climbing out a chiminey at the end. It was loads of fun, but we got pretty dirty. Fortunately, this was the moment to go to the beach, so we got to wash off.

Some of the people on this tour told me about the Full Moon Party in Kendwa beach, which was the next night. It sounded pretty good, so I decided to go. It was awesome! It occurs every full moon. Tourists and locals from all over the island come. Good music, good dancing, good drinking. I woke up on the beach at 7:00 in the morning (this is 1:00 Swahili time) with some new friends and we went to have breakfast - Safari beer.

Before coming to Kendwa, I planned to stay a couple of days there and then go to the east coast. But it was so beautiful and peaceful (after the party) that I decided to stay until the end. I did do some snorkeling. It was a full day trip, leaving at 9:00 and coming home at 5:00. After passing a school of dolfins, we continued in our dhow to the east coast and had a couple of hours swimming in what appeared to be a giant aquarium. There were huge corral reefs and fish of every color. I'm really glad I did it, although my back is still pretty red as a result. After this they fed us on fresh tuna, rice and a vegetable sauce that the cook prepared on the coast while we were snorkeling.

The rest of my days were spent walking on the beach and in the villages and eating seafood and drinking beer.

I met some really great people like Nicola from Germany, Trolles from Denmark, Ben from Israel, Tal from England, Katie from the State, Haroub and "Big Nation" and Masoud from Stonetown, and then my friends from Kendwa: Dende, Msigawa, Ali and Moudi. Because of these people I had one of my best vacations ever.

If you want to spend your vacation in paradise, come here to Zanzibar. You'll never forget it.

Saturday, November 10, 2007

In Nyala Now

I moved from El Geneina to Nyala Monday, the 5th of November, with the 33 pounds of personal belongings I brought with me from France. The coordination has been split in two so that we have people in both states (El Geneina in West Darfur and Nyala in South Darfur) who can negotiate with the local authorities.

There are two reasons that I needed to come here. The first is that the small logistics base we have here has more than quadrupled in terms of personnel and property leases in the last month. The second is that we are gearing up for a new project in the state.

The Nyala logistics operation is going from 8 people to 36 in a very short time. We need to write the job descriptions, recruit and train the local people, and house and feed the expats and relocated national staff moving here. We are now 3 expats stationed here, plus 2 expats from El Geneina for the moment for the new project negotiations. We were staying in the office for the first few days, but moved into the house yesterday. It’s pretty nice. It’s a large house (5 bedrooms – this is a transit stop for new people coming into and leaving Darfur) and the logistics team has done a lot of work on it. The house for the relocated staff is nice, too. The office is taking shape; we’re still having some teething problems with the communications equipment and computer equipment. I’ve gotten pretty good lately at taking an IBM Thinkpad apart and putting it back together again, and at configuring internet connections via mobile telephones.

Unfortunately, the negotiations for our new project are not going quite so well. It’s an up and down situation. It is a 6-month project in a small town between here and the border with West Darfur named Kass. About 35,000 newly displaced people have arrived in the town since March, and they have not been registered in the food distribution programs. Our proposal is to work in the local hospital in cooperation with the Ministry of Health staff in the pediatric ward, adding a section for severely undernourished children who must be treated under hospital conditions. Currently there are 30 beds; we would like to staff for 100. At the same time, we would install an outpatient feeding center for undernourished kids who can take their treatment (the famous Plumpy Nut) at home. And we would also add a measles vaccination campaign in cooperation with the Ministry of Health, water treatment, and a food distribution program targeted at the entire population of children under 5 years old (22,000). All of this, of course, free of charge to the population and the Sudanese government.

Sounds pretty good, right? Wrong. Apparently, the HAC (Humanitarian Aid Commission) granted the rights to the pediatry ward to another NGO (non-governmental organization) who won’t name. They mean well, but are in over their heads, and they refuse to admit that there is a problem. (We are getting patients from Kass in our clinic in Thur, 50 kilometers away, so we know that there is a problem!) The local government officials who seconded them for this project are embarrassed to admit to a mistake. Some officials are behind us, but territories also come into play. So it is a game of egos, protection and stubbornness. I am involved in the staff plan and budget for the project. It’s a lot of work which may get thrown away if we are not allowed in. In fact, if it falls through, we will probably have to pull out of South Darfur entirely and will be moving back to El Geneina.

Saturday, October 27, 2007

Alone at home

For most of the past week, I’ve been here in the compound all alone, like a big boy. (Ok, there are two guards on duty at all times, and the office is full of national employees during the day.) Anyway, we are in between the departure of several members of the coordo team and the arrival of the new ones. Effectively, I am the coordo team during this period.

The most important thing I’ve had to do during this time is facilitate the arrival from some stuff across the Chadian border. Get ready; it’s a long story.

As you know by now, West Darfur is full of camps housing internally displaced populations (IDPs) from the countryside since 2003. These people have fled their home villages due one conflict or another (it’s complicated) and continue to do so in some areas. As they no longer have a livelihood, they are dependent on humanitarian organizations for all their basic needs. Food distribution is done by some of these organizations on a monthly basis, but new arrivals sometimes get left out of this process. And sometimes, the families might sell part of their distribution to pay for other basic needs. Add onto this the lack of rain this year, which means a reduced crop harvest.

We are seeing a higher level of malnutrition cases in our clinic in Zalingei than last year, especially in the age group of under five years old. This is alarming because kids in this age group who are undernourished are much more vulnerable to other pathologies than kids who are in a normal weight/height range. In other words, they are much more likely to die. We have set up an ambulatory treatment center to help combat this malnutrition. Even we have been caught unprepared for the number of patients arriving for treatment. The result: we are on rupture of the product we use to treat these kids.

Up until recently, these cases had to be treated in hospital conditions, because the product used to help the kids get back up to their proper weight was a powdered, enriched milk product, which must be prepared fresh (at least four times a day), using clean, disinfected water (which is usually not available at home). Recently a new type of treatment came out. It’s a ready-to-use therapeutic food (RUTF), which is also based on powdered, enriched milk, but in a long-conservation paste form, with the taste of a rich peanut butter, in a foil pouch. It can be distributed and taken at home, freeing up hospital resources for treatment of the more complicated cases.

This product, called Plumpy Nut (ain’t that cute? Plump-peanut!), is what we are short of. We can order it (it’s made in France), but the shipping and customs clearance time is over a month. It turns out that our colleagues in MSF-France in the neighboring country of Chad have a stock of Plumpy Nut that they don’t need right now, that they can give us. The Chadian border is about 50 kilometers from here.

That’s where my work came in this week. This product is classified as a drug, so it’s importation across borders, as in any country, is highly controlled. I drafted a letter this week, which was signed by the general director of the state Ministry of Health, asking the federal Humanitarian Aid Commission in the capital of Khartoum to ask the aid of the federal customs office in clearing 1500 boxes of Plumpy Nut for entry into Sudan from Chad. You must remember that Sudan is Africa’s largest country and has a pretty poor communications system. So once the letter was signed, I had to find a scanner in town (found in one of the UN agencies), send a scan of the signed letter via internet to our capital office in Khartoum (fortunately, it was one of the two days this week that high-speed internet worked – a scan is pretty big!), send the original letter by plane to Khartoum, and ask one of our staff to take the letter to the Humanitarian Aid Commission, who was expecting it. The state director of the Ministry of Health is great! Not only did he sign the letter, he is also taking it upon himself to work with the local customs officials to simplify the importation. So we are hoping to have our treatment arrive within about a week.

That was my big task this week, but there are a myriad of other small ones; like checking on the refrigerators. Certain drugs, like vaccines, need to be kept between 1°C and 8°C at all times. All the electricity in the compound is provided by generators, which run from 8:30am-12:00pm, 2:00pm-6:00pm and 8:00pm-11:00pm. With all of these cut-offs, we chart the temperature twice a day. If we approach the outer ranges, we need to quickly prepare another solution to the storage.

And I needed to remember to make the radio contacts twice a day. We contact each of our sites by shortwave radio at 8:30am and 6:00pm every day of the week, and 12:00pm on Fridays and holidays. Some general info is passed on (for example the times of U.N. helicopter flights between sites – we are forbidden to take most roads outside of towns for security reasons), but the main reason for these contacts is to make sure that everyone is okay. Today, not one site responded! Since the mobile phone network wasn’t working either, I finally got each of them via satellite phone. Everyone’s ok! One site was tied up in a meeting and forgot. Another had turned down the volume of the radio so they could have another conversation on the satellite phone. And the radio on the last site didn’t capture my signal because of atmospheric conditions.

These things, along with my day-to-day tasks, kept me hopping. I have a lot of longer- term issues that I need to attend to, but they must wait. Sandrine, our pharmacist, returns from her break tomorrow, so we can split some of the tasks, including necessary meetings with the other humanitarian organizations in the region. The new Head of Mission, Medical Coordinator, and Logistics Coordinator should arrive at the beginning of November.

There are some advantages to being here alone. I was invited by the guards and the driver on duty today to join them for lunch. I know about five words of Arabic, and their English is about the same, but they had prepared a real feast. It was a pleasure to share a good meal and some time with them.

Friday, October 12, 2007

Eid Posting

My computer died Wednesday. I spilled some 7-Up on one corner of the keyboard. Even though we dried it off, the damage was done. It starts up, but the screen stays black; not very practical to work with. Fortunately, I learned on my last mission how to take out the disc drive, pirate the connector from my external drive, and then stock the data from the computer disc onto another computer. I got everything! It’s now on my own external drive, so I can work on other computers until a new one arrives from Paris.
Whew!

It’s Friday again, so we are off. That means that I will work less than 10 hours. And tomorrow is Eid, the end of the month of fasting, so it’s a four-day holiday for the office and house staff.

Tonight, we have invited the 2 expats from MSF Switzerland here in El Geneina to join the 3 of us expats from MSF France for dinner. It turns out that I know their newly arrived logistics guy from my last mission in Niger.

I have experimented a method of making a pie crust using vegetable oil, because we don’t find butter or lard here. It’s not bad. I’ll make a pie for this evening with the Swiss (who are both French – the only person here with a Swiss passport is our MSF France head of mission)

Sunday, we are getting together with the staff here for an Eid party. The meat for this party, a goat, is roaming around the compound somewhere for the moment, unsuspecting that these are his last days. The office and house guards will do him in Sunday morning.

Aside from the newly arrived (and soon departing) goat, we have Maurice. He’s a small hedgehog that the expats found when he was a baby. They raised him and he stayed in our living area, a screened porch, for a long time. One day he disappeared, but he has come back a couple of times this past week, just to say hi. There is also Bob, a bumble bee who lives under our dining table. Sometimes he is shut inside the screening at night, and he’s fairly pissed off when we open in the morning. There are also a variety of birds, insects and lizards who come and go, both inside and out, at they please.

This morning at 7:00 there was a lot of shooting. We’re assuming (hoping?) that it is to celebrate the last day of fasting. Anyway, it makes for a rude wake up call. The mullahs are singing “Allah Wakbar” continually. Tomorrow it’s over.

The expats turnover is in full bore right now. I have picked up the human resources responsibility, along with finance. A couple of people are leaving this week, and one more is out of here next week. We have some people coming in to fill the holes temporarily, but the permanent replacements aren’t yet lined up. Since coordination is already stretched pretty thin, I will not be moving to Nyala as soon as expected; not before the beginning of December at least. I was hoping to get to the field at the end of this month, but we need to have someone here at all times, and I may be the only one left for a few days!

On the security side, things are heating up for a couple of reasons. One is temporary: Eid. It’s like Christmas here; people need money to buy the food, party clothes, and gifts, so there’s a lot of theft. The other reason is more political. There is (I’m simplifying here) a lot of power positioning between the different factions before the new round of peace negotiations and the arrival of UN peacekeeping troops. There was tension in Nyala about 10 days ago, which erupted one morning in the market with no warning whatsoever. Zalingei, which has been pretty peaceful until now, has also had quite a bit of violence lately, including killings and kidnappings. Niertiti, which is at the frontier of the rebel zone, is always unstable; we have stopped going to our clinic in Thur twice a week because of violence on the road used to get there. Even here in El Geneina, we stopped using the 4x4s for a few days (these are frequent targets, especially the pickups, because they are in high demand), because a couple of guys were shot last week during the theft of a car.
Of course, if all was rosy, we wouldn’t be here! We realize that the context here is dangerous and complicated. We try to keep up to date on the security situation through contact with the other NGOs, the UN and the local population. We try to keep our security and evacuation guidelines up to date. And we stay neutral, which means that we are not a designated target. I have walked into town a couple of times, not at all feeling insecure. But we must remember to be cautious.

Friday, September 28, 2007

First budget revision finished

I just finished my first budget revision. It was a nightmare. I slept 2 hours the night before sending it to Paris, and that’s one solid week of work. We’ll see what feedback I get and what needs to be changed.

The whole team here will soon be changing. Our short-term Head of Mission and Logistics Coordinator will both be leaving before the end of October. The Medical Coordinator and Human Resources Coordinator, both of who have been here for 9 months, also leave during October. That leaves me and the pharmacist (who is taking 2 weeks of vacation in October!). I take over the human resources, along with finance. A Canadian should arrive to fill in for the Medical Coordinator for 6 weeks. The new Head of Mission arrives at the beginning of November. No Log Coordinator in view. Besides, I am sending my finance assistant to another site to fill in for someone on vacation there. AND the finance assistant in Khartoum, who we sent to Paris for training, has disappeared into thin air. She may have decided to live there. We’re having fun now!

I’ll do as much as I can do, but I’m really looking forward to a time when a complete team is in place. I should still be moving to Nyala in South Darfur (El Geneina, where I am now is in the state of West Darfur) at the beginning of November, but I’m skeptical. All our projects for the moment are in West Darfur. The idea is to have some management in South Darfur to negotiate with the local officials for us to set up some new projects there. There seems to be a real need, but I am afraid that we will really start screwing up if we try to add more projects while we are so short-staffed in coordination.
Apparently, the security picture is not pretty at this time. We got a phone call today from the Head of Mission saying that he is making a plan for staff reduction (partial evacuation). For us, this means reduction of expats and national staff hired elsewhere than where they are working. I’m not yet sure what sites are implicated in this plan, but my bets are on Nyala (where I should be moving) and Niertiti. To be continued……………

Wednesday, September 12, 2007

First trip to the Field

I am just finishing my first field tour, so I have a better idea of the work we are doing here in Darfur.

In Zalingei, our main work is with the local hospital, alongside the government’s hospital staff. We work mainly in the services that see the most IDP (internally displaced population – this means refugees inside their own country) camp patients: emergency room, pediatrics and a therapeutic feeding center for undernourished kids. We also have home visitors who go into the camps to refer patients who need help to the hospital and get a general feeling about the number and condition of arrivals in the camp.

For the moment, the number of undernourished kids is increasing rapidly, so we have just opened an outpatient therapeutic feeding program (OTP) in one of the camps. This program provides therapeutic ready-to-use food to undernourished kids who don’t have any associated pathologies, to be taken at home rather than in the hospital. This kind of program allows us to treat more kids with fewer resources during this peak period. They are followed on a weekly basis until their weight comes back to normal. Of course, the kids with pathologies enter into our therapeutic feeding center at the hospital so that they can be followed medically.

We feared an outbreak of cholera here. A treatment center has been set up, but fortunately, there is no need for the moment.

The staff in Zalingei is great. Some of the high level national staff live in the same house as the expats, and the atmosphere is really good. We spent some late nights talking, singing, and watching old Tom and Jerry cartoons.

Niertiti is a very small town with two very big IDP camps. It is closer to the fighting zones; we heard some heavy artillery fire Saturday night. We run our own 42 bed hospital (emergency room, maternity, pediatrics, therapeutic feeding center, women’s ward, and men’s ward), which currently has about 70 beds. It’s a bit crowded, but activity is decreasing here. In cooperation with the government’s health care service, we also work in an outpatient clinic which includes a women’s health program. Both of these operations were set up for the IDP camps, but we get people from the town as well. We also have a big home visitor set up as in Zalingei.

We usually transfer surgery to the Zalingei hospital, but sometimes there are situations that call for small surgical interventions to save lives. This includes primarily cesareans. Some women walk several hours to get to our clinics and are pretty far along when they arrive. Zalingei is about 1 ½ hours away when the security is good and when we can arrange for transportation. We have doctors who are capable of performing these operations here in Niertiti if necessary. So we are preparing a surgical annex with the basic equipment necessary for these emergencies.

We also have two outlying clinics: Thur and Kutrum. I got to visit Thur yesterday. It is a small outpatient clinic much like the one in Niertiti. We have 600 consultations a week, and the medical team goes from Niertiti on Tuesdays and Thursdays only, joining local employees on site. People come from quite far away, because this is the only clinic around.

Kutrum is in the Jebel Marra area, an area with a lot of fighting. In fact, we have been prohibited since the middle of August from going there because the security of our people cannot be guaranteed. It seems that this travel restriction may be lifted so that we can return this Saturday. The team from Niertiti leaves on Saturday mornings to join the local employees in Kutrum, and they return the following Thursday evening. This clinic is again along the same lines as the outpatient clinic in Niertiti and they also get about 600 consultations a week.

In Niertiti, the office, expat compound and national staff compound (for Sudanese employees who work in Niertiti but were recruited in other cities) all touch, but are sort of divided. It makes for a lot of intermixing, but allows some privacy, too. Niertiti is a lot colder than our other locations, being at an altitude of about 1200 meters. They say that Kutrum is a paradise. It is higher up the mountain and is known for its delicious oranges. Unfortunately, with the travel ban, I didn’t get to see it this time.


Tomorrow, it’s back to El Geneina where I have to finalize the August accounting by the 15th. We have a big coordination meeting the 17th to decide on actions up until the end of the year. And based on this, I have to complete a budget which must be in Paris on the 20th. I don’t think I will sleep much until the 21st. Then I need to go back to Niertiti to help them prepare the pay for their staff at the end of the month. It’s good to be needed.

Sunday, September 02, 2007

Greetings from El Geneina

At the time of writing this, it’s Friday, the weekly day of rest in Sudan (I am posting it on Sunday, because we haven't had internet access for a week). I just took a walk into town with Fred, to get out of the compound. It rained pretty hard last night (we are in the rainy season up until October), and the market was pretty ravaged. We bought some meat and vegetables for tonight’s dinner, I found a guy to repair my leather flipflops, I bought another pair in plastic, and Fred has his water pipe (shisha) fix.

The coordination team has miraculously filled up; we are a complete team now. Besides me, the token American doing the accounting and budgets, we have 5 French and a Japanese.

Fred is the Head of Mission (the big boss). He is French, but has lived all over the world since he was 12. He now lives in Jakarta, Indonesia with his Italian wife when he’s not in the field. He’s been working for NGOs (non-governmental organizations) since 1992, and not only MSF-France. He arrived this week, but is only staying for a couple of months.

Mathilde, a French doctor, is our Medical Coordinator. She’s been with MSF for about 6 years, working 9 months with us, then returning to practice in northern France for 6 months at a time. She will be leaving around the end of September.

Thierry is the Logistics Coordinator. He arrived 10 days ago, and will also be staying for only 2 months. He has had a lot of experience with other NGOs and now is a permanent employee of MSF-France in the emergency pool.

Chloé is the Human Resources Coordinator. I met her in Paris when I worked in headquarters last summer. She started MSF about the same time I did, in the autumn of 2005. When she leaves at the end of September, I take over her responsibilities as well as my own.

Sandrine is the Pharmacist. She’s from Bayonne, in the Basque country. She has been here a while, but will probably be extending a couple of months, as she enjoys it.

Mathilde, Chloé and Sandrine all worked together before here in Akuem, in southern Sudan, in their last mission.

Hayato, whom we call Toto, is the Japanese guy. He is our Supply Logisticien. He also has worked with several other NGOs, although this is his first time with MSF. He as also lived around the world. He should have left in October, but has just extended for 3 more months.

It’s a great team. We all get along well. Since the living quarters and the office are together, it’s a good thing. I still do some of the cooking the day that the house staff is off, but Toto is also a great cook, and today, Fred has prepared the lamb for the grill and made the salad.

I will be leaving Monday for my first field office tour. The trip will be 10 days in 3 different sites. After 1 month here, I am looking forward to seeing our programs in action. It’s necessary, because I have a budget revision to prepare for 20 September. This is supposedly a small revision, but the programs are changing every day. I have to fix onto one hypothesis to formulate the costs. To give you an idea, our annual budget for Darfur is around 6.5 million dollars.
It sure doesn’t seem like I’ve already been here for a month. I feel like I just got here.

Friday, August 10, 2007

I have arrived

I arrived in Paris Sunday the 29th of July to begin my briefings. The departure from France was Tuesday at 11:00pm, arriving in Khartoum Wednesday at 9:00pm where I had briefings again. I flew out to Nyala Sunday, from where I flew out again Tuesday afternoon for my destination, El Geneina. So it took one entire week to arrive from Paris here. I arrived just in time to do the closing of July’s accounts; I’m already in deep shit.

Our compound here is called “the prison”. It contains the office and the expat housing. We don’t leave very often; it’s not at all in the middle of town (where there is nothing to do anyway). The conditions are fairly primitive, but the team (there are 7 of us) is a good one.

The security of our operations in the field is precarious. We’re working on a pay plan that will allow us to have a minimum of cash at the sites, because some other organizations have been robbed several times. We don’t take the roads between sites; we go by UN helicopter flights. The camps exist since 2003, but conflicts continue to send in new refugees all the time. Their villages no longer existing, they are completely dependent on humanitarian organizations for all their needs: food, shelter, water and health care.

There are lots of holes in our organization chart; apparently it’s tough to find experienced people to come work here. And most of our coordination team are scheduled to leave at the end of September or in October. It’s probable that the Darfur coordination team will be split between El Geneina qnd Nyala, zith medical and head-of-mission in El Geneina, and logistics and finance (me) in Nyala. If that happens, it will happen in October. Nyala is the biggest city in Darfur. It’s also in South Darfur (El Geneina is in West Darfur, with all our current operational sites). MSF wants part of the coordination team there to negotiate with the local authorities, especially since we would like to set up a new site there. It’s also possible that my position will change from finance and human resources coordinator for Darfur to human resources coordinator for North Sudan (in Khartoum) and for Darfur. We’ll see.
It’s Friday, the weekly day off in the Muslim world. But I must get back to my accounting closings; I have 14 account books to close and I’ve never done this before. We’re having fun now!

Monday, July 30, 2007

Off for 9 months in Darfur

I'm writing this from Paris where I am having my briefings for Darfur. I leave tomorrow evening, getting into Khartoum on the 1st of August. I will stay in Khartoum until the end of the week, then flying down to El Geneina in Darfur.

I will have plenty of work to do. As part of the coordination team, I will be travelling between sites more than my first two missions. (For the moment, we travel only by air, to avoid armed attacks.) At first I will be responsable only for the finance (accounting and budget). Then at the end of September I should also take over human resources.

The program is changing. We have nearly finished our participation in a hospital in one site. We are reducing our activity in another hospital, but are refocusing on malnutrition and epidemiology in the camps there. In another site, we are augmenting our activity. We want to open up a new clinic in the rebel zone, but the government won't yet let us. And depending on this new opening, the regional coordination (that includes me) might be split with finance (that's me again) moving to a different city. Aside from all of that, there's a lot of work to do on training the staff, improving the security, controlling the expenditures, improving cost analysis, etc. In summary, it's just another MSF mission, although I will have more of a management position than in my previous missions.

Hopefully when I return, I will have a place to live in Lyon. I finished tearing everything out around the middle of July and then cleaned the stones and redid the joints in the one stone wall. All the electrical appliances have been purchased and delivered. I worked with the renovator last week to modify the mezzanine, put in the bathroom walls and string the electrical conduits. That gave us the time to define details together. He will return in November to finish the work (hopefully). Anyway, I won't be back until the end of April or beginning of May. I will do the painting then; it's only three walls!

I will have internet access in Darfur, although it will be slow and expensive. I'll try to keep this updated, but probably not more often than once a month.

Tuesday, June 12, 2007

Here today, gone tomorrow

My going away party was very good, although the beer disappeared more quickly than anticipated. I got back here to Savoie the 11th of May. I already miss the people in Maradi.

I have started tearing out some of the partitions and plaster in my condominium. The entire outside wall is stone, so I will do the joints and leave it that way. I will be working with an interior architect who is a former customer from Cafe Francais Bar Americain. I still have quite a bit of work to do before we can start making it over.

I went back to Paris for MSF's general assembly and met up with my old friend Malcolm Hudson for lunch. He's still as much fun as ever. I saw quite a few old friends from MSF, too.

I left directly from Paris to visit my family in Indiana. Byron's girls are big into volleyball and will soon be going to Orlando for the Junior Olympics. Mike's kids are also staying busy. Mike and Martha have pretty much recovered from their traffic accident in Mexico at Christmas.

From Indiana, I left for a week in California where I visited old HP friends I hadn't seen since 1988. It was a great trip. They all look the same. The drinking water out there must come from a fountain of youth.

I have just accepted a new mission with MSF. I will be leaving for 9 months in the Darfur region of Sudan at the end of July as a regional administrator on the finance sidem possibly picking up the human resources at the end of September. The mission objective is to provide medical assistance to the Internally Displaced Population (internal refugees) in the area. These are huge refugee camps. One of the best parts of this mission for me is that it is an English-speaking mission! That will make my work a whole lot easier.

In the meantime, I will try to get the work on the apartment moving along, so that I will have a place to live when I return in May 2008.