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(well, on Saturday we had two, read on to find out their fate), and two goats (like the roosters, this statistic is now out of date).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. ...

Well, I survived my first week as the log/admin for the Nimba project! The big event this week was me taking over financial responsibility for the safes and all the cash in the project. At the same time, I also helped close the books for June. We had a troublesome 281 USD to track down, but thanks to my training in Geneva, which happened to cover the precise tricky bit accounting we were having trouble with, I got it fixed. Of course, the majority of the work to prepare for closing the books was done by my assistant, Mr. Toe. He brings me the books ready to go, and I review them. He tried his hardest to get them to balance, but this time it was up to me to find the remaining errors. ...

On Friday, Jerome and I made the drive up to Nimba County. We took 2 patients, their 2 caregivers, and a baby. In Africa, hospitals budget for two people for every admitted patient. The second person is a caregiver, who is responsible for feeding and washing the patient. This doubles the amount of logistical needs related to patients (food, transport, etc) but it dramatically reduces the per-patient workload of the skilled nursing labor, which means the few nurses the countries have go farther. But the downside is that the families are more profoundly disrupted by someone going to the hospital, since typically the wife/mother is the caregiver. That means the older children at home have to do the work their mom was doing (gathering firewood, farming, doing the laundry) which may mean they leave school temporarily. So you can see that the ripple effects go out and out when MSF decides to admit a patient. ...

Today Jerome (outreach nurse in the Nimba project) and I are heading out to Nimba. The roads are in good shape, so it is only a 6 hour drive. We drive halfway and meet a car coming from the other direction. We transfer ourselves, our two patients, their two caregivers, and our cargo over to the other Land Cruiser. Then each car returns to it’s own base. That way each base only loses a vehicle for one day, instead of one base losing a vehicle for two days and one night. ...

Hey, just a quick update to let you all know I got to Monrovia safely. Arriving in Roberts International Airport was an interesting experience. First, the runway could use a paving job, so while the landing was perfect the deceleration part of the flight was a bit hair-raising, even for someone like me who doesn’t worry much about flying. Then as we taxied off the runway and almost immediately came to a stop, we passed about a million UN planes. They really gave me the “we’re not in Kansas, Toto” feeling! Getting through passport control and customs was very easy, but then all my baggage had MSF logos on it, and I was wearing my MSF t-shirt. I’m told it helps immensely with customs. ...

Just a quick update to let you all know that I have arrived safely in Monrovia. We rode in from the airport last night in an MSF Land Cruiser through an evening rainstorm. The weather here is comfortable… it is quite hot and humid, but not as bad as Mississippi or Guatemala was. The tropical rainstorms are strong, warm, and short, so they are easy to deal with. My room is comfortable, with a nice mosquito net and screens on the windows. ...