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.