November in Nigeria

I arrived in Nigeria about 10 days ago. I got into Abuja the evening of 10 November. Up until the 1980’s, the capital of Nigeria was Lagos. But as that city is already huge, overcrowded, and located in the southwest corner of the country, it was decided to create a new capital (like Canberra Australia or Brazilia, Brazil) in the center of the country. So Abuja is a very new city with good roads and a construction explosion everywhere. This is where I will be based for the next year. All of the expatriates coming into Nigeria pass through here. Since we have 2 surgical programs in the country there is a huge turnover – surgeons and anesthetists typically go on missions during their vacations and thus only stay between 2 and 6 weeks. As a consequence, our house is HUGE – it kind of looks like a mansion from the outside, although the details of the interior are pretty simple. It is a duplex, with our Head of Mission, his wife and daughter in one house, and 4 permanent staff in the other, with people passing through and other visitors spread through the other rooms in both houses.

I stayed 1 day in Abuja and then flew south to Port Harcourt. There is a new administrator in this program and, as the person whom I am replacing in Abuja doesn’t leave before mid-December, I came down to help her get started before starting my own work. I will be here until the 27 November. For me, this is great. I get to see and understand our biggest program in the country before getting into the coordination work.

The main activity in Port Harcourt is surgery, and I spent 2-3 hours in the operating theatre yesterday, watching them repair a bad leg injury. I was right next to the head of the guy being operated on. He was under a spinal tap, so he was conscious – I even talked to him a couple of times. At the same time, I could see his leg, open about 8 inches with the skin and muscles spread apart about 5 inches in the middle to expose the bones. (He, of course, could not see this because of a curtain cutting off his vision of the operation.) The 2 orthopedic surgeons had a tough time setting the bone back into place because it had already started to heal in the wrong position. Then they put 4 screws into the bone and sewed back 4 layers of muscle, fat tissue and skin. I wasn’t sure how I would react to seeing the open wound and all the blood. At the beginning, I had to sit down on my stool a couple of times because I felt faint. But after about 30 minutes I was used to it. By the time they got to using the power drill for the screw holes I had no problems at all.

Port Harcourt is a very lively city, more so than Abuja. We have a limited area in which we can circulate in the city, but there are still some things we can do on the weekends. Last Sunday here was phenomenal. Sunday morning one of the surgeons made pancakes for the 14 people in the house. Then we were invited to lunch in a swanky chinese restaurant by the owner. After returning to the house, I went with the new Field Coordinator to explore the walking routes we are allowed to take. The limit of one of the routes brought us to a hotel/restaurant were we had a beer by the pool, returning home as required when on foot before sunset, around 6:30pm. Then most of us went out to an outside bar close to the house which has a live band every Sunday evening. The music was great and I danced all evening.

After returning to Abuja I will have a couple of days for a meeting between the current finance and human resources coordinator, a person doing some special human resources projects and me to get the conclusions of the human resources projects before that person leaves on the 30 November. Then I will tour our remaining 2 permanent projects in the north of the country before really starting my handover with my predecessor. Around the middle of December, Nathalia will leave and I will officially be in charge of finances and human resources. For the moment, I am on a contract here for 1 year, but I cannot really see myself returning to a very cold Europe in November – I will probably extend until March or April 2012 if all goes well.

Nigeria

I just received confirmation for my next assignment with MSF. I am going to Nigeria. At first I will go to Port Harcourt to coach a new field administrator there. Afterwards, I will be going to the capital city of Abuja to be the finance and human resources coordinator. This should be a 1 year assignment.
Our operation in Nigeria is run by the New York office. The people from there are currently in France for some meetings, so I go to Paris Wednesday to have my briefings with them, returning to Lyon Friday evening. I will leave for Nigeria from Lyon on the 10th of November.

I have already received a ton of reports about our work in Nigeria. We have 3 projects – a surgical program in Port Harcourt, a women’s health program in Jahun, and a nutrition program in Kasaure. It is nearly the same size as our Congo operation. Like Congo, there are also emergency programs when the need arises, usually associated with an epidemic of some kind. I will be doing finance as well as human resources, so it will be pretty challenging. And the great thing is that this is an English-speaking program. That means my reports will be much easier and faster to write. My written French has greatly improved since starting with MSF, but English is still a lot easier.

It is a very good thing that I am leaving soon, because I have spent nearly everything I had saved up, and then some, during my 2 ½ months in France. It has been a good stay, but expensive. Also, I am happy to be leaving before winter really sets in. I haven’t had a winter in 5 years, and I am already freezing here.

October

The details of my future are a bit in limbo for the moment. I do not yet know to which country I will be going with MSF, nor when I will be leaving. It will probably be SOMETIME in November, and the destination will probably be Nigeria, South Sudan or Haiti. I hope they let me know 2-3 weeks ahead of time. And I hope that the departure is not too far into the future, because I have been spending money out the wazoo and it won’t hold out too much longer than the end of November. (We are on short-term contracts. When not working – zero income.)
One of my expenditures has been on a new chandelier for the apartment. The one here when I arrived was really horrible. So I found this one. Don’t worry – it is a fake. A real crystal chandelier like this one would costs thousands of dollars. This one is completely plastic.
I also spent quite a bit on the Lyon bi-annuel dance festival. I went to several dance shows – 2 from Brazil, 1 from Algeria, 2 from New York (same dance troup but different shows), plus the parade. Each show was mainly modern dance, of which I know very little. But they were all beautiful. There is a South African dance troup coming here in November, but I since I am not sure to be here, I am reluctant to buy the ticket now.
I am not sure when my Tanzanian friend Nende is coming to live in my place either, or whether his wife Alma is coming at the same time or later. Ndende is probably coming before the end of this month, but no date has been fixed yet.
Other than all of this, I am meeting some interesting people in Lyon. One day, on 2 different occasions the same day in the middle of Lyon, I ran into old customers from the bar in Aix-les-Bains! That was pretty strange. One of them lives here now, and he has introduced me to some really nice people.
Other than that, I am doing pretty well meeting people on my own. My sex life took a big jump a few weeks ago for about 10 days. After 2 years of abstinence in Congo, that helped clean out the pipes. Now we are pretty much back to normal. Alas
Yesterday morning, at the outdoor market on the banks of the Saone river in the middle of Lyon, I ran into the mother of my old friend and partner in the bar, Paul. She is looking great – she is over 70 – and in great form. I haven’t had any news from Paul for about 2 years, but she hasn’t had any news in 4 years! And I thought I was a bad correspondent!
Next weekend, I go to see a couple from the bar in Aix-les-Bains also. I really love these two people and their 2 children, so it will be nice to see them again.
I have also met a few people on the internet. One is a Nigerian guy living in the Ukraine – yes, pretty strange. We spend quite a bit of time on Skype. And this afternoon, I got a call on Skype from a good friend and MSF colleague, a Japanese guy we call Toto, with whom I worked in Darfur and Congo. He is now in the north of France on a logistics training course. If I go to South Sudan, I might find him there.
I need to work a bit more, however. I need to organize my work from Congo for future missions, but I am waiting for bad weather. When it is beautiful outside, I don’t have the heart to stay inside in front of the computer, and we have had really good weather since I have returned. That should change this coming week, so I hope to get a bit more done. I must get organized before leaving again!

September in Lyon

Wow. I just realized that I haven’t posted since the beginning of July.
I went to Kinshasa the 8 August, to prepare for and close down the MSF-France representation office there. There was a lot to do, including firing the 9 people left in that office. They worked the last week, knowing that they would soon be finished, and with the new tenants, MSF-Spain moving into the house at the same time. It was not really comfortable, but it went pretty well. I am proud of the staff to have been motivated right up to the end. I paid all the final payments Friday the 13th (great omen), then paid a LOT of daily workers the same day. In all, I paid out well over $ 100,000 that day. Then the next night we had a closure party in a bar/restaurant not far from the office. It started out pretty subdued, but after a couple of beers, the atmosphere lightened up and we had a lot of fun. A couple of the oldest employees even came in the following Monday and Tuesday to wrap things up. They didn’t have to do that, and I was overjoyed to see their loyalty. Of course they ARE hoping to get jobs in the new MSF-Spain office.
I got back to Goma the day before my replacement arrived for a short week of handover. He’s a great guy. He came with his companion who will work with us as a psychologist. She’s great too. I feel that I have left things in good hands. He has already worked in human resources in Congo for MSF-Switzerland, so he knows the labor law of the country and the way things work.
My going away party was Saturday the 21 August, and it was great. We had it at the house in which I live, and there were a lot of people (as always in Congo when there is free beer). We had most of the staff from Goma, staff from our bank, my favorite waiter in a small shop, and a few friends I know from outside of work. At the end, around 1:30am, I had to break up a fight between to guardians – it reminded of when I had my bar in Aix-les-Bains!
I left Goma Tuesday the 24 August in the morning, because I had some last minute work to do in Kigali, Rwanda. I got everything done that I needed to, and I also had time to visit the Genocide Museum. It is very interesting, but not really a very happy place. When you already have the blues about leaving after 2 years, it is not the best place to go.
I arrived in Paris the morning of 25 August, and all my debriefings were the 26 August, so I made the rounds of the headquarters to say hello to the people I know. After 5 years, there are a lot of them, but it is amazing also the amount of turnover. I am starting to feel like a dinosaur.
I arrived in Lyon Thursday night the 26 August. It is great to be back in my own place. Being so small, the great thing is that you can clean it completely in one afternoon. Since being back, I have arranged some more storage in the kitchen area and painted the window frame.
I also had news that a friend from Zanzibar, Tanzania is in Spain. He got married to a Spanish woman in Zanzibar and came up with her. But right now they are both living in her parent’s place in Madrid, and it is not easy. I have invited them both to live in my place for the winter, since I am never here, and they will probably take me up on it. If they arrive while I am still here, it will be VERY tight, but Ndende is a good friend, and I would be very happy to help him and his wife Alma
Lyon has a dance festival every 2 years, and it is happening right now. I went to the parade Sunday. It was a beautiful day, and the parade was great! It is a huge event. Tuesday, I went to a presentation by the Ailey dance troup from New York. It is modern dance, and it was really incredible. I have tickets to 2 more events before the festival ends at the beginning of October.
And this weekend it the annual “Heritage Days” in France. That is a weekend where a lot of national treasures open their doors to the public. I plan on visiting quite a few.
Yesterday was a day of information at the Lyon branch of MSF for people wishing to be volunteers with MSF. I was invited as keynote speaker to talk about my experiences in the field, and then to answer questions with others. For me it was interesting – I still remember how it was for me at that meeting more than 5 years ago, hoping to work with MSF. It went very well, and the questions were interesting and pertinent.
The person who came from headquarters for this meeting is the woman who is responsible for my next assignment. I have asked to be in a pool of flying human resources officers. She told me that, for the moment, they have one person, and they will need another, but probably not right away. In the meantime she has LOTS of possibilities for me: South Sudan, Nigeria or Haïti; one or the other for 6-9 months beginning in November. (I hope my money holds out – I didn’t put a lot aside during my stay in Congo). Any one of these would be great for me – especially Haïti. The emergency is over, but it is still a very interesting project.
So I am on vacation, lots of things are happening in Lyon, I will probably helping a friend in his pursuit of happiness with his new wife, and I have an assured future with Doctors Without Borders. All is good with the world.

Independence Day in Congo

Wednesday the 30th of June was the 50th anniversary of Democratic Republic of Congo’s independence from the Belgians. Since the political climate is a bit tense now (now, before, after, forever), most of the international non governmental organizations took security precautions for their international staff.
Some even shipped their staff off to neighbouring countries. We stayed here, but were confined to the houses. So we did a barbeque! It was nice. And at the end of the day, there were no real security problems associated with the commemoration.

The people I have been replacing are in place now, so I am back to doing one job – my own. This is a relief! But our head of mission wants to get several projects in shape before some of our group finish leaves, so things are hopping. It is true that someone new coming in will lose momentum with the handover and lack of insight WHY we are doing these things. I am involved in several of these projects so there is no rest for the weary. We are in a big recruiting process for Congolese doctors and medical specialists (surgeons, gynocologists, and anaesthetists). We are also recruiting a cleaner for the central pharmacy (140 candidatures for 1 job!). We have negotiations going for our agreement on how we work with the Ministry of Health staff in two hospitals (one risks to be a very tough round of negotiations). I will need to go to Kinshasa to shut down our office there right before leaving. All this, plus trying to finish up several other human resource policies in less than 2 months.

But in the meantime, I am trying to reduce my hours to avoid burn out. I leave work most Saturdays around 5:00 pm now, and I only work a couple of hours on Sundays. I realized that I had to do this after returning from my Uganda break. I really had a hard time getting re-motivated after that. And replacing the other 2 people didn’t help. Now that those positions are filled again, I am less in the day-to-day stuff and more into the long-term projects. It is not any easier, but a lot more fulfilling. I am happy to be back on these things, and hope that I can finish a maximum of them before leaving.

So today the program is attending to my personal mail,
posting to my blog, walking into town 1 hour each way) to buy stuff to prepare dinner tonight (we are 8 in our house this evening), stop in a bar to have a beer or two (Primus, the beer of Congo!) with a coupld of friends name Pierrre (Peter) and Jean de Dieu (John of God), and maybe watch a film or two on my computer before turning into bed. Ahhhhhhhh. Relaxation.

You know you are a humanitarian worker when......

The following is translated from a French Facebook entry, with one or two phrases added by me. Anyone who has ever worked for a humanitarian organization will find it extremely accurate.

You know that you are a humanitarian worker when:

• Unlike your friends who have normal lives, you don’t have a wife/husband, children, or house, and when you return home, you sleep in your parent’s place.
• You have a university degree, you manage a team of at least 10 people and a multi-million dollar budget in a civil war situation, but you earn a minimum wage.
• You earn a minimum wage, but you have a cook, a house keeper and a chauffeur 24 hours a day.
• You enjoy sending verbal missiles at your colleagues from other non-governmental organizations.
• For you, Save the Children is called Save the Chicken, World Vision is World Illusion, and MSF is MFS (pronounce emefess – in french Et Mes Fesses - translates to: And My Ass!)
• You don’t like people from the United Nations, but once you have a beer in your hand, all white guys (Mzungus) are your friends, especially when the presence of females is limited.
• You are always criticizing the United Nations, but secretly, you would love to work for them to triple your salary.
• When you return home, your friends and family all ask the same question, “So how was it?” hoping that you can summarize 1 year of mission in 3 minutes, because after 3 minutes, they are no longer with you.
• You tell your acquaintances that you work in the humanitarian field, and they respond “Ok but what’s your job?”
• Upon returning home and looking for work at the unemployment office, you put in a listing under “southern coordination” and you explain to the work counsellor that he/she would be better off not wasting a lot of time on you. Anyway, you don’t fit into any of their categories!
• When you return home, you love making the round of your friends, but when you realize what their every-day lives are like, you wish to return quickly on mission.
• You really laugh when young street marketers stop you in the street and ask you “Have you ever heard of Action Against Hunger?”
• You would love to work in Latin America or Asia, but you always find yourself in Chad, Democratic Republic of Congo, or Sudan.
• You understand mysterious phrases such as:
o The watsan always sends his sitrep to the HoM before leaving on R&R. (The water/sanitation guy always sends his situation report to the head of mission before leaving on break.)
o The nut and food sec want to use Plumpy Nut to combat kwash in under-5s in MdM’s CNT. (The nutrition and food security group want to use Plumpy Nut (a weight-gain product) to combat kwashorkors (one type of malnutrition) in children under 5 years of age in Médecins du Monde’s (Doctors of the World) therapeutic nutrition center.)
o The logs at Sol are working on NFI kits and shelters for the DAH proposal in RDC. (The logisticians at Solidarity are working on non-food item kits and shelters for the DAH proposal in the Democratic Republic of Congo.)
o Kilo Juliette for November Yankee, the situation is Oscar Kilo. (Kiwanja project (KJ) calling Nyanzale project (NY), the situation is OK.)
• The weekend, either you work, or you recuperate from an over-alcoholised Friday night.
• You shave at most 2 times a week and you have forgotten how to tie a tie.
• You always have a VHF radio and 3 different telephone chips with you.
• After having destroyed 3 blackberrys in six months, you buy a Nokia at $20 …. with the little flashlight on top and the black and white screen… which lasts 2 years.
• You have an IBM Lenovo laptop; ugly but indestructible.
• You have an external disc drive full of films, television series, music and nothing pertaining to work.
• You know that Relief Web is not a geographical site.
• For you, malaria is just a bad flue that everyone passes around.
• Nutella and/or Jiffy peanut butter become luxury items that you would do anything to have, at any price.
• A reinforced Toyota Landcruiser is what you call a car.
• A 30 hour bus trip (including a Jackie Chan film) on non-existent roads seems as normal to you as a New York – Washington plane shuttle does to others.
• You hop on a plane like others get into their cars.
• Entire villages in Africa call you by your first name, but you don’t even know the name of the person who lives across from you at home.
• All your friends are called Kasereka or Abdoul.
• Seeing men armed to their teeth on every street corner seems completely normal.
• You watch the news on TV and tell yourself that you have a job for life.

Back from Uganda

My break in Uganda went really well. I arrived at the Entebbe airport Tuesday around noon. Since le boat to the Ssese Islands wasn’t leaving until the next day, I visited the animal orphanage that afternoon. I also wanted to visit Entebbe’s botanical garden. While walking there I struck up a conversation with a guy, and it turns out that he works there. So he went with me and gave me a great tour. In the middle of the gardens is a rain forest, and it is in this rain forest that the original Tarzan film was made! The gardens are right on the banks of Lake Victoria. They are beautiful and very interesting.

After that, I went looking for a bookshop. I didn’t find one, but another shop owner LOANED me two great books! The people in Uganda must be the friendliest people that I have ever met. That night, I ate in a Chinese restaurant. Goma, where I am in Congo, must be the only big city in the world which doesn’t have a Chinese restaurant, so I really enjoyed that meal.

Wednesday morning I took it pretty easy, and caught the ferry in the early afternoon to go to the Ssese Islands in Lake Victoria. (Yes, I finally decided to go there rather than return to Lake Bunyonyi.) I stayed in a pleasant lakeside campgrounds on Bugala Island. The food was great! The following morning, I decided to take a long walk - it turned out to be a 6 hours. That did me a great deal of good, but I also got a pretty good sunburn. I didn’t see a lot of animals – just some vervet monkeys and some beautiful birds and butterflies. For the rest of the time, my program was reading, talking with people, eating, drinking beer and sleeping. I was rather tired, and this part of my break really restored me.

Saturday morning I took the ferry back to Entebbe and continued to Kampala (after returning the books to their owner – he then gave me another one), about an hour away. There I met up with a really great guy, Timothy, who took care of me for the rest of my trip. We decided to go directly to his town, Mbarara (I had passed through there 5 years ago when going on my first mission with MSF). We took the evening bus, but the driver was a bit too crazy. We got off at the first stop, Masaka, and went to a club. There we met two other people who decided to continue on with us to Mbarara the next day. Like I said, the Ugandans are really friendly people!

Sunday, Timothy hired a motorbike, to take me to visit his home village. It was about 70 kilometers away. I met the whole family and a lot of the villagers. They don’t get many white people out there, and they seemed pretty impressed that I had come out to see them. While we were visiting, a big rainstorm occurred. Timothy’s uncle offered to put us up for the night, but we really had to get back to Mbarara where we had left the guys from Masaka. The ride back on a motorbike on mud roads in the dark was quite an experience. But Timothy pulled it off really well. That night, we all went to a bar and had a great time.

Monday we took the bus back to Kampala (this is a 5 hour journey not including the wait in the bus for it to fill up). I left Timothy to his occupations that afternoon. That night we went out again to a club and had another good night.

Tuesday, he took me into town again, to catch a motorbike out to the airport in Entebbe. The arrangements for buses, mini-buses and motorbikes are fairly complicated, and I really appreciated his help. I got back to the office in Goma around 4h15 pm, and I was already in a coordination meeting at 4h30! I also had 450 email messages waiting for me. I just got caught up with those today, so I am relieved.

In all, it was a really good time – 3 days of relaxation and 3 days of partying. I now have 3 months left in Congo before ending my mission. It’s going to fly!

Visit to the Capital

Although MSF-France’s headquarters for the Democratic Republic of Congo (formerly Zaire) are in Goma, capital of North Kivu on the east side of the country, the capital of the country is Kinshasa, on the west side. We have a representation office there, to deal with whatever needs to be done at the central governmental level, such as residence visas, lobbying central ministries, importation licences, and renewal of our authorization to work here. Unfortunately, we have a huge lack of experienced expatriates at this time, due to a lack of recruitment a few years ago and several emergencies throughout the world requiring our interventions right now, so we have no one running this office. Our solution is that each of us in coordination goes there for about a week at a time on a rotating basis, to take care of business. My turn was last week.

Although I have been in Congo now for 20 months, this was my first trip to Kinshasa. It is really a capital! I was surprised – asphalt streets, big buildings, traffic jams, construction, and restaurants - everything good and bad associated with a capital. To make a comparison, in Goma, we only have 2 asphalt streets and a couple of ethnic restaurants.

I had a lot of things to do, so I didn’t much profit from the fun things. But I did go out Saturday evening with my counterpart from MSF-Holland, a beautiful Swedish woman named Ingrid, in a great Italian restaurant. And Sunday, I walked from our office/residence into the middle of town. I got robbed. A car pulled up next to me, and four big guys announced themselves as policemen and asked me to get into the car for a routine control. I was in the back seat between two of them. While the guy in front went through my backpack, the two guys behind on each side of me frisked me. When they decided all was well, they let me out of the car and took off. I quickly realised that the guy in front had stolen all of the money out of my wallet, including my $200 of “security money” which was hidden in a pocket, and also the money that I had hidden in my backpack. I lost about 600 dollars. That hurts!

On the work side, the visit was good. I met with the Director of Migration concerning expat visas, the Schengen House concerning visas to Europe for our national staff, the General Tax Direction concerning an investigation concerning out payment of income taxes for our staff, the other sections of MSF, the headquarters of our bank, our lawyer concerning several issues, and many, many others. I also interviewed a potential expatriate psychologist for our program, who turned out to be great for the job. Just before I left Goma for Kinshasa, it was decided to close this representation office – we are considering a more efficient way of representing us and the other sections of MSF in the capital – so I had the pleasure (ha!) of announcing this to the staff. This will be my 4th project closing since I have arrived in Congo, but it doesn’t make it easier. Anyway, the staff took it pretty well. They have heard rumours of this closure for more than a year, and the fact that it is now announced takes off the pressure. They have all been with MSF-France of several years, and they will get a pretty healthy layoff package.

I got back to Goma Tuesday afternoon, and things have been pretty intense since. We are recruiting a flying administrative assistant and a national staff psychologist. We are preparing for the semi-annual strategy meeting in Paris in June, and revising out budget for the year. All this, along with my other big projects keep me hopping.

And I leave this coming Tuesday for a week-long break in Uganda. We are supposed to take a break every 3 months. My last break was in January, and I really need this one. I will probably go to Lake Bunyonyi in the southwest corner of the country. I was there before in 2005 and it is great. It is a lake formed by volcanic flow, and there are 29 islands in this lake. I will do nothing but canoe, hike, read, eat, drink and sleep. And I will probably spend a day or two in Kampala before leaving.

I now have a little over 3 months before leaving the Congo. It is starting to seem very short, especially since I still have a lot to do. I know I can’t finish everything, but I would be great to finish at least 4 of my 7 big issues.

March Posting

Hello, readers. I haven’t posted anything since the middle of January. Sorry, I have been busy.

My collegue who takes care of the finances returned to France for family reasons, and I had to replace her during that period. And this past week the person who takes care of all the transit (airline bookings, visas, etc) was ill (a malaria crisis, along with typhoid fever!), so I was taking care of her work too. At the same time several staff problems came up, including 2 former staff members to took us to court for abusive dismissal. We won our case, but it ate up 2 weeks of my time. I thought I would die. But the finance person returned to work Friday evening, the transit person should be back Monday. And I head off now to one of our field operations, Nyanzale, for 4 days.

It is always good to get out of the coordination office to go to the field. There we see the beneficiaries of our work, which is always motivating. In Nyanzale, we work in an existing health center. We have been there since 2007. Nyanzale is a small town at the limit of various ethnicies and has been often been the front between various armed groups in past conflicts. We entered a very small health center and turned it into a 110-bed hospital. We also have 3 teams who go to outlying health posts each day to assist them in treating the populations where needed. We change the routing of these teams as the need arises – epidemics, displacement of populations due to conflict, an increase in sexual violence, etc. The outlying area also has a big need for clean water in the villages. We are currently looking at projects to provide this access to water.

There are a lot of reasons for my visit. The entire expatriate team turned over during the month of January, and they need some support. I need to talk with each of the members of our staff who have potential to grow with our organisation to plan their growth paths. We need to put some systems into place concerning human resources. There are some discipline problems that I need to look into. And we will have a general staff meeting where I will answer questions concerning our human resources policies and remind them of our charter of treating everyone equally and without prejudice, to the best of our abilities.

We leave tomorrow morning. It is a 7 hour car trip. I will be going up with 2 other coordination members: our pharmacy manager and one of our flying logisticiens. They are both great guys, and I am looking forward to the trip. I will be returning here to Goma Thursday.

Update on MSF's activities in Haïti

The MSF teams have been working through the long queues of patients waiting for treatment and surgery, even as Port au Prince was shaken again by a very substantial aftershock this morning. In Choscal hospital, where two operating theatres have been working round the clock for days to deal with the seriously injured, the patients were so alarmed by the tremors that they once again had to be taken out of the building and put into tents in the grounds outside. The operating theatres have continued to work with four surgical teams rotating through the day.

In Carrefour hospital, the team has started psychological support for the patients who have had limbs amputated and their families. A different form of intensive post-operative care is underway as pysiotherapy work with burns patients has started in another hospital, while the dialysis treatment of crush victims continues in the big Genral Hospital. Six patients have now been treated with dialysis and the team is using a detection test to identify other patients with crush injuries who are in need this intensive care.

Every functional operating theatre is used night and day, while logisticians are racing to set up new ones or rehabilitate damaged ones. MSF surgical teams have been carrying out an average of 130 operations per day for the last few days and this is increasing as new surgical teams start work. There are now 10 operating theatres, 7 in Port-au-Prince hospitals (Choscal, Trinité, Carrefour and Chancerelle hospitals) and 3 in towns in the west of the capital (Leogane and Jacmel). In addition, minor surgical procedures like cleaning and removing dead tissue from wounds are taking place in small operating theatres in Trinité and Pacot hospitals.

Capacity will further increase in the near future, as additional operating theatres are being prepared in Port-au-Prince and in the west of the island (Leogane and Grand-Goave). The inflatable hospital with two operating theatres and 100 beds is emerging on a field in Port au Prince.The construction team expect to have it working on Friday morning.

New challenges are emerging as the people of Port au Prince have been fleeing the city. MSF is trying to identify the medical needs of those who have been displaced towards and across the border of the Dominican Republic. And MSF has received reports of 300 injured people gathered in the town of Lekai on the southwest coast, who had left the city and are now without adequate medical care. MSF is exploring way to get them to its medical facilities.

January Break

I just returned from my break on the south coast of Kenya. It was, as usual, great. I stayed in Diani Beach, a coastal holiday town 35 kilometers south of Mombasa. The town has one road and 10 kilometers of white sand beach. I was adopted by a bunch of locals, and they showed me every possible alcohol to drink in the area (local corn beer, coconut wine, Tusker and other Kenyan beers). One afternoon, they prepared a late lunch of duck (which we slaughtered and plucked ourselves), rice pilaf and salad. I paid for the food. There were about 10 of us to eat this fabulous feast, which cost me about the same as one meal for myself in a restaurant. It was really a great afternoon.



A lot of my time was spent in the villages around Diani Beach with this group, seeing how the Kenyans live. Compared with Congo, Kenya is a rich (and stable) country, but the typical Kenyan lives in a home with no electricity or running water, and jobs are scarce. Tourism and agriculture are the primary business sectors.


I also spent 2 days in a game reserve, Tsavo East. It is one of the largest reserves in Kenya, and a bit less crowded than some of the others. I saw 3 out of the big 5 – elephant, lion, and leopard (no rhino or buffalo). The leopard was a rare treat! I must admit that the lions were so far away that they could have been big dogs and I wouldn’t have seen the difference. We also saw giraffes, zebras, hippopotamus, wild hogs, ostriches, giant lizards, a jackal, baboons, and assorted types of antelopes and birds. There were 10 people in our open-top minibus – 2 French speakers, 7 German speakers and me. My German made a pretty quick comeback. Although I have a very small vocabulary, it helped. There were two kids in the group who were really well behaved and made us laugh constantly. Our Kenyan guide, Cyrus, was great, and VERY patient.

My last 3 days were less that stellar. Three of us were supposed to do a snorkelling trip from an island off the coast, but the guy who should have done the booking for us (the brother of one of my local buddies) took off with the money. The next day, my buddy was locked up in jail. We think that it was his brother who arranged the deal with the police to keep him out of the way while he spent the 150 dollars. And I missed my first flight out because of some problems with the ferry between the south coast and Mombasa. Fortunately, there was a second flight which connected brilliantly with my flight between Niarobi and Kigali.

I returned here to Goma just in time to participate in a 2-day meeting with our project coordinators to plan our activities for 2010. It was a good exercise. The field team now has a much better idea of what my role is in the coming year as human resources coordinator. Now, I must catch up with the work which arrived since my departure AND continue working on the long-term projects. It won’t help that I have been pretty sick since returning – vomiting, diarrhoea, an infected spider bite and a huge, flowering case of herpes. I’m very rarely sick but when I am, everything seems to hit at the same time.

I also arrived to the news about the earthquake in Port-au-Prince, Haiti. Doctors Without Borders (MSF) already has a big orthopaedic surgery team in place there, so we were well positioned to help immediately with the medical work. And we have already begun to send reinforcements. I know at least three people who have already left to join the emergency team there, including the lady who was replacing me here during my break. This is the kind of intervention that we do really well. It will be exciting but challenging work.

Approaching Christmas

My workload has been pretty intense the last 10 days. We have several recruitments going on simultaneously. For example, we are recruiting a pool of people whom we can call for manual labor and to replace guards who call in sick. We received 148 candidatures. We narrowed this down to 68, by selecting the people who have already worked for MSF in this capacity, or those who live in the neighbourhood of our office and our pharmacy warehouse (so that they can come quickly if needed). We had a short interview with each of these people. From that, we selected 14 people for the guard pool and 20 people for the manual labor pool. The final step will be to select 1 person from the guard pool to be hired full time to replace another guardian who has moved up the ladder to be a radio operator. This process takes a lot of time. At the same time we are recruiting a pharmacy supervisor, a country-wide supervisor of our sexual violence program, and a maintenance man. We have just completed recruitment for a mechanic, 2 psychologists, and 2 pharmacy managers.

We also had to fire our pharmacy supervisor and 1 of our pharmacy managers. This was tough. They have been with us for several years, but they still make the same mistakes that they have been making all of those years. That is a real handicap for our programs, so we decided that they had to go. The labor law here is based on French laws, and it is not as easy to fire someone as it is in the States. It took me a lot of time to build the file for each guy justifying our action. In the end, they accepted the decision much more quickly and easily than I expected. We had not even received the responses to a couple of legal questions when they told me that they accepted the decision and were ready to sign the termination letters and leave.

We are also restructuring one of our programs. The human resources aspect of this restructuring is fairly complicated. I have been working with the team there by telephone and email. At the end of next week, I will be going up there to continue the work.

Also, the outgoing members of our team have been working overtime to put their pet projects in place before finishing their missions. That has kept us all busy.

Finally, we have had an abundance of disciplinary problems in the last few weeks; some minor incidents and some very serious and complicated situations.

All this plus the normal workload has kept me very, very busy.

Our head of mission left this past week, and his replacement arrived today. Over the next month our deputy head of mission, medical coordinator and logistics coordinator will change also. That will probably create a change in policy and direction. MSF expatriates tend to have pretty strong characters and a will to get things done. We will see. Here’s a photo of a big part of our staff in Goma. It was taken last week just after the weekly staff meeting and just before the departure of our head of mission.


Bad news: my computer disappeared 10 days ago. It is usually in the living room at the house so that everyone can listen to music, work on photos, and watch movies. I have never worried about the security before, seeing that we have guards on duty on permanance. But at the time that it disappeared, we had a temporary housecleaner and 2 electricians working in the house. We never found out which person left with the computer and 2 portable speakers, and we never will. Fortunately, I had the major part of my files stored on an external hard disc. I was thinking of buying a new computer when I return in August, and I was going to give this computer to a local charity organisation for their use. Now that won’t be possible.

We are approaching Christmas, and I am looking forward to it. I love Christmas on mission. When you work with people a while in emergency situations, you really become a temporary family. It is great to spend some downtime together. In August, I bought quite a few small items so that everyone in the 2 houses will have a gift. And as usual, we will prepare a holiday feast with the local means.

I will be taking my next break the 6th of January through the 13th of January. This time I will be going to the south Kenyan coast, just south of Mombasa, to a place called Diani Beach. For 2-3 days during that week, I will visit the Tsavo game park. It will have been 4 months since I returned from France, and I need this break. Fortunately, there will be someone to replace me this time, so the workload upon my return shouldn’t be so bad.

An MSF measles vaccination program used for military purposes in North Kivu

Press release Kinshasa, 6 November 2009: Seven sites of a vaccination campaign by Médecins Sans Frontières (Doctors Without Borders) in North Kivu, Democratic Republic of Congo, recently found themselves under fire in attacks by the Congolese army against one of the major rebel groups, the Forces Démocratiques de Libération du Rwanda (FDLR) .

Assisting the national health service, MSF began a mass vaccination campaign Saturday, the 17th of October 2009 in the territory of Masisi in response to a measles epidemic. The medical teams of MSF were vaccinating thousands of children in Ngomashi and Kimua, areas controlled by the FDLR. Although they had received guarantees of security by all the parties involved in this conflict for the vaccination in these areas and at this time, the Congolese army launched the attacks at each of the seven sites of vaccination. All of the people who had come to have their children vaccinated fled the intense battles and are now under safety. The MSF teams had to stop their activities in these areas and have been repatriated to the city of Goma.

“We feel that we were used as bait.” explained Christopher Stokes, General Director of MSF. “The attacks coincided with the beginning of the vaccination campaign and the MSF teams, as well as thousands of civilians, found themselves trapped under fire. These attacks represent an extreme risk to the lives of civilians, and an unacceptable utilisation of humanitarian actions to serve military objectives. How will the population consider MSF from now on? Will our patients still feel that they are under security with us? We have chosen to strongly denounce this situation, because our neutrality has been compromised.”

MSF is an independent medical humanitarian organization which provides medical services without discrimination and in strict respect to the principle of neutrality. This neutrality permits MSF teams to vaccinate in areas controlled by the FDLR, which are inaccessible to personnel of the national health system.

The last few months have seen an augmentation of attacks against humanitarian organizations by different armed groups in North and South Kivu.

“MSF asks all parties in this conflict to respect the work of humanitarian organizations”, adds Meinie Nicolai, MSF director of operations. “It is the population who pay the consequences. Already exhausted by the extreme violence and incessant displacements, today they risk being cut off from humanitarian aid.

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165 000 children between the ages of 6 months to 15 years have been vaccinated against measles as of today. In the territory of Masisi, MSF aids a hospital and a health center, and provides mobile health clinics and vaccination campaigns. MSF also provides health services in the territories of Walikale, Rutshuru and Lubero, as well as in the province of South Kivu. MSF has been working in North Kivu since 1992.

October / November posting

One big project down: we closed the site of Kabizo last week. Although the closing of a site is not the most pleasant of events, it went well. My changes to the payroll software for the final payment worked like a charm! And the team on site did a great job of communicating with the staff, helping them put together their résumés and to apply for jobs available in our other sites. Even the government made some concessions, making it easier for the staff to apply for government-run training to help them with reinsertion. We also paid a big portion of the final payments here and the other sites, so that the staff didn’t have to travel with a lot of money on them – road robberies are a common thing here.

But with the closing of Kabizo, and the down-sizing of the Kayna project, I should have some more time to concentrate on the long-term projects. At least, until we open up a few more sites.

Here in Goma, we are doing a lot of recruiting. We just hired a psychologist (to work with patients, victims of sexual violence, and even with the staff) and a radio operator for the weekends (we stay in contact with the cars by HF and VHF radio). We are in the final stages of recruiting a maintenance person and a mechanic. We have just started the process for a guard (148 candidates for 1 post!) and for a pharmacy manager. And tomorrow, we start the process for someone to coordinate all our activities concerning violence (sexual violence, armed aggression, etc.). Recruiting is managed directly by me, to protect our national staff. Unemployment here is very high, and friends, family members, and others in the community would put enormous pressure (physical, monetary or both) on a national staff member to be hired. And it is also unfair to put national staff members in a position where they could be tempted to take bribes in exchange for influence in the hiring process.

Our head of mission just returned from the semi-annual meeting in Paris, concerning our directions for the coming year. No big changes. We will continue to work in the hospital in Rutshuru, where we send all the surgical patients in this area. We have 3 surgical teams, and will be adding a 4th team to cut down on the hours these people put in. And we continue with Nyanzale, a health center in a zone which changes hands between the different factions of conflict very often. Up north around Kayna, the programme changes every week, with sporadic fighting breaking out here, then there. So we are modifying the program to give us more flexibility in getting to the areas where we are needed, when we are needed. Other than that, we will continue to follow the situation, opening where we have to. We are sending a team to south of here tomorrow to help with an outbreak of cholera. Already this year, we have had 13 temporary programs of this type, and that will continue.

That puts quite a bit of pressure on the staff, so from time to time, we try to lighten up. It had been a long time since we have had a staff party, so we had one this past weekend. A lot of the staffs who had just been let go from Kabizo were there! No one got drunk enough to be really obnoxious (not always the case). And, seeing how the party was on the day of Halloween, I just had to play the idiot. Some of the staff really thought that I had been attacked when I showed up. I swear that someday, I will grow up. But don’t hold your breath.

September

I’ve now been back in Congo for a month, and I just finished reading and filing away the 1500 emails that arrived while I was gone, while keeping up with the new ones arriving even faster. That is really a relief!

We are in the process of closing down two of our programs. This is actually good news. It means that those areas are relatively more secure than before. But it also means that 170 people will be losing their jobs. I’m becoming quite an expert on the legal aspects of firing people in Congo. Call me terminator. Fortunately, we have a very good lawyer who is keeping me on the straight and narrow path.

At least these are total closures, not like in Niger where we reduced our activity and therefore had to decide which 350 people out of 770 had to go. That is a lot trickier. We will be able to place a handful of our key people in other programs, but not too many.

To get ready for the first program closure at the end of October, I am working on our pay-slip generation software, to correct some errors and make the final pay-slip easier to understand. We realised that we needed to do this in May, but the closures have made it a priority. It’s a pretty complicated task, but very interesting.

Once the two programs are shut down (probably by the end of the year) we will remain with two big programs plus our coordination here in Goma. And since the conflict in the Kivu region of Congo continues, we will probably need to open new programs in other areas. But getting back to a normal size should allow me more time to work on the big projects such as restructuring the salary scales, refining our policy for working with employees of the national health care system, changing our job function scale to fit an international MSF standard, developing model work contracts for new projects which allow us to change the orientation of the program as the context changes, and a few other projects.

I have also been working on some tools to help our transit person to make sure things don’t slip through the cracks for arrivals, departures, travel for breaks, and all other travel. We have at least 15 nationalities represented here, all with different visa requirements for Congo and Rwanda (all our flights are to Kigali, Rwanda and afterwards there is a 3 ½ hour car trip to the Congolese border, thus doubling the visa nightmare). And Congolese staff going to Europe for training courses or for expatriation to other countries must go (again from Kigali) to the French embassy in Kampala, Uganda to obtain a visa before leaving. It can get pretty complicated.

A lot of our coordination team have extended their contracts here: me (2 years), the financial coordinator (1 ½ years), the logistics coordinator (10 months) and the pharmacy manager (10 months). The head of mission, his deputy, the medical coordinator, and the psychologist have also extended their stays by 1-2 months. That is really good for the continuity of the mission. But the top 3 posts (head of mission, deputy head of mission and medical coordinator) will all be changing between the end of October and the middle of December. We will see what management style comes about with the change. The atmosphere is pretty intense for the moment, partially because we have some pretty strong personalities in the group, partially because the short-timers are trying to get all their objectives in place before leaving. And the objectives of some are in conflict with the objectives others!

I’ve been thinking a lot about my sexuality since returning from vacation. I am gay. (For those you who didn’t know, now you do.) And that is not something that we talk about in a big portion of Africa. The expatriates here know (and don’t care). But I don’t announce my sexuality to the national staff. Even if some have suspicions, I think they are more comfortable not really knowing. And I do not go looking for partners here. That could be dangerous, especially with my position as human resources coordinator (conflict of interest, abuse of power, etc). I don’t really have a huge sexual urge (breaks and time back in France give me sufficient opportunities), but it is kind of frustrating not having some “colleagues” around. Some evenings after work and before going home, I take advantage of the internet to connect with other gays, and it helps. I have “met” some really interesting and refreshing people, both gay and gay-friendly. Thanks to Mihai, Marcus, Alan, Ion, André, Masoud, Msingi, Josh, Pasha and Yannick. You have helped to keep me relatively sane.

Big news of the week: We now have city power in our house! Before, we were dependent on the generator which operated a couple of hours in the morning and from sunset at 6:00pm until 11:00pm. An electrician has arrived in our coordination team, and before heading off to the field, he is putting some things in place here. He found a way to connect us into the city power grid (legally, of course!). It’s not perfect. The power grid goes off for a while almost every evening, some of the lights and outlets are not on the same circuit and thus do not work, and I did get a pretty good shock in the bathroom the other day, but it is really an improvement. Nicolas is slowly getting the kinks out of the system, and we still have the generator when the grid goes out.

It’s Sunday, and I am not working as much as I usually do. It is nice to be in the office, though, when there are less people around. I can get a lot more done, especially on the long-term projects which require more concentration.

End of my vacation - sigh!

I am at the end of my break.

I spent 3 days in Paris for meetings at MSF headquarters, then I went to Indiana for a bit more than a week with my brothers and their families. I missed on of my nephews, who is working in Boston this summer – that was a problem with my timing. But everyone is doing really well, and it was a good trip. We had some great meals together, Mike and I moved my niece to Ball State University for her second year there, and I met her boyfriend. Byron's youngest daughter was amazed that I had never heard of Wii - she thinks that I live on another planet (yes, Congo is sort of another planet). But the thing is really fun! I explored Louisville a bit - it is becoming more and more interesting.

Finally, we had a "flash flood", if natural disasters are your thing. We had 15 inches of rain in some places (38cm) in 75 minutes. And since they already had a very wet season, the ground couldn't hold any more. In the parking of University of Louisville, there were cars hidden in the water! It was incredible to see. But no damage in my brother's houses.

I returned to Lyon on a Tuesday, and flew off Friday to Bucharest, Romania, to see a friend there. He introduced me to some other people, and we had a great day at the Black Sea, near Constanta. I was really impressed with the country – it is more developed that I thought, and the Black Sea is great. Bucharest is a huge, beautiful city, although I had very little time to explore it. This is Ceausescu's parlimentary palace, the second largest building in the world after the Pentagon! I did visit a "village museum" - a collection of houses from everywhere in Romania, reconstructed in a beautiful park, demonstrating the diversity of old housing styles. Many thanks to my friends In Bucuresti for a great weekend.

Then back to Lyon for about 12 days. That also has been nice. I saw some old friends, I met some new ones, and I missed out on a couple of people. I did nothing constructive! But I had a lot of aperitifs and ate some really good meals. I even went out dancing a few times. I bought a lot of books, electronics, and gifts for Congo. I also stocked up on deodorant, razor blades and Chapstick for the next year. And I spent a lot of time on the internet, since our connection in Congo is so bad. I caught up on a lot of things, and spent some time on some naughty sites, too. Bad boy!

So now back to Congo. I leave Lyon with the fast train tomorrow at 7:46am. I will be at MSF again tomorrow for last minute meetings. Then, I take the plane Thursday morning for Kigali, in Rwandan, arriving at 10:40pm. So the MSF driver will pick me up, we go to the hotel, and then we leave for Congo the next morning. I should be in Goma hopefully around noon Friday.

It will be really great to see everyone there again. The month has gone quickly, but I would start to get bored if I stayed with work any longer. Mind you, it was VERY nice to do nothing, but now I am ready to attack our big projects in human resources which are waiting for me. Plus my 1000+ backlog of emails, I imagine.

Anyway, my next break will be in January! (I hope I don’t spend as much money as I did this time – my account is EMPTY – but it was worth it. That is what the money is for anyway – to enjoy. And I did.)

First 6 months of 2009 for MSF- France Congo

I often communicate what is happening in my life and job, but here is a summary of what MSF-France really does in the North Kivu, Democratic Republic of Congo:

There is a bit less violence this year, but still quite a bit. The variation is feeble, even though the political context has improved. Our approach and positioning in the region seems to be good, although we question the pertinence of one of our programs - questions which will be analysed for a decision by the end of July.

Good news: fewer epidemics this year. MSF and the other non-governmental organizations are much more reactive in following outbreaks than in the past, and we have developed a strategy of lobbying so that the central authorities and humanitarian groups are notified as soon as a medical situation is noticed among the displaced populations. Another factor is that we performed a large vaccination program in 2008 against measles. Also, in 2008 there were many spontaneously created camps in the regions where no humanitarian actors were present to assist in developing sanitation systems. These camps are perfect breeding grounds for epidemics. These camps no longer exist.

To summarize our activities for the first 6 months of 2009:
1936 cases of sexual violence treated
233 injuries due to conflicts received in out-patient clinics and emergency rooms
572 surgical acts for wounds due to conflicts
320 cases of cholera treated
14 cases of measles treated
38 cases of meningitis treated.

And our biggest activity consists of 110,254 medical consultations in our mobile clinics (setting up where needed) and out-patient facilities.

Success!

Hooray ! I finally got authorization Friday evening, the 19th of June, for the salary and job function scale changes. Then it was a race against the clock to implement these changes. We had an all-day meeting Saturday with the project coordinators, so I couldn’t do anything that day. Sunday I worked from 10:00am until 8:00pm implementing the changes into various tables and data bases, and prepared my presentation for the staff. Monday, I cleaned up all the essential work necessary before going on an announcement tour. Tuesday the 23rd, I left for Rutshuru (3 hour drive), where we made the announcement the same day. Wednesday, I went to Kabizo (2 ½ hours), where we again made the announcement the same day. Same thing Thursday for Nyanzale (3 hours). I had to leave Nyanzale rather late on Friday, arriving in Kayna at 5:00pm after a 2 ½ hour drive. That was too late for the meeting (the staff needs to be home before nightfall at 6:00pm for security reasons), so we made the announcements Saturday morning, the 27th at 7:45am. I left directly afterwards at 8:30am and arrived here at 5:00pm. My last presentation was to the staff here in Goma at 8:30 Monday morning. It was a whirlwind trip, but I had to put the changes in place at each site and announce the actions before paying the staff on Monday the 29th.

Overall, the acceptance of the changes was good. Essentially, we made an operational change in the job function scale to allow us more flexibility in moving nurses between different services. And we augmented the lowest salaries to maintain an acceptable living standard for our employees. Of course, the people who didn’t receive an augmentation would have preferred to have one. We explained that they are already fairly well paid next to other organizations like ours, and that we would continue to monitor the situation for future salary evolutions.

Since Sunday, I have been catching up on the work that arrived while I was gone.

Today (the 30th of June) is the Congolese national holiday, the 49th celebration of independence from Belgium. President Kabila is here in Goma for the celebrations. They finished the road work just last night on the street on which the parade took place! Kabila flipped the switch on the new streetlights last night as part of the festivities. Today a few of us expats went downtown to watch part of the parade. I think about half of the town was in the parade, with the other half watching.

Most of the other non-governmental organizations went across the border into Rwanda, in case any of the rebel groups took advantage of the festivities to make a “statement”. But with all the military troups in place, I have never seen the town so secure. Unfortunately, the troups tend to be less disciplined after dark, so we will not be moving from the compound after 6:00pm until their departure.

June in Congo

A month has gone by, and still no decision on our salary and job function scales! The team in Paris who should validate these has been decimated lately by illness and family problems. Hopefully, the team will be complete next week so that we can get some decisions. I need to put the changes into our human resources management system, and then I have to make a tour of the projects to explain the changes, all before the end of June.

And it is going to be difficult to find the time. My finance collegue just returned from her break in France, and she must go out to the field all of this week to finalize the budget revision - she is also under time pressure. So I am covering for her. And my own two assistants are at the MSF-France general assembly for the moment, so I am covering for them too. It’s pretty hectic. But it is the same for all of us. When I leave on vacation for the month of August, my finance collegue is going to suffer!

For the moment, security here in Goma is changing for the worst. There have been a couple of attacks on some of the other big Non-Governmental Organizations (NGO’s) here in the las couple of months, and these robberies were very violent. About 80 homes were burned and looted this past week in one part of town. And at 8:00pm last night as I was preparing to leave the office for the house, there were a few gunshots just behind the office. The guards actually saw the bullet traces go over our compound.

But this is still very calm next to the towns where we have our programs. The people living in the compound in Rutshuru spent part of last night in the security room due to shooting. In Kayna, this happens fairly regularly (as it did when I was there in 2005-2006). The attacks are usually attributed to one armed faction or another. The soldiers are paid sporadically and they have guns, so the take what they need. For various reasons, the unemployment here is very high, and MSF is known to pay our staff rather well. This makes our people good targets for bandits, and aggressions against them are rather common.

Our head of mission and medical coordinator get back this week from strategy meetings and the general assembly in Paris. We will have all the project coordinators here in Goma next weekend with us, to hear the results of these meetings and to plan the process of achieving the strategies. We are all looking forward to hearing which of our proposals were accepted and which were not.

Here to stay......longer

The visit of our interdepartmental team from Paris was very useful. The big topics included our salary scheme, the job function scale, and our relationship with the employees of the Ministry of Health with whom we work in some structures. One of the outcomes of these meetings is that we have a lot of work to do - some of it short term, and some of it medium to long term.

After talking with our human resources referent from Paris (who is also a good friend), I have decided to extend my stay here as human resources coordinator for the Congo for another year, up through July or August 2010. The projects will be really interesting for me, and will allow me to learn a great deal about human resource management. It will also allow us to have some continuity in the development of the systems. My decision also puts me on a path of little or no return – I will be out of the running for a purely operational post, such as project coordinator. But I have thought it over and I prefer to continue in HR, where we have a real shortage of expertise in MSF (as do a lot of the other non-governmental organisations).

And I will need a break. So I will be returning to France at the very end of July. After a day of debriefings in Paris, I will go to Indiana to see the family. I am booked to arrive on the 1st of August and to leave on the 10th of August. I will then have 3 weeks in my own place in Lyon before returning to Congo for another year.

After that, who knows?

By the way, here is a photo taken by an Australian photographer, Kate Geraghty. It is taken in Kabizo, where we operate a health center serving the local and displaced population in the area. In the foreground are some of the patients, who were fascinated by the camera Kate had. In the middle ground is our medical coordinator, Manal Shams Eldin, a Sudanese doctor. In the background is me, doing the traditional head-bump greeting with one of our staff who I had not seen in a long time.