Recalibration

I work with populations that are stressed and traumatized. It starts to get to me, and I don't often realize it. I become calloused and cynical. Babies die, old people get left for dead, women get raped. War passes through towns, entire lives go up in flames, and the sun still rises. My calculations are about the emergency minimum for people to not get sick. Can a family live on 5 gallons of water per day? For how long? My horizons shrink and violence becomes the norm. I lose sensitivity.

I see mothers in their teens, with babies strapped to their backs, hauling water all day. The only redeeming factor of the baby is that it is lighter than the water on their head. Children becomes burdens in this war-torn land.

Then I get moments that break through my calloused shell, that jolt me out of the apathy and cynicism that have become my normal.

I see our driver bouncing a baby up in the air and cooing. A 50 year old man with grey in his beard, beaming like a kid with chocolate. "Aww, is that your son?" "Nope." He's just happy to see a baby.

I pass by a vaccination site, full of people waiting in the sun, crying children, and loud health promoters. A mother takes the time to kiss her child's boo boo after getting vaccinated. She stops crying. I continue on with a lighter step.

Early Mornings

Dawn is stretching itself across the eastern sky. I used to be excited when I had to wake up before first light to go out on field activities. Now it's just early. I stir myself enough to take a picture of the sunrise, since I have an hour car ride to the mobile clinic site that I'm visiting. I'm out so early to check up on the setup procedure, which I have heard is still problematic, even after 3 weeks of activity. We should be able to set up a functional mobile clinic in a couple tents within an hour and a half, and apparently we are taking 4 hours. When I heard about that, I programmed myself on the next early morning ride.

The next day, I'm on the road again at 6am, before first light, but this time by foot. I'm walking from the living compound to the pharmacy compound to give a cold chain training, and the sun is rising in front of me. I load my training with funny expressions, so the audience of 40 people packed into the cold chain shelter will remember the information I am droning at them. I call the ice packs pregnant, I talk about chickens hatching. I'm not sure if anything I say resonates with these nurses and doctors, but I hope it is memorable. I'm recalling my physics classes in high school, with the high specific heat of water, and the second law of thermodynamics. Somehow, I don't think bringing that up would be helpful. I'm referencing science and asking the trainees to think back to their school days, in science class. I have no idea how the school system is structured in Uganda, whether they were expected to learn any of this or not. We go over the state changes of matter, and the freezing point of water. We get stuck on the fact that ice can be colder than 0 degrees. We go over it again. I think we get past that. I hope I'm not giving offense. We move on to condensation. Hopefully without condescension.

The rest of the day passes in meetings and reports, and the sun sets with me still in the pharmacy compound, finishing a meeting over whiskey. As we walk back to the living compound, we mourn there is no time for our favorite workout video, to say goodbye as a team.

Because tomorrow I leave at 6am for the end of my mission. I will see the sun come up one more time this week, while on the road in Uganda.

Check In

I haven't been writing very often in the last few years because my everyday life has normalized for me. Every once and a while, I wish to share aspects of my daily life, either as a day-in-the-life telling of a particularly crazy day (or to illustrate what I do on a daily basis), or taken collectively to highlight a particular difference or observation. But my lifestyle has become normal to me, in my 4th year in my current job. It is harder and harder to find the impulse to point out a particular instance or to tell a particular story. To avoid having a tone too philosophical or introspective, I should start sharing stories.

Even as my life becomes normal for me, I still have stories of what happens. You know the stories, when something is so absurd you think to yourself in the moment, "I have to tell someone about this." Or the stories that come out of an adventure gone wrong, and you console yourself by saying, "at least I have a good story now."

A group of us were leaving from my last mission in Borno State, Nigeria. The airport in Abuja, the capital, closed on Wednesday. Two of us from our mission had flights on Friday. Probably. I didn't have a flight ticket, but I was pretty sure it would be for 2pm on Friday, leaving out of Kano, our designated secondary airport during the closure. The problem was that our charter plane wouldn't make its Friday rotation into Kano until the evening, so I had to go by car. The problem was the car was 6-8 hours, we think. So not possible on Friday morning. So we would leave on Thursday. A last-minute call put me and the other team member, a hospital logistician from Afghanistan, in the car with an administrator of another MSF section to get to Kano. Our car would meet another car halfway, we would switch our luggage and climb in the Kano car. 9am Thursday starts our journey, and everything proceeds smoothly. We get to Kano in 8 hours of mostly smooth roads, and we mostly slept. Except, every time I woke up the driver would reassure us we were in Kano. An hour later, yes yes, we're in Kano. Apparently he meant Kano state, not Kano town. Sigh...

The next day, we go to the airport for MSF's first ever departure from Kano International Airport on our 14h15 flight on Ethiopian Airlines. We leave just before noon, and get to the airport in a speedy 15 minutes. Already, this is better than expected, and things are going well. We convince the guard at the gate that we are actually an NGO, and that we actually don't pay private fees, and we find our terminal. We go through security, yellow fever health check, and something that might be security, or asking-for-a-bribe post or maybe another health check. They check the men's bags but I'm let through after a 2-minite conversation about how nice Nigeria is. Sometimes a smile goes a long way. But I'm annoyed that I had to talk to a stranger for 2 minutes. I check to see if my smile is still pasted on my face.

Check. Next.

Next is the Ethiopian check-in counter. They closed 4 minutes ago, apparently. Uh oh.

It's 12:34 and we took 15 minutes to walk the 50m from the front door to the desk. We're trying to get on a flight almost 2 hours later, and there was no notice of check-in time. The people behind the check in counter ADAMANTLY refuse to check us in, despite being 5 people sitting there with nothing to do. We see the successfully checked in people dropping off their baggage just a few meters in front of us. It's got to be a joke.

We get referred to the office, just on the other side of a glass wall. Another five minutes go by as I track passed all the health checks, bribe posts, and security, to get to Ethiopian's office. The lady wants to reschedule me on the Monday flight. Darn, they got me. Diversion tactic number 1. I rush back around the glass wall to my two colleagues who are fiercely guarding luggage and keeping the departures desk open. Behind their screen, I rush the stanchion when security is not looking and appear on the other side of the debate. I'm now behind enemy lines and can talk to the supervisor who was hanging back. She's flabbergasted that I'm also making demands of her, and I insist that the office told me to come here and said that I would be able to check in.

A manager appears, and has all of us worriedly pleading our case to be checked in. He starts collecting passports. He's on the other end of the desk, and catches my eye. He motions for me to come around to talk to him, but I only have 2 of our passports. I catch my Afghani colleague's eye and ask for his passport. He tries to hand it across the security gap, which is now staffed with several distraught staffers, who have already tried to eject me back onto 'customer' soil. The passport gets shoved out through no-man's-land and I grab it, at the same time as a security guard. A three-way tug of war ensues, with much shouting and pleading. I remember having a distinct moment, reflecting on the weird situation of being an American in Nigeria, holding the passport of a Togolese colleague, and reaching across a security line, fighting a man for the possession of my Afghani colleague's passport, shouting "it's a passport, it's a passport, don't tear it!" repeatedly. What a multi-national hodge-podge, ignoring current political tensions and stereotypes. Somehow, finally, I get the passport, and I squeeze through the crowd to the manager, and safely deliver all 3 passports. He says the magic words of "check these people in, no one else, but check them in" and we are in the group of last travelers allowed.

Whew. Then it's chaotic business as usual, with information being hand-entered into notebooks and security checks being performed out of a suitcase (they have some border security control computer that travels in a suitcase, and is arranged on the floor), then we get ferried into the slowest moving line to drop off our baggage. Despite there being a frantic group of 20 people trying to get to the counter, no progress seems to be made. Eventually another counter opens up at the end of the crowd, and we three, who are thoroughly last in line, sneak up to it. We have boarding passes, and got our luggage ticketed (after a tedious game of "Which bag is yours?" "This one" "This one?" "No, this one that I'm holding for you" "This one?" "No sir, the one in my arms right now" "This one?" "Yes." "Any other ones?" "No." "This one?" "...").

We go to customs, to another maybe-bribe post, to immigration, and security. There is no one there. We saw 20 people pushing and fighting in line ahead of us, for almost an hour, and there is not a single person waiting to get to the boarding area. Surreal.

We get through the eerily quiet security point and find a surprisingly pleasant departures hall, where we board our bus to get on the plane (after a pat-down security check and full bag search; great to see confidence in the security guys with the x-ray machines), and have a smooth flight. It's a good end to a very eventful check-in experience. I told the next group of people to get there just 5 minutes earlier.

Scars

I talk to myself a lot.

It's a weird part of being an introvert.  I make grandiloquent speeches that will never be delivered.  Sometimes I transcribe them, but mostly I just get myself fired up with how right I am to have my own opinion.  Not very helpful, but I impress myself.

When I get back from mission and try to reintegrate into my own culture, the country where I was born, the city that I chose to live in seven years ago, I feel a distance.  I've experienced things that are hard to explain, difficult to share, and utterly unlike anything that most people have seen, aside from news stories.  And there is only so far words can go in explaining bad things, especially on a succinct and pithy platform like nightly news, or the headline of a buzzfeed article.  So I think on a metaphor and launch a rambling speech in my lonely hotel room, here in Paris, perched between my life in the field, in Nigeria (this time), and the Western World, on my way to Bordeaux to meet with more MSF field staff like me.  I'm currently in a city of refugees and Westerners, privileged and destitute, far from my own home, as loosely defined as 'home' is.  And I think on mental health, and well being.

I think about scars.

In my my post about home, I was thinking on how disparate experiences give us disparate origins, since two children having grown up in the same town can reunite after decades, realizing that they no longer share a history.  Some experiences are experiences of culture, of norms and of rules.  But some experiences are about events, about something happening.  And this is less about where you are from, but more about what you have seen.

And which experiences leave a mark.

If I come back from Africa, eyes afire, and you greet me as a long-separated friend returning, with a happy exclamation and an invitation to coffee, as we settle into our seat across from each other and make small talk, and you get around to the questions, you ask me, "So how was it? What happened?" How do I answer?  I consider.

I've brought back a knife from Africa.  It is exotic, fantastic in its description.  Captivating, alien.  Powerful, dangerous, sexy.  You see complicated feelings in my eye as I talk about the knife.  I weave a vague and deflecting story.  You ask me more about the knife.  It intrigues you.

I have this knife, and it is interesting, but it is dangerous.  I hint of the scar I took when I met the knife.  I don't show you the scar, but you who know me can see that I don't use my left arm as dexterously as before.  Nine months ago, I was nimble and deft, but now there is a hitch.  You know the scar is there, on my left bicep.  Your eyes are drawn there as I weave obfuscating screens around the story.  You ask again about the knife.

I have it with me.  I carry it always, now.  I never let it go.  But I don't tell you this.  I don't show you the knife, and I don't show you the scar.  But you are canny, and you know of the scar, and you hear me talk of the knife, and see the expression in my eye.  It's powerful, and it's here.

You ask me to see the knife.  You are captivated, it is from a different place, a different time, a powerful artifact of a lifestyle that you will never lead, a culture you will never encounter.  You could never have the same experience as the scar that hinders my arm, but what an entrancing thing, to just be pricked by it?  Why not to have a full taste, to feel your flesh be parted by this horror, this artifact from quaint warfare, from divided societies thousands of kilometers away.  You ask to feel the bite of the knife.

How can I, in good conscience, prick you with this knife, that will leave a wound that your doctors cannot heal.  A wound that would leave a scar, even as diluted as the blade would be from the conversion from events--heart-pounding, vision-blackening, urine-inducing events-- to mere words, gestures, symbols, trying in vain to convey the chemicals pounding through your blood stream as your body dumps adrenaline, goes into fight or flight mode.  Despite not being the sword of first-hand experience, the knife of description still holds an edge.

I bring a knife back into your polite society.  I cannot in good conscience draw it.  And to ask me for the stories, to ask to feel the bite of this blade, is unfair.  I won't cut you with the stories of the things I have seen.  I will not mar your psyche with the dimpling of scars from this black blade.  I will instead seek others whose blades are similar to mine, whose scars are reminiscent of mine.  And we will all hide our knives together, obliquely referencing our scars.  Occasionally, we will show each other our knives or our scars, and we will bear the burden together.