Bahai Beach 4- sand sand sand - 30-07-2006

Bahai Beach 4
30-07-2006

The Libyans are the main suppliers of goods in the souk (market). They travel in huge Mercedes Benz trucks convoys loaded so full that they are twice as broad as usual. You rarely meet more friendly people. In a mixture of French, English, Arabic and Hindi We exchange stories and share foods and teas in copious amounts. One can not leave without having a full belly. The bring to this isolated community: clothes (buying a FZ Barzalona Shirt), food items, but also satellites, television and other goodies. The souk provides opportunities to starta proper chicken farm in the compound. Need to haggle hard because as a khawadja (white man) the price for items is twice the local price. Also me being a leading expert on chicken they may sell me infertile, blind or mentally retarded chicken defeating my vision of an egg emporium in Chad with little outlets all over the country. If this plan is succesful however the camel breeding project is second on my list.
Water is becoming a major issue. Although it has rained it is not yet in the amounts we long for. Trucking is our second options from a dam about 10 kilometers from the camp. This body of water should suffice for about 3 months. In any scenario it needs to rain across the border in Sudan so with the gravity and aquifers it can fill up our Lake Cassoni and I can have a massive swimming pool to my disposition. Sancho Yoda, our midget logisticians is back in the project and we spend our nights exchanging list of most senseless movies- innuendo – mischief and other projects two 35 year old with the mindset of a 12 year would engage in. And new staff is about to be rolled in the project a new health coordinator and a member of the emergency response team. Charles (ERT) is here to reduce staff numbers in the health departments and work out a proper memorandum of understanding with the Ministry of Health Hospital at Bahai. And Sylvie will be here to coordinate the different departments: Reproductive, Clinical, Public and Hospital Health. I hear we are recruiting for a Hospital Manager as well. Let us wait and see what time brings us.
The most impressive story of this week was the prolonged labor and delivery of a child in the maternity ward in the camp. After an episiotomy (cut) and lots and lots of help the mother managed to push out a baby boy. No cry, no heartbeat, floppy, bluish immediately neonatal resussitation was started but after 15 minutes of mouth to nose mouth breathing, medication and heart massage the baby boy had to be declared as a stillborn. On seeing the sadness in my eyes the traditional birth attendants responded in a touching way. Dr Ashis do not worry, the mother is still alive and inshallah she will deliver again in a years time. No need to further express the survival mechanisms the Sudanese people in the camp are used to. Another boy took some traditional medicine or improperly prescribed drugs in the camp and developed a severe fixed drug skin eruption. He had blisters all over his body. Yet after nursing him properly he is improving day by day. As in all countries I have worked in the danger of HIV/AIDS is eminent. In our wards are two patients who have all the signs and symptoms of this lethal disease. The MoH hospital is understaffed however. The doctor is on a sick leave/strike/holiday and the lab technician has left them as well. And well we are at the end of the world in semi dessert how can you blame them ? I am getting to know the health staff better and better and overall I am very happy about their motivation and skills sets. They love teaching session and traditional birth attendants, nurses and community health workers each have 2 sessions a week on those topics that are relevant given the season or because they are basic skills for their work. Last week we discussed malaria, malaria in pregnancy, diarrhoea and prevention thereof. Also we have started a bed net distribution program for pregnant women and intermittent treatment of all pregnant women with an anti malarial drug in the second and third trimester. Malaria cases are expected to shoot up in the next two weeks. Every week a new challenge is up so the learning curve is still steep and is what I like. The final words for this week will be that although we have a total rupture of vaccines since 1 week, a case of acute flaccid paralysis is in the camp (possibly polio), incentives for the 96 health staff need be prepared, drug order for hospital and health centre are being arranged, weekly and monthly reports are due, rupture of water delivery may be on the way and many many more things going to the Oure Cassoni camp six days a week is like filling up my tank brimfull of asha (hope) and energy for the next weeks and months to come.

Namaskar,

Ashis

Thank you for all you for writing your tidings I really enjoy it.

For those of you who wish to see some pictures: try http://www.flickr.com/ and search for polio or ashis_brahma.

In due time a myspace photolog will bein place as well. But having difficulty uploading pictures there.

Bahai Beach 3, Yippie - 21-07-2006

Bahai Beach 3

21-07-2006

Matthias picks up his shoe and smacks it on the floor. Bang another cockroach less in this world. But no it is a scorpion size about 8 centimeters. Both John and Matthias will be sleeping inside both have been bitten before and have felt the excruciating pain in the past. Frankly there is no treatment for a scorpion sting in our pharmacy. Luckily I have gone to the local uruk (traditional healer) and he has made a leather amulet to ward of scorpion stings, snake bites, knive stabbings and bullet wounds. Comes in handy these amulets.
Two days ago a young chap arrived who had been attacked with an axe like weapon. Part of his skull has crushed. All we could do here was stabilize him and get him evacuated to Abeche where there is a surgeon. By the way our Ministry of Health doctor has self evacuated and we pray that he may return here. Presently I am the only doctor in an area with 30000 refugees and 40000 host population and surgery is not my cup of tea. Challenges, challenges, John the Kenyan male midwife is traveling on Monday for a new mission in Liberia leaving me in charge of the Clinical – Public – Hospital – Mental -Reproductive Health for two weeks. The good news is we are recruiting a Chadian doctor and a new Health Coordinator shall be arriving Inshallah first week of August. As these interviews have to be done in Abeche I will probably fly up there next week to conduct them. The score for cancelled flights this week was 3/5 however. Mechanical failure.. Always good to hear when you are flying. We are encountering some sensitive political issues. The sultan is more or less demanding that we recruit local people only. It is hard to deny him many things as he is the brother of the Chadian president. Yet the illiteracy rate in this region is very high and trained doctors or labtechnicians are not available in the region. We have tried recruiting local nurses but there are just none. Some posts therefore stay open even if the budget is there because Chadians from outside the region are not always accepted.
The first party since I have arrived was in the UNHCR compound. Main guests were the staff member of UNHCR (security man) who was leaving, a gazelle (male), 2 ladies and about 40 men. Yet when the African music hit the speakers hips were churned a great mélange of dances from Benin, Burundi, Ethiopia and Holland were shown off. The cleg dance went down very well indeed. Since about a week I go to the souk (market) regularly to work on my Arabic and Zagawa, drink tea, gossip and get to know the people living in Bahai. In the camp nowadays we share breakfast with the Sudanese nurses. Either lentils, or beans or camel with bread.
An attempt is being made to contact the foci (healers by scriptures from the Koran) and bada (trained to remove djinn through there own two devils) yet it is culturally unacceptable for them to talk with a khawadja (foreigner). Overall besides the security the program is up and running with potential for improvement. Our expatriate staff numbers are low however and will not be replenished very past so although we are consolidating better to say we are trying to float.
Since the cock awoke me at 0430 and otherwise the pigeons at 0500 I am closing my eyes and want to thank all of you for writing it makes my day. Will attach a photo of the lake. Or what remains of it

Bahai Beach 2 - 17th July 2006

Bahai Beach 2
17th July 2006

Dear friends,

Another week at the job and it has been mildly eventful.
Attending a leaders meeting is fun. After explanation of the activities of the main actors in the camp the leaders get the chance to put in their questions. Instantly the sea of white turbans releases snapping fingers. Elaborate introductions- blessing of all present and Allah and then sweet itinerary. Could UNHCR replace all 10000 tents before the rainy season (due now), can IRC take care of the roaming donkeys, we need 3 new traditional birth attendants as the Blacksmiths have different birthing customs than the Goran and Zaghawa, can you provide the rain to fall. When you are about to answer any of the above questions men and women will add on to the previous requests. Yet hearing all the dynamics-politics-clans-testing the NGO’s makes me realize I need to learn to be very prudent.
Traditional birth attendants were very happy this week as the new maternity ward had opened. A fresh 4-roomed white washed building (teaching room, 2 delivery rooms, 1 examination/storage room) Dr John gave an interactive teaching session on the delicate issues surrounding sexual transmitted diseases. In a role play two midwives demonstrated the difficulties of needing to address not only the one patient but also the partner and possible other 2 to 3 wives. Rich men in the refugee camp may have up to 4 wives and 20 children. Well what remains of it, when the janjaweed came some ran with only the clothes they had on. Some were more fortunate and crossed the border with up to 300 camels.
Outright sad was the news that our team leader of vaccinators younger brother had been killed fighting in Darfur (Sudan side). The medical team visited the ceremony to pay our respect to the mourning family.
On a lighter note this week: the gazelle (male) Ruby living in the UNHCR shall be mated with a female gazelle living in an adjoining refugee camp. An 85 year old lady was admitted with a snakebite. It took me a while to wrestle the snake off the lady and I ended up getting entangled (see attached photo for proof)
The market (souk) has finally been explored today: The Libyan market (truckers drive straight through the Sahel/Sahara) has sheeshas, tea stalls, plenty of Bibsi, shoes from China, phunky Football shirts (bartering hard for a Barceloona shirt), blankets, cup. All you need to be happy in a desert cum beach resort as Bahai Beach. One of the Libyan drivers actually had lived in Pakistan so I was able to exchange some Urdu with him. We ended up discussing who was the greatest Indian actor Shah Rukh Khan or Hritik Roshan.
We are awaiting the rains… No rain will put the camp and entire region in severe danger. All depends on one wadi (lake) photo will follow. If not tomorrow I shall perform a rain dance to ensure thunderstorms and driplets.
It was good to hear from all you wish you all the best and until the next week or for the lucky skypers : ashisbrahma

Namaskar Ashis

Bahai, July 9, 2006

Bahai, july 9, 2006


Dear friends,

One week in the country and what a week it has been !
A calm start with a flight from Amsterdam to N’Djamena, the capital of Chad. The local club scene has potential with one or two discos and open air restaurants/ drinking holes. The one I visited (Carnivore) has live music, a local band and plenty a singers and dancers. Mustapha the driver and I chitchatted about the IRC and Chad. Sunday I spent visiting the market and eating at a Lebanese restaurant. Early next morning with a World Food Program airplane to Abeche which is a city in the south east of the county. It has a population of 72000 and many many NGO’s, UNHCR and the French military. It is the nerve centre for all the refugee camps in Eastern Chad. Due to the conflict in Darfur about 200000 refugees have spilled over from Sudan into Chad. There are about 12 refugee camps run by different NGO’s. The international rescue committee runs the most northern one near Bahai beach. It is called Oure Cassoni and has about 29000 beneficiaries. After one night in Abeche I flew with a teenie weenie aircraft to Bahai. From the air one sees sand, wadis (dry rock formations which from time to time contain water) tiny settlements and Acacia like trees. At the airport I was picked up by Pascal the logistician in one of the Toyota landcruisers. He is an American chap with a wicked sense of humor.
Whisked to the lovely compound (photos will follow) were the first surprise was awaiting me. I got the George Clooney suite! (try http://www.theirc.org/ or google Bahai+IRC) Any hair I find shall be sold on E-bay soon) At present our team is in transition but in Bahai we have about 7 male expats (from Kenya-Eritrea-Tanzania-Italy-USA-Burundi) After about 2 days shit hit the fan. About 35 local youths (including sons of the Sultan) came into the office armed with sticks and demanded jobs. It took the local gendarmerie and UNHCR 2 hours to get them out of our office and free our national and expat staff. Another common crime here is carjacking one car a month gets stolen from the different fleets available here. For now part of the program will be shut down and talks are being held at all levels to sort out the issues. The camp I have seen but once due these security issues but it looks ok. Two years and some permanent structures are up amongst a health post, health centre, maternity wards, schools. My job responsibilities have been adjusted as well: I am now the Public Health and Clinical Health Manager. In the team there are about 2 translators, two assistant managers, 4 Chadian nurses and in the camp; 39 Community Health Workers, 3 Team Leaders, 1 Supervisor and 6 Sudanese refugee nurses. John Kwenda, the present Health coordinator is giving me a two week handover to explain budgets, the program, the context etcetera. As some may have noticed there is internet facility when we have the generator on i.e. working hours in the office and perhaps after working hours in the compound. Therefore I can skype-msn messenger-yahoo. Our non local national staff (about 40) are staying in our compound for security reasons since the incident. Yesterday we watched Germany thrash Portugal as we have Camerounian tv reception. The food is ok to good – only thing missing is fresh fruit but what to expect in the desert. At night one can gaze at the stars. And during the day play with refugee children. The health status of the camp is not at all bad but always on the look out for outbreaks as there have been in the past: thypoid fever – mumps. Well it is 0700 in the morning now I am off for breakfast. Wish you all the best around the world and do drop a line when you find the time my yahoo-hotmail-gmail may all be used. The IRC e-mail address I shall keep for work only

Love and Truth---Namaskar Ashis