Random Looks

I keep my phone in my pocket at all times, next to a copy of my passport and a country-wide contact list.  I use it as a calculator and camera, rather than a link to the outside world.  It's a good notepad.

Despite our no-photos policy for the country, I need to take pictures for documentation and communication with coordination.  We have several construction projects going on right now, and there's always the requisite broken part that needs replacement.  Combined with the policy to not take pictures of environments, people, or property, this leads to some pretty odd photo collections on my phone.  Showing my photos from a mission to friends back home is pretty anti-climactic.  "This is the latrine.  This is the other side of the latrine.  This is the roof of the latrine.  This is the little hole in the corner of the roof of the latrine..."

They don't come close to answering the question of what is it like, but it's interesting to stop and explain some photos from a normal week in my life on mission.

It was a busy day in the office, and when the printer made its way in to be tested, that was threshold of ridiculous amounts of stuff in my office.  Hence, picture.

We had a huge thunder storm on Friday, and during the storm, apparently, the ceiling fan wobbled enough to embed a blade in the ceiling.  Oops.

A sunset over our compound

The major construction site, with 6 projects to be completed this year.

 

 

Drainage channel construction in the courtyard of the hospital.  Look at the channel.  I mean, really look.  This is why my slide shows stink.

Mmmmm, grease.  Cleaning out the grease trap, which was so disgusting I had to take a picture of it.  They're not usually this bad.

I needed to show the size of our gravel.

See where our percolation test hole is?  A picture is worth a thousand words.

We need this part for a land cruiser.

Our phase balancing for our warehouse generator.  I'm more worried about the low voltage output on phase 1.

Blood Bank

"Log Ref, Log Ref for Blood Bank."

"Go ahead for Log Ref."

"The log tag is alarming, over."

"Can you send it with a driver? Over."

"Can you come to see? Over."

"Yes, but later.  I'll be there a bit later.  Over."

"Affirmative.  Thank you, out."

This is not the conversation that I want to be having at 7:45am on Sunday, but with the pharmacist on his one-week R&R leave, I guess I'm the de-facto cold chain monitor-er.  We don't want to lose any blood units, and we've already had several cold chain breaks that threatened our blood stock.  We've changed out the fridge, so I'm confident that the fridge is OK.  I don't know what all the alarms are about, but I'll check anyway.

Weekend

This weekend is exceptional only in that Saturday is SPLA day--a national holiday to celebrate the founding of the Sudanese People's Liberation Army.  We're woken at 6:30am to the sound of small arms fire rippling through the town.  We all stare blearily at each other as we stumble out of our tukuls in the pre-dawn light.  We knew celebrations would happen, and we knew celebrations involve firing into the air.  We have been warned to stay inside and not move by foot on Saturday.  Bullets raining out of the sky is not an appealing weather forecast, and it has become all the more real at sunrise today.  I watch the sky as I head to the latrine, even though I know it's silly.  Still, I don't see any bullets.

The rest of Saturday passes in a normal whirlwind of slowly getting my list done while other problems emerge.  It feels like swimming upstream.  I have a meeting about patient flow in the ICU, but then get sucked into a supply discussion about expat food, which we truck in from the capital.  How will the rainy season effect our consumption of Pringles?  I wrangle all of my supply questions onto a paper, quickly cross a few small, pressing tasks off the list, then head to the hospital to urgently plug in the fridges that I moved yesterday.  They need time to settle after they're relocated, and we want to monitor their performance all day before moving the products into them.  I visit a few construction sites while I'm there, then call the Logistics Coordinator in Juba to ask all the supply questions.  After, I head to the warehouse for a weekly walk-through of the pharmacy and warehouse to see the premises and ask any relevant questions.  Halfway through, we find a huge shelving unit, newly built.  The log in charge of the warehouse and I exchange looks.  "Did you do that?" "No, did you?" "No."  Silence.

After a quick debrief about cold chain, a couple more tasks, and a recruitment preparation, I grab a 20-minute lunch of salad (hard boiled eggs chopped with cucumbers, tomatoes, and some sort of local parsley) and bread, then sit for a clarification meeting on the questions we will ask during this afternoon's interviews for a top-level logistics manager.  We have half an hour to get our act straightened out, and we cram in the final edits and hit print as the first candidate walks in the door.

Four hours later, we're done with interviews, and I haven't checked in with my team at all.  I try to find them to ask about disciplinary procedures, electrical installations, and supply status, but I can only get a quick update on a disciplinary procedure about a driver who threatened a colleague.  Sigh.  I'm off to the hospital to check cold chain to see if we can switch blood (which is very sensitive to temperature change) to the newly-functional fridge we just installed.  The shift changes at 7pm, but it's 6:45pm.  The only driver happens to be in the above-mentioned disciplinary interview, so instead I call references on the candidates we just interviewed.  I won't make the shift change, so we agree to move blood tomorrow, afer confirming that the roster has the personnel capable of switching blood actually scheduled to work tomorrow.

At the hospital, as dusk falls, I slip into the OT, change into gown and slippers, and trudge into the recovery room.  I run my tests, check the temperature, and move the drugs into the fridge.  The cooler where they spent the day can stay until Monday.  We'll haul it away during working hours.  Off to the blood bank, to check the temperature just in case, since the pharmacist is on leave, even though we will be moving the blood tomorrow rather than today.  Just as I finish, my technical referent calls me from Juba to check on several points.  Construction, cold chain, radio, supply, we go over several areas as I head back to the base.  After the call is lost due to bad network, or low battery, or something, I head into the recruitment debriefing meeting where the admin team, the project coordinator, and I all decide the results of the interview.  It's inconclusive, and we agree on a course of action.

As the meeting breaks up, I sneak into my office to close out the day, and wrap my head around the list of things I was supposed to do today, sitting on my desk forgotten for 12 long hours.  I settle my thoughts and organize myself for Monday, even though I'll probably manage a couple of hours on Sunday just to keep things rolling.

At 10pm, I clock out and go grab a beer at our dining/hangout tukul in the living compound.  Time for dinner, it's Saturday night.

We all sit around talking and hanging out, much preferable to a night club, bar, or other typical nightlife scene, for me.  People trickle in and out, and we break out the rum.  Captain Morgan is imported from somewhere, and we briefly muse over how far it as come.  Around 1am I turn in, leaving the last few people debating the pending economic collapse of South Sudan.  Or maybe they had moved on to favorite ice cream flavors, or fart jokes.  It's all on the table at this point.

Sunday is sleep-in day, and I get to 10am without anyone bothering me.  I spend a lazy morning over crepes (crepes!!  Thank goodness for our organization's French heritage) and a Kindle.  I wonder to myself if it's a first-world problem when one of the many flies buzzing around me lands on my Kindle's touch screen and it turns a page.  A group leaves to the market, to get some fabric made into pants, skirts, dresses, or bags by one of the local tailors.  I wander in to the office to see what I actually left at the end of the day yesterday, and to head to the hospital to change the blood.  The car washers come in, because they didn't finish on Saturday, apparently.  I get their machine out of the mechanic's office.  The med ref catches me and talks to be about a cold chain concern with one of the fridges, which is showing a bit of a high temperature.  The project coordinator and I confirm a meeting for the afternoon for the second interview of a candidate for the recruitment.  It's hot and lazy, and it's ok because it's Sunday.  6pm is volleyball, and everything between now and then is slow.

Life goes on in Aweil, and work goes on in MSF.  Just another weekend in a six-month-long mission.

Water Leveling

On my previous mission, I had an official company blog.  On this mission, I do not.  I am finding myself doing similar technical surveying techniques, so if you missed my post last year about slope surveying, here's a rehashing.

We're doing a large drainage project for the inner courtyard of the Aweil State Civil Hospital.  There are some horror stories of intense flooding in the middle of the hospital, as well as mosquito-producing lakes.  That doesn't sound like it's up to MSF's hygiene standards, so we have a large-scale intervention planned, with gutters, drains, soak-away pits, and water holding tanks.  The first step in all of this is a depth survey of the courtyard.  We're installing a 2% grade on the earth of the courtyard, through landscaping, and a 2% slope on the gutters that will line the walkways.  The 'surveying' boils down to a lot of measurement with simple math.

The infamous courtyard, pretty dry now.

The measurement happens with the construction log and I taking a clear tube about 30m long and wandering into the courtyard.  The contractor and his assistant happen to be walking through (they're on their way to the new showers they are just finalizing), so they stop and help after the first few measurements.

We fill the tube with water, then we attach one end to a stake hammered into the ground at Reference Point 1 (which happens to be a random corner we picked because it was here).  We pound a stake in the ground 30m away, and the comparing of levels is underway.  We compare many points to R1, measuring from the water level to the ground in each place, then move on to R2 for the middle of the courtyard, and finally R3.  We get a jumble of numbers that hopefully makes sense in a few hours when I have the time to sit down and type it out.

Tons of notes, a calculator and a word document is almost like having a CAD landscaping program, right?

A very sophisticated depth chart of the whole courtyard, mostly annotated by hand.

The contractor has started working on the sloping of the courtyard, and we'll bust out the water level several more times over the course of construction, to check slope measurement.  We'll also pour water on the ground and see where it runs, which is kind of more useful as a slope measurement, but sometimes it's good to be technical.