In any organisation many words get redefined from their original meaning, I think even more so on MSF. I am already using “mission” and “native” totally differentially to last month. I am also in an “emergency” mission. I had assumed all missions were emergencies and this was one of the reasons for MSF’s existence. But of course there are emergencies that have been going on some time and are reality stable, and emergencies that have just happened and are still developed; such as in Tigray, which has spilled over the border to Sudan.
What these means is that everything around me has been thrown up in the last 4 months. The water supply, the electricity, the staff and the drug supply have all been cobbled together in an emergency. This is dynamic and exciting in principle. It is pretty amazing to think there is a functional clinic and hospital, with outreach teams, logistic teams and clinical staff where previously there was a patch of dirt.
It also means conditions are fairly basic. Both for my living conditions, but more importantly for the population. Out pharmacy is patchy and incomplete, missing both basic medication needed for primary care (steroid cream) and some crucial life saving medications (diazepam to stop seizures). It means that out diagnostics are not well developed yet, meaning we are treating some conditions blind. It means that if we do refer patients; we are unsure of the quality of care they receive.
It also leads to some staff shortages. Why I got diverted here from my original project to fill a gap between international doctors, and why I am operating in an environmental slightly above my experience level. And when my co-ordinator is meant to be on a rest day I still have to text him for help up to hourly.
But it is dynamic, at the moment I am mired in the frustration of shortages of drugs and equipment; feeling disempowered that when my doctors raise concerns about certain medications we do not have, that I am still uncertain who to raise these problems with and how to obtain these vital supplies. But I hope it is going to get better, the potential is there. The shining vista of a new hospital being built next door is only somewhat obscured by the spectre of rainy season and all the changes that are going to have to be made to make this place liveable when the ground turns to sludge.