Twice now, we’ve gotten huge numbers of injured people from vehicle accidents. Things are difficult in a hospital made of poles and plastic sheeting in the best of times, but with an influx of 15 to 20 injured people at night, it can get ugly fast. Luckily Emir (our doctor) is really good at handling situations like that. The team works together really well, and we all know our specialties well and how to anticipate problems, so it’s exciting, but not utter pandemonium, ...
Today we had a little excitement in the compound. The storekeeper came to me really agitated. He said that he’d gone in the food store to check that things were ready to deliver food on Monday. But when he opened the door he found a big snake. He showed me that it was as big as his forearm. Now, we have snake scares from time to time. It results in a frenzy of activity, as all the expats run for digital cameras, and the Liberians who grew up in the bush get their slingshots, cutlasses and sharp sticks ready, and all the city boys from Monrovia scream like girls. I tend to try to steer clear of the circus and watch the country boys to make sure that the snake is dispatched swiftly and safely. ...
The TFC is the Therapeutic Feeding Center, where severely malnourished patients can be fattened up. This is significantly harder than it sounds since it turns out that human bodies do not take well to severe starvation. As you put in fluids and carbohydrates, the body needs to adjust and deal with the new chemical balances. You can kill a person by feeding them. So the medicine in the TFC is actually a specialty, like urology or proctology, but less icky. Unfortunately for all the malnourished people in Africa, it is also a rare specialty, so we here in Saclepea are just sort of doing our best to run the TFC according to the books the experts in Europe wrote and sent to us. There’s a certain amount of “if it works, don’t change it”, which is OK, but can be dangerous if things aren’t actually working, but you don’t understand what’s happening enough to be able to tell. ...
Hello from the middle of a huge rainstorm. It has been threatening to rain all day, and getting muggier and muggier, so it is nice that the rain and the cool breezes have finally come. It means, of course, that when I am done writing this and try to send it, it will fail because the satellite signal is blocked, but this is a small inconvenience to trade for the cool breeze coming through the office. ...
I have been quite busy here recently and my energy level is flagging because a Sunday that was supposed to be restful ended having several fire drills in it, so the whole team pretty much missed a day of rest. We have 4 guests here right now from Swiss Development Corporation, so they take a bit of attention. But luckily, tomorrow is Flag Day, a Liberian holiday, so we get an extra day off. ...
I haven’t mentioned the weather here much yet, but today weather dominated my activities, so I have it on the mind. When I first got to Monrovia a month and a half ago, I was welcomed back to the tropics by the heat and humidity I had become used to in the Peten, in northeastern Guatemala. As we were on the ocean in Monrovia, we got nice breezes, and the temperature was quite mild. But still it was the kind of heat and humidity that makes you sweaty just five minutes after a shower. ...
The rules say you aren’t supposed to have any pets in the expat house so that there’s no problem with allergies or fleas. But rules were meant to be broken. Our compound has: one dog, one cat, one hen with three Guinea fowl chicks as big as it, another hen with 9 chicks, 2 roosters (well, on Saturday we had two, read on to find out their fate), and two goats (like the roosters, this statistic is now out of date). In case someone from headquarters in Geneva is reading this, I would hasten to add that these are not pets but “program resources for maintenance of employee morale”. Are the bean-counters gone yet? OK, I can tell you about all our pets then… ...
I got lots of stuff done on my “day off” yesterday due to the Liberian Independence Day. The threat of unrest on a national holiday meant that we were confined to the compound all day while the staff had the day off. Even though I had a day off to catch up, I had a really hectic morning with a thousand little problems to solve. The most embarrassing one is that we ran out of rice for the hospital. Last week we ran out of tea, which was a big crisis because the staff is so touchy about missing a tea break. Running out of rice and tea were basically both squarely my fault, but each time they were easy to fix, and I’m confident that we’ve got things set up right for August. ...
I sat down to do my Sunday blog posting at about 10 pm but was immediately interrupted by our night watchman. He came to me to tell me that the hospital staff had an UNMIL (UN Mission in Liberia) vehicle there asking MSF staff to go with them out into the night to fetch an injured patient from the site of a motorcycle accident halfway to Tappita. I knew we probably couldn’t do it, because it breaks several rules (staff don’t leave the hospital to treat patients, we don’t travel at night, and we don’t ride in UNMIL vehicles), but I went and got a second opinion from the field coordinator, who is the most senior person on site. She agreed, so I had to give the hospital alternative instructions: give UNMIL dressings for one patient and instructions on how to stabilize them and transport them. I also got the guards on the radio and reminded them of their responsibilities with respect to UNMIL, which is that their vehicles must stay outside the hospital gates, no matter how insistent the driver or how urgent the situation seems. MSF staff may go out and carry in any patient that UNMIL drops off (no questions asked; it could be a soldier, as long as he’s unarmed). The watchmen know the drill, but emergencies get people excited, and sometimes people forget rules. I figured it was better for the voice of reason to remind them of the rules than to have someone make a bad decision and then have people talking tomorrow about how the new log lets UNMIL come in the hospital. ...
I figured I should give people an idea what exactly a logistician does. The glib answer is that we do everything the medical team either cannot or do not want to do. But actually in this project, at this time, it is a combination of upper management (meetings and signatures on slips of paper) and construction planning and management. I get up each work day at 6:45 am. I spend 15 minutes or so getting awake, and then I meet my assistant and chat about how the day is going to go. The drivers are arriving at 7 am and getting their vehicles ready. Sometimes they arrive late, so they are put away dirty, so there are people washing cars, checking oil and other fluids, etc. The stock keeper, who is responsible for the fuel store, is fueling vehicles. Once I have a general idea that things are going according to plan and which vehicles will be ready to work that day, I head in to share breakfast with the team. ...