Posted by: jewelinthelotus | January 20, 2013

Somber Sunday

I wrote the below last night with the intent of editing this morning, but as I was at the end of my yoga sequence I hear the FieldCo calling my name outside my door. When I opened my door she was saying there is work to do in the office. I of course was puzzled as it is Sunday – our day of rest. It turns out the driver, Aminu, who was hospitalized for carbon monoxide poisoning died this morning. It was my job to prepare his settlement. I was flooded with a cold feeling. I didn’t know him well, but distinctly remember on day four me and the woman I was replacing greeted Aminu and climbed into the truck, me excited for my first venture grocery shopping and my replacement visibly tired. We stopped along the way to pick up what I learned was kose (which I’ve been addicted to since that day) from his friend and then departed for the hour drive to the market and grocery store listening to American 80’s rap music. Aminu was my driver the few times I’ve been to the hospital and to get my 20th passport photo. He often wore black driving gloves and gold rimmed glasses. It made me laugh a bit as it made me think of Chicago yet we were in tiny little Muslim town where the dust is so thick it resembles fog. The last time I saw him was last Sunday morning when he was in my office with puffy eyes and still crying. His grandmother had died and he needed a salary advance so he could return home. I felt so bad for him as his grief was palpable. I wasn’t sure what to do or say as in this part of the country a woman can’t shake a man’s hand much less hug him. All I could do was convey how sorry I was for his loss and let him know we were all thinking of him.

There is so much death here that seems senseless. Although, it is also the first time I have been around so much death. I respect and admire the clinical people who come to do this work. They see cases that maybe they have only read about in a book, but certainly never seen. The OBGYNS in the project are at the hospital close to 24/7. There is one MD that every time I see her I wonder who she is and then remember, right, one of the MDs. She makes an appearance around dinner time then goes back to the hospital. The women here are very sick and there is a 1 in 5 survival rate in the babies born. Many of the women arrive with the babies already dead in their womb. At some point I will write more of the project, but will save that for another time. A lot of the stories are not for the faint of heart and my own heart isn’t up for it today.

Written on Saturday
This has been a long and strange week. It feels as if two was in one. A national doctor was killed in a car accident. One of our drivers went home when he learned of the death of his grandmother only to end up in a coma from carbon monoxide poisoning. Why they put the generator in the house is the million dollar question. Fortunately, he came out of the coma on Friday and is oxygen. The Admin Assistant who reports to me got his key jammed in the safe on Monday so we were not able to pay salary advances on the 15th. For some reasons this really hit a stress button that in retrospect I am not sure why. Maybe it was something tangible to stress about it. I think I was looking for empathy – not sure. I think it was also my exhaustion settling in. I haven’t slept well this week. I’m tired – really tired. I’ve hit the one month mark and this is now the longest I’ve been away from my creature comforts. I need to find the balance of working and living in the same place. The days are long and the work week is six days. I am not used to that. The long week combined with living with the same group is a lot so I need to make an effort to decompress after the day. In addition, I’m grappling with what I call house arrest. We are not able to leave the house and if we want to go to the hospital we must go by car. Most frustrating as it is a short walk. I have strong freedom needs so I’m working to find that inner peace or subdue the restlessness and find a way to live in confinement working and living with the same group of people with essentially very little privacy.

I’ve now heard it said by many within MSF as people rotate through – there are some you will miss and some you are not sorry to see them go. The composition of people on the project are four long term people and the medical people come and go about every 4-6 weeks; a few exceptions with an OT nurse and Midwife manager staying through March and May, respectively. The woman I replaced told me the first few months are awkward. It is true; I arrived to a team that have their set norms, rules and rhythm. This will begin to shift on Monday. Three long termers leave Monday and it is time. They are tired. In my observation leaving is a combination of sadness, joy, and disappointment at not being able to accomplish what was set out to accomplish.

One of the new long terms arrivals works for Kaiser in California as a labor & delivery nurse. We’ve already shared a few rants about Kaiser. She has to go back for her break otherwise she loses her job. I don’t envy her as the clinical people tend to work seven days. She is going to need that break. We’ve already been described by the Log as being similar with our laid back west coast attitude. Apparently he hasn’t heard our rants. It made me laugh as I consider myself FAR from laid back. It’s probably because he heard us talking about all the herbs we brought with us. J

In my short time on the project, I have already sat in on three disciplinary meetings (part of my job). I walk away from these feeling disheartened as what I’ve witnessed thus far is lack of acceptance of the infraction. It is communicated back as the expat has the problem. Last night I was talking with one of the long-termers who said part of the culture is there is no need for self-improvement. Instead of hearing this feedback as useful and as a way to grow it is dismissed and met with defensiveness. Although, not radically dissimilar from my management experience in the states. I’ve also sat in on three interviews and it is interesting they are very quick to answer the what are your strengths question, but when asked the what area would you improve question, it is evaded and am told culturally that isn’t atypical. It is interesting given that most in the United States find it difficult to answer the strengths question and easy to answer the weakness or as now asked, areas for improvement.

Promise to write more about the project once I’ve had more time to spend at the hospital. I hope to by February.


  1. D – Your confinement to a single space and small group of people is akin to our deployments. You have to find a place that you can escape – the blog, a nightly “Go to sleep” playlist on your MP3, some good books. While you are never really alone, you will enjoy your solitude despite the chaos around you.

    As for your mission – enjoy the satisfaction in knowing you have helped some, but accept that you can not help all. Any of us who have worked overseas need to accept that our work is very much the “Starfish story” – the one where a man comes across a 2nd man walking along the beach that is covered in starfish. The 2nd man is picking up a starfish every few steps and throwing it back into the sea. The 1st man walks up beside him and asks what he’s doing – when he says he’s saving the starfish the 1st man looks confused, “but there are so many you can not possibly save them all.” The 1st man looks at him and smiles, “Yes I know, but I have just made a difference to this one.”

    Aminu – I am so sorry he is gone. A seemingly preventable death is by far the hardest to work through when living in these conditions. I highly recommend you and the staff have a small service for Aminu – a time you can share your memories with eachother and maybe even write them down to share with his family. They have now lost 2 family members in a very short time, and I’m guessing Aminu was the source of income for many of them. Take the time to reflect on his part of your team and give yourselves a few moments to grieve before you continue on with your work.

    Overall, enjoy the excitement, embrace the suck, catalog the memories and know that you have forever been changed by this. It is experiences like these that make us grateful for what we have and enable us to savor the travels much more intensely.

  2. Debbie, so very tragic. I’m sorry for your loss. I can only say that it’s a great thing you are so grounded and do yoga, as this will help you immensely. And I agree with the starfish story. It’s hard to get Instant gratification which we Americans are so used to. It’s hard to trudge on without some sort of positiveness which spurs us on further. I admire what you are doing. I know myself I could not do what you’re doing. I may want to, but I know I could never. You have done this and you have continued to do this. This is who you are and I admire you greatly for it. You are fighting the good fight. You are an awesome warrior! A peaceful warrior and my hero!


  3. Debbie,
    Thank you for sharing your experiences and your heart with us. My thoughts and prayers are with you my friend. My love to you as well.

  4. What a hard day – you can really see how fragile life is in these places. And then to hear of something so tragic as carbon monoxide poisoning! Sorry, my friend – these are hard things to absorb and i hope you find ways to take care. I am in Turkey now…Paris tomorrow.

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