NO GUNS

Although it has not made it to the press anywhere that I noticed, 3 days ago a French logistician on her first mission with MSF France was shot and killed while travelling in an MSF vehicle in the Central African Republic. I got a shiver of pain when I read about it on IRIN news (www.IRINNEWS.org). I shivered with realization that a comrade was killed and the renewed recognition that our missions are usually played out in areas of danger. Sometimes we forget that. We never forget that guns are not allowed in our humanitarian space, we have seen how guns rather than protecting us, serve as agents of conflict and suffering.
One of my T-shirts that I made recently proclaims " Killing is for cowards". Guns are easy to use to kill. There's nothing brave about a gunman whoever he or she may be. This point needs to be hammered home. I'll leave it at that for now, 'cos I could really let loose with it...and spray the room with my contempt for firearms.

What ?

Somebody sent me an email that described CHAD as the "Dead heart of Africa". How nasty is that! It certainly is the geographic heart of the northern portion of the continent, I can tell it is anything but dead. Two weeks before I leave and I'm starting to not believe I am actually going to. I walk the streets of NYC and try to imagine the dust (or mud) of this heart of Africa. I look around at all the faces of people going about their business and I see others far away going about their own business of surviving, living in little shelters of stick and plastic. The rainy season is about to start and getting around is supposed to be very difficult.( Not so apparently for the Janjawid who can scoot over swollen rivers on camels.)
I hope I can write of what I see and experience and am able to convey it to anyone who reads this. I remain a little scared, but overjoyed to be leaving and embarking on a new path. The reality is and will be much more intense than 'club med' Burundi and I have had some fleeting thoughts of how serious the situation in Goz Beida may be. So, let's see shall we...?

WHAT AWAITS?

One day in Burundi -2005- I had to set out with a small team to start one site of a massive meningitis vaccination campaign. I was the only Muzungu(white guy) on the team in the car, and when we arrived at a fairly remote village the crowd above was waiting to receive whatever care we could deliver. I was a little scared and overwhelmed for varying reasons. Luckily my team were all Nurses I knew and liked. The crowd erupted and rushed the wooden/tarp covered classroom once we started sticking the needles in arms and crowd control was managed (as usual in Burundi and other places) with big sticks deftly wielded (NO not by me !)
I sit here in the safety of Chelsea NYC and wonder, what exactly awaits me on my new mission? I received the Job Description a couple of days ago, and some of it reads familiar. I looked over it and my brain -of course -searched beyond the words and created images. The truth is I really have no idea what truly awaits( Truly: in the psychic, interpersonal and spiritual dimension) and that is a huge part of the reason why I am going.
But it does sound like that this particular Burundi experience will be echoed in Chad. We basically are going to refugee/IDP camps to triage and supervise healthcare, taking the sickest people to the town of Goz Beida. There will probably be also the frustrating work of deciding who can fit in the car for transport. In Burundi one of our more memorable 'moments' at a remote health center was turning around to find our landcruiser packed over the legal limit with mothers, grandmothers and babies all wanting transport to our hospital. We had to physically pull people out as they would not budge. This particular situation was valuable in that it showed our team that when you lose your temper and curse and scream it always unconsciously manifests in your first language. So I guess no-one understood "get the fuck out of the car mama, there's nothing wrong with you".

Peppermint soap, ipods and chiggers!

In case anyone is wondering what the best things to bring to Africa are when packing...well I have a few suggestions-
Most important is an
* electric adaptor, cos you know there's gonna be electricity at some time ( I never said constantly) and probably of dubious origin - and without that you can't plug in your *WAHL clippers....for us 'mens' the clippers are very important- this year instead of bringing a rechargeable one with its attendant transformer/dock I am bringing a plug-in one cos it's better quality. In Burundi we had many happy hours cutting each others heads and then not being able to wash the hair off as there was a water ration...
Of course an* ipod, but you know I did not listen to it as much as I thought I would. I was so alive to the sights and sounds of where I was, and alert to possible ' Danger' that frankly, listening to an ipod seemed a little careless and crass. Especially when you have a walkie talkie with you at all times. The ipod is good for traveling, or to block out sounds or when you are safe (are you ever?). I also found myself listening to it more towards the end of mission- I guess I was preparing to re-enter the world I had left behind.
*Dr. Bronners Peppermint soap. Big Bottle. You can- shave -wash yer arse- wash anything- hair -face- clothes etc. etc. and it's cooling and smells nice . I think this may be particularly useful in CHAD where I do believe its 105 degrees f. at the mo'.
Maybe a *nice cologne/perfume. I have a few I like and I don't know which to bring. Remember, this smell may become very associated with your mission in the future and may bring all the memories back as these things do. SO, if you have a shitty mission you may associate your cologne with that , and will never want to smell that smell again....
I have a deodorant that I bought in Bujumbura in 2005. It's still at my house and I never use it except to open the lid to sniff to remind me of the mission.
*Deodorant- I don't know about this ackshully...In Africa in a hospital you soon acutely realize that most -sorry, NO people use anti-perspirant/deodorant and I got used to it, even welcomed it... and would only recommend a deodorant that is not occlusive, and mild or none at all. My personal favorite is Body Shop men's deodorant stick.
*Scrub pants- If you have a couple bring em, they are so light and I rolled them up when it was warmer. And you can leave them with the staff when you leave. You should plan to bring things(shoes, pants) that you would be happy to pass on to the National staff. They are very appreciative of this, and it means you travel light- as you should- all the way home.
* Birkenstocks...they are so comfortable...and pretty durable but you can get CHIGGERS even tho' you wear these ( or flip flops) the Chiggers are in the dust which gets on your feet through any openings. I never forget when I was at the base one night and I told the Doc. I had a white pimply spot on my foot. I joked " its probably a chigger'. We lanced it and sure enough it was a little larva curled up..ugh. I was both excited to have gotten one of these legendary creatures and disgusted at the same time. It hurt to pick it out as Martijn was very surgical about it. AND--The excitement certainly subsided when I got another chigger two weeks later.
Anyway this is the list for the moment...I'll think of more stuff or you can add some of your own.

"Amazi"

The little girl was cradled in her mother's arms as we brought her into the hospital. I could see that she was badly burned. On examination I determined she must have had at least a 50% BSA full thickness burn. She had been playing in a hut with other children when it caught fire, according to her father she was too scared to run out through the flames and stayed inside. Now she lay there on the examination table, eyes wide open and immobile wrapped in a pagne. We got an IV in and inserted a catheter, clear yellow normal looking urine came out. I was encouraged by this until I realised it was probably the last urine she had made and there would be no more. She lay there repeating the word "Amazi.... Amazi... Amazi." I thought maybe this was someone's name. I thought it sounded beautiful. I asked the nurse beside me what the word was. "Water" he replied.
I held her and she died soon after.

Kinyinya Hospital, Burundi 2005.

737-800 Kenya Airways!

YOU NEVER KNOW

My heart goes out to those waiting news of the Kenya Airways crash. It hits close to home for those who travel in Africa, as KA is such a utilized airline and Nairobi is a huge hub for all the NGO's etc. I have fond memories of early-morning Kenya Airways flights from Nairobi to Bujumbura. They have the best hot breakfast!! Spicy tomatoes and sausages and egg... I always had the danger of African air travel in my mind while travelling, but KA was always professional and had new airplanes. Unfortunately this airplane was brand new, so there goes that reassurance. Those of you who don't know me should know I love Airliners and flying. When I was a kid I used to collect air-crash clippings from the newspapers, and would stage my own crashes with lego airplanes (built from scratch baby!) filled with toy soldiers. Think what you want. Travelling by air frequently does not make you feel any more safe, to the contrary I find myself filled with fear more easily than I thought. In case you are wondering-'cos I certainly was- It looks like I will be flying to N'Djamena (Chadian Capital) with Air France on a boring old A 320. Ha!!

GOZ BEIDA

Here are the MSF projects in CHAD. Find Goz Beida on the map...where's Nurse Fiddler?

Carbon Offset from the soul.

Can I Just add that one of the reasons underlying my self-interest in traveling with MSF is to try in some way to atone for the nastiness of this Republican administration and the lack of compassion throughout the world. I believe that somehow the ripples that spread from each act of goodness can serve to offset the acts of the cruel people in the world. It's kind of like a carbon-offset surcharge for/from the soul. And remember, there are more people doing good everyday than you will ever know....join them!!

CHAD!!

Getting ready!!!

Here I am now getting ready to prepare to go to my next MSF posting Nurslings!!! It is almost confirmed that I will be sent to Goz Beida, CHAD (80km from Sudan border). Look it up on google earth, it's there in detail. Monday we should receive the official reply from MSF. The new operational center for CHAD is in Berlin I do believe. Usually (!) the MSF'er recruit will go to the Operational center for a briefing before flying out to the final destination.
So you know I have been looking up the destination already, I have talked to some returned Chad-ers about what it is like there, and I even received a call from the Project Coordinator in CHAD.
You must know that despite the altruistic nature of these MSF missions, there is certainly a huge component of self-interest. People say that I'm brave to do this, I just say that I'm not particularly brave, but I am certainly ABLE to go and do these missions. Mostly because I have been planning my life to optimize my ability to travel with MSF. One of the MD's who had returned said that it is only as you trundle past the soldiers with their guns, grenades hanging like fruit ready to drop and RPG's that you realize truly how dangerous the situations are, and how really 'brave' or feckin' foolish you were to volunteer!!!
Anyway I'm excited and a little fearful- the fear comes from wondering are you really up to the task when faced with 100's of ill refugees with babies screaming. In my limited experience you initially feel like all the years of education in healthcare you have received fall away, and you know nothing- luckily the fact that you are there (and have no real way of escaping!) facing the crowd means you just jump in and act as if you know what you are doing...and before long you are doing what you do best to the best of your ability.

"WE WERE RIGHT"

"The list is endless. Over and over again, we were right, and they were wrong. So, who are these people? They’re called conservatives, and on their best days they’re just wrong. More often they’re mercenary kleptocrats whose one skill is that they’re well practiced at the fine arts of deception.

Anyone shocked to find out that so-called conservatives (actually, ‘regressives’ is nowadays the more accurate appellation) are wrong about just about everything hasn’t been doing their homework for history class, and should consider staying after school. Conservatives have almost always been wrong, almost always on the wrong side of
history. When the Founders were mutually pledging their lives, fortunes and their sacred honor to each other and to their cause in the eighteenth century, Tories took the side of colonialism and monarchism. When nineteenth century progressives fought for the ‘radical’ notion of abolishing slavery, conservatives led the opposition. In the twentieth century the record of failure ranges from women’s suffrage, to civil rights for blacks against which they staged the longest filibuster in Senate history, Native Americans, women and now gays, to environmentalism, civil liberties protections, McCarthyism, Social Security, the minimum wage, Medicare, massive federal debt and more. Nor have they done better on foreign policy questions, either. While Hitler was amassing power in Europe, conservatives forced American isolationism, creating a powerful adversary who only had to be faced down in more lethal form later. These are also the same folks who brought us Vietnam and the present war in Iraq, not to mention the toppling of democratically elected governments in Iran, Guatemala, Chile, and beyond, US-sponsored terrorism in Nicaragua and El Salvador, and winks and nods for apartheid in South Africa. And no, my Kool-Aid inebriated friends, Ronald Reagan did not ‘win’ the Cold War. However stunning his heroic victory in Grenada, the Soviets were neither wowed nor spent into submission – though we may yet be.

Quite a stellar record, eh? Indeed, what I don’t get about conservatives – always so big on honor and morality – is why they don’t do the ‘right thing’ and... well, at least shut up. If I was that wrong, that often, I sure as hell would."

A tree falls in the forest...

I have been wondering what I should record on this blog, and as no-one has started reading it much yet, I think I will do a verbal code brown and clear my system a little. Later I can revisit this rant and see how much I have changed my POV....
I think the President should be impeached for his Lying along with all his lying liar cronies. I think the opposition should stop their pandering to what they think the people want and be honest about their feelings...on all issues. I think Mary Cheney is a fuckin' hypocrite and all her type...
I believe any nurse or doctor who agrees in any way with the republican (and much democratic) Agenda- specifically towards Gay and lesbian people should not be allowed work in healthcare. My hospital requires I treat all patients without regard to their 'anything' yet all these religionists and this government discriminate...I believe Moderate republicans are just as guilty as the regressive radical right...as are conservative democrats . I strongly believe that ALL homosexuals should come out en masse and if challenged- leave the military, and all soldiers who disagree with this war should desert. I DO NOT SUPPORT OUR TROOPS! What have they done for me?
And Why should I ? They are fighting an illegal, morally bankrupt war for nothing- these are adults who should have the guts to stop. I know that holding a gun does not make you brave. I know killing people doesn't make you strong, if anything it fucks up your head or makes you eager to kill more. Killing is for cowards, if you wanna be brave, have gays in the military and if you are such a good shot, wound, don't kill.
I believe religion is limiting , small minded and at its best a crutch or cudgel. I believe this world is more beautiful and more shimmeringly alive in spirit and visual tactile beauty than any badly translated fairy story. I don't need to read an old book of Tribal pre-mediaeval SNOT, to know how to treat people with kindness and respect. (By the way I am being kind to the military.) How can ANYONE take the bible seriously? How dare it be considered anything important or of importance...spare me your " faith" .. I'm supposed to be thoughtful and respectful of your faith...but what the hell is it?...WISHFUL THINKING.. clothed in artifice and not a little camp..... myth and magic. OK, that's good for now.....

..lie there and suffer...?

General Peter Pace Chairman of the Joint Chiefs of Staff opposes openly gay soldiers in the military (read Nurses)
I may as well post my recent addition to a NY times online discussion on this subject...

" I’m a Critical Care Burn Nurse-I worked to save the lives of the Burned victims of 9/11 here in NYC.
Sometimes when I hear the small minded idiocy and squirming of the ilk of the general and his supporters, I entertain the idea of NOT taking care of a burned and badly wounded straight soldier (” lie there and suffer! “)
If I was in the army they would throw me out- as they have other gay Nurses- Because I’m gay.
I really don’t know what soldiers do to their wives/girlfriends in bed, but it seems the imagined sexual acts of Gay soldiers are really what these ‘men’ are scared of. They are scared of Homosexuals. And to defend a sick policy on the basis of the fear engendered by thoughts of what I may do sexually to others or them is just incredible. Wimps! Call yourselves brave?
To all those I say-
I am a critical care nurse- I am trained to comfort, care for, palliate and heal my patients on many levels. I will take care of you if you are injured, and you will be lucky to have me as your nurse, I can guarantee you that. I can save your life, and I would try, regardless of what I think of your private life. Will you be thinking of what I might do to you in my bed, as you lie in pain dying in your own? I think not.
Remember me."

Me and Rhian

Rhian Gastineau and Myself, happily bringing the message to the masses at the "refugee camp in the city" (central park NYC)! Rhian was my recruiter for my first mission, she was so great to me and helped me segue into my role as a MSF newbie. The staff at MSF HQ in New York are wonderful, the office is a great place to meet and explore...If you are interested you should go attend one of their monthly info. sessions, and all you Nurslings who are interested in working for change around the world....Learn French!!!!! I have provided the links to MSF and Alliance Francaise, so jump to it!!!

RUYIGI Hospital BURUNDI

The REAL and the IMAGINED

So here goes- I believe nursing at its most vital is a profession that crosses all boundaries and touches on all aspects of our humanity and on the burning issues of these times. Unfortunately not all nurses see it that way. I have no choice, for ME Nursing is the political, the freedom fighter, the rebel, the compassionate who 'fights' with caring. The Nurse can be the person who can smile and warm hearts even as death cools others. Nursing has to grow and expand as a human spirit should, open to learning and innovation, forgiving of itself and striving for excellence. Sounds like a lot of hot air eh?

That's why I have decided to start the drive to build the FIDDLER HOSPITAL FOR HOPELESS CASES (FHFHC). My last year teaching Nursing students after being in Africa renewed my plans for the ideal hospital . I have the vision of a Hospital where I can choose the staff, try out innovative procedures and no HIPPA is ever needed. For example: It will be staff from the FHHC that will pay unannounced visits on JCAHO headquarters looking for mean people, unimaginative clothing and redundant paperwork.
Please leave comments and ideas on how you think you can add to the FHFHC dream. Together we can upset the old nursing applecart and lead the way. I have lots of ideas from fab Uniforms to 'theme' nights on the nightshift, to having CEO's periodically cleaning up bloodspills... Maybe you can already tell it will sometimes be hard to tell the possible from the impossible. THAT'S THE WHOLE POINT. So if you feel comfortable with the suggestions that will follow, there may be a place waiting for you on staff ... or as a patient - welcome to FHFHC!

A clear limitless sky

Birth

Here we go I'm starting out, I took the suggestion and started a blog. If you're interested I hope you will continue to be - and if not....Ah well....
You may notice betimes that my musings take Flight and become kinda like poetry, or on the other extreme my anger at a current injustice Spills into script...Whether flying or spilling I guess all is fine as long as I land safely, and mop up the mess!