finally in Africa!

This June 14^th I finally made my first trip to real Africa! I have been in Tunisia before but can’t call it the Africa most of us white, naïve Europeans look forward to discover, so we experience different habits, interact with locals, taste new flavours, feel a different kind of heat.

My first African country is, against all odds, Guinea. Not Guinea-Bissau, where they speak Portuguese, but Conakry-Guinea, where they speak French. And, of all times, I’m coming with MSF/ Doctors without Borders during the Ebola epidemics (now with much lower cases, thankfully, but still far from being erradicated). 

At first yes, I had the same reaction, EBOLA, no way! But then, meeting different people who have been here, knowing that actually security rules are even less strict than in Haiti (the main risks are robbery and carjacking, when the driver is alone in the car), having heard so much buzz about emergency missions, I needed to see what MSF is best at – going right where the action is. By now, Ebola has sadly also been around for more than a year, so a lot of learning and very well established measures, protocols, rules are in place, which makes me think MSF is somewhat THE expert to avoid any form of contagion of these epidemics, especially when it comes to us lucky ones, the expats (people like me, with European contract, coming for a short mission).

Let me maybe tell you some of these rules so you have a feeling of what makes this mission rather “special”, and another of the reasons which compelled me to come experience something I will probably never ever live again.

No touch policy is maybe the hardest and strictest of the rules. This means we literally don’t shake each others’ hands, don’t pad each others’ backs, don’t hug, kiss or dance with anyone during this whole mission. And any other activity which involves touching, of course :) This seems daunting at first, and emotionally harsh for a psychologist like me and in fact it’s not just because of risk of ebola contagion, but just about any risk of getting sick as it can scare all the team, lead to speedy evacuations, create a bad atmosphere, basically it limits the potential of panic and stress during the mission. And it can save our sanity.

In case of any problem, we lock ourselves down in our rooms and call the 24/7 available doctor within our team.

We also take prophylaxis for malaria all the way throughout our mission, which means 2 or 3 months-long, even though I get less mosquito bites here than I did in Haiti (no prophylaxis for the whole 9 months there). The reason is because the symptoms of malaria and ebola are quite similar, thus this helps to diagnose malaria out of the picture.

Every time we enter a place, whether home, office, CTE, banks, supermarkets, etc, we wash our hands with a chloric solution in it. We are also very often asked to measure the temperature with a aerial thermometer, which you put close to your forehead and it pops a number. 37,5 or above are the scary numbers, but then again, you probably will feel it if you get such high temperatures.  Aside note from our nurse, these thermometers are really not very effective so they don’t replace traditional "under the arm" ones, but hey, it gives some comfort to people. Plus, they look like little blue guns against our head. All in all, they are an extra with little value but important as an external sign of things being under control.

Because of the chlore ever present, because you cannot rely on how well the cleaners do the laundry or iron, and because things get “lost” every now and then, I am also learning a lesson on bringing the shittiest clothes and shoes one possibly possess. Or buy them, if you don’t. Since I am still new to this, I have brought quite some clothes and shoes which I like and would like to keep and use long after the mission. Some usual ‘missing items’ are also underwear, because they are more similar to each other’s and go unnoticed... Unlike my beach towel, wrapped around the Logistician's ass this morning! So in case of doubt, I keep clothes on a bag and wash them myself. Currently, this means almost half of my wardrobe… I need to let go of the materialistic instinct…

The food, our rooms, our toilets, this all goes as usual within the organisation – everything is done and prepared for us. On top, it’s very common to have a swimming pool (filled with chlore) and even a gym, as we usually spend the little time-off in and around the house, sleeping or else using these above mentioned facilities/goods. One day I would like to study a way to make humanitarian life more ‘normal’, as in having places to go out which are not fancy restaurants and 5-star hotels, activities which don’t take place between 4 walls, interaction with the locals which goes beyond 7 to 5pm…

And a hard one, usual emergency mode is 6-days of work per week. One day-off highly recommended, but depending on any urgent work needed to be accomplished. That is tiring! It’s only been 2 weeks now and I feel like my sleep is not the same, I wake up every day at 6.25, feel my energy levels going up and down and hardly being able to nap throughout the day-off (today as a matter of fact). No major accomplishments or plans for that day, which also feels weird… makes it look like a silly day in a regular person’s life.

Other than that, we can walk around pretty much anywhere, but at a minimum of 2, not alone, we can interact with locals (without touching haha), we can see the ocean from our windows and balconies every morning and evening, we are pampered with good food, clean rooms, washed clothes without moving a finger. It's luxury beyond what we are used to back home!

That’s it for rules so far, on the work side, I some new things to learn, which is great. But given the huge dimension of our project, we are actually a lot of people working on HR+ Finance: three expats plus 3 local employees. Which means that at times it is not clear what each one does and how to split responsibilities. After we do some major tasks which everyone is super stressed with, we will soon get to the routine procedure which will not need so many people (frankly, out of the 3 expats, we will only need 2 and that is felt already sometimes, we are a little army!). On the other hand, the ebola activities are not yet finished and there are a few projects around, and this week we just heard we will be opening a new center in the north of the country, so with a bit of luck, soon we will be entertained with more on our plate.

The local teams is usually one of the best parts of such missions, it is tremendously rewarding to have a chance to work with local staff on almost equal level, to share thoughts and ways to do things. This time again, I think we have a good team and I’m happy to hear that they also seem to be appreciating the way we are working together. It seems like in the past, there was a high level of stress and a lot of responsibility, maybe even blame, put on them. So far, we are doing just fine avoiding problems and errors, but our role as expats should also be to take the blame and protect our team from impossible-to-miss-disaster. Let’s see how it unfolds.

The rest of the expat team is cool. Can't tell you how happy I am to have a real team, instead of just 3 or 4 people, two of which are besties already, another one who is not really talkative and the other one always out at bars. Haha the difference between a team at coordination and within a project is pretty huge! Most have been there for a month or more and still big on smiles, excitement in their conversations, passion for what they do. One month and a half or two seem like nothing, but not so rarely, there are people getting back pretty tired and down after that time, so I’m happy to see that not everyone looks ‘defeated’. I intend to leave this mission smiling too. In fact, it is a non-negotiable domain, if I see my work is not needed or that the frustrations are higher than the accomplishments, then I will not stay any longer. Life is too short.

There is however some levels of frustration, which seem to come from lack of communication, no-clear boundaries between different levels of responsibilities and chaotic planning. This is both felt and caused by the expats at the same time. We can be usually the hardest part of a mission, dealing with each other, respecting each other, giving enough space, playing fair, knowing when to shut up or leave when we are grumpy or exhausted beyond quick recovery.

Plus, Guinea has been the neglected brother of the three Ebola countries, some say it doesn’t help that it’s the only French-speaking country (against Liberia and Sierra Leone, both English-speaking ones), maybe less mediatized than Liberia where news would show people dying on the streets, and very diverse with some local communities still denying or ignoring the existence of ebola, the means to prevent its transmission or the role MSF has played. To all of this, we add the politics and the continuous flow of money donated to ebola, going into the hands of the government. MSF was supposed to open a treatment centre in Coyah last month, but it all went down the toilet when instead the government got a huge donation if only they manage it themselves. So guess what they decided for... MSF keeps being pushed out of certain activities, limiting its scope and presence in the country and our ability to support the prevention campaigns, before the government elections when, not being able to deny that there are still cases, the local authorities will just try to capitalize on the collective work of all humanitarian actors to their own benefit = win some votes. 

Just last week, after pushing MSF away from the whole region, we were now asked to help in the opening of a centre in the north, close to the border with Guinea-Bissau, where some cases and contact-tracing is ongoing. The moment where fresh money comes in to that centre or region again, the authorities will probably find a way to reduce or exclude us from the region all over. No wonder there is a level of frustration within the team. Instead of controlling and preventing the epidemics, this is more of a game of power, money and visibility.

Last thing before I go to sleep: Conakry. In all honesty, unlike my usual me, I have acted like an Asian, and didn't go around taking that many pictures since I arrived. In fact, I think I have taken 10 or so in total. The city is… not that pretty. It is a bit dirty, with chaotic traffic and high levels of humidity. They do open all your unlocked bags before they reach you at luggage reception in the airport, the police will ask you for money when they see you are MSF... They will try everything for that European Euro or American dollar. It has shocked me as the first time in Africa should and so far it has not charmed me as much as Arab cultures or Haiti’s natural beauty and joy of life. I need time to get to know more, to understand the underlying reasons, to get to the details and exceptions. But the smile of children, how some can be extremely shy and feel so special when given a can of soft drink, or the cat or dog who comes for a cuddle or to play with you... those you have here too and it makes it worth the trip already :)