Chris is currently out of the office

My day started well, I slept in until 830 and took a driver shopping. I had just learned that was going to move to Tari, in the highlands, where MSF provide surgery in the ministry of health hospital. Unlike coastal Lae, Tari is cold so I needed a jacket and a jumper so went to the second hand clothes market and got one of each. Arriving at the office I was surprised not to see either of my assistants. They don’t normally work on Saturdays, but half of our medical cargo that should have arrived at the airport the day before did not turn up, so I told my Robin, my supply assistant that we had work to do and my admin assistant volunteered to help too.

The airport is some 30km outside Lae and the road towards it is dangerous. We travel the road at high speed in the bus of a security company. Getting 1,200 kgs of medicine from the airport to the warehouse (that a friend has let us use for free) is risky business. Having to do the journey twice made me uneasy.

So when it reached 10 o’clock and my supply assistant (who had the only notes on which boxes we received so far) had not arrived, I was annoyed. I don’t get annoyed much, but getting the shipment back into MSF custody was a high priority.

I took the unprecedented step of sending a vehicle to collect Robin from his house. Friday is pay day, is drinking day and is partying day so I was in a foul mood assuming that he had been up late the day before and slept in for one of the most important work days of the year. The car radioed back that
he was not at home. I sent the driver to check the bus stops. It was raining hard and demand for busses would be high.

Then the clinic guard came in to my office. She told me Robin’s brother was here. They were both attacked and robbed last night. I marched through the hospital with his brother, idle visitors jumped out of my way, surprised at our pace. “Where were we going?”, I wondered, panicking as we approached the intensive care department. We walked past, were we going to a ward? No, we walked past. We we going to Accident & Emergency? No. We approach what I assumed to be a dead body, leaning against a wall, under a blood soaked sheet. Robin’s brother points to the figure. My admin assistant who has been trying to catch up with our pace the whole journey and I are speachless as we peel back the sheet and see Robin’s badly beaten face. Emotion overwhelms me, am I am horrified that he has been sitting in the hospital entrance lobby under a sheet having not receive any medical care since he arrived over 12 hours ago. It is obvious that something needs to be done. Immediately. I run through the corridors back to the clinic and arrive at the bosses office out of breath and upset. I tell her the story and she agrees that we put him straight into the private hospital.

Arriving at the hospital I despair to see a room with 50 people waiting. All look rich and healthy reading magazines and drinking tea. I am close to exploding as the slow receptionist asks me Robin’s date of birth, home address, how we will be paying. “Keep calm”, I say inside my head as Robin sits soaking more blood into the sheet over his head. I stand where the doctors come to call the name of the next client. I grab the hand of the first one that comes, reading her name from the box she is about to grab a patient file from. Fortunately, she knows of our clinic. “Have you got a client for me?”, she asks. “Yes. This fellow here, under the sheet has been sitting bleeding all night. He has received no medical attention in 12 hours. He is my colleague and my good friend. I’d like someone to look at him now” (with emphasis on the ‘now’). She can see the determination in my face. The nurses take him straight into their Accident & Emergency room. I relax. A little.

My thoughts turn to the shipment. I get a driver to take my admin assistant, a radio and a plastic sheet to the transport company to arrange the collection of the missing medical items. I then send the other driver to get clean clothes for Robin. I had given a bag of clothes that I wasn’t planning on taking to Tari to the guards on duty at the house and I tell him to go and fetch shorts and T-shirt. Robin asks for some juice too and the driver goes shopping with the money I had given him to buy fuel before things started going wonky. My admin assistant radios. The transport company have already left without him to supervise the collection. They have no means of calling them back. We agree there is nothing they can do, we can only hope they bring back all the items. 10 minutes later he radios again. The vehicle is back at the depot with no medicine. I call the transport company from the hospital and my frustration boils over when he suggests that our airport trip is a waste of his time. “You are a transport company. This is your job. We are paying you. I have 500kgs of medicine sitting getting warm in the airport. It must come here today”, I shout down the phone at him. He agrees to send them back in the afternoon. Being friendly and patient is generally the way to get things done in PNG but by now I don’t have the patience. I can see people glancing at me nervously in my bloody clothes.

I wheel Robin’s wheelchair from A&E to X-ray. I leave the room as I see that the technician isn’t going to warn me before he gamma radiates us all. I’d at least like the option of being a father at some point in the future. 6 pregnant ladies in the corridor are waiting for scans and I strike up a conversation with them in Tok Pisin. Most “white men” just fire someone who is sick and get a new worker, they advise me. I explain that Robin is my friend and colleague and where I work we take care of our staff. “God will thank you” they tell me. I loose it and can’t hold back the tear any longer.

I wheel Robin back to A&E where his wounds are dressed. The doctor calls me over to discuss his X-rays. We chat for about 5 minutes in medical terminology before it strikes me that she thinks I’m a doctor. (“Doctors without Borders” is the claim on my T shirt). I can see relief in her whole body as I tell her that I’m mainly doing security and transport. She had been thinking that I was analysing her medical decision. Robin’s nose is broken, but skull is OK and there are no signs of any brain damage. I take him to our house where we have ice packs before getting a driver to drop him at his home. At the house, an air conditioning engineer has been waiting for me. I grab a cold drink and let him tinker with the medical store air con unit, give him some money, tell him I’m going to Tari and thank him for the good work he has done (much of it for free) as he is just one of many people in Lae who really support what we do and I rush to the transport company to sort out the medical shipment. I was embarrassed to ask him early on the journey, but it seems Robin has wisely kept a copy of all the cargo paper work in the desk and so things are looking brighter in terms of our cargo’s logistics. “Mi sori tru yu no amamas long me”, I apologise to the transport company manager, “wokman bilong mi gat buggerap face long plenti man pitem em assday. Mi askim yu sendim man long airport bringum cargo bilong mi”. My Tok Pisin isn’t great, but good enough to impress locals that a foreigner can try. He smiles and send the same team as yesterday with my admin assistant.

I go to the clinic and tell the boss the morning’s events. With a few hours to kill before the cargo will be back in the town I go home to see if there is any food. It is raining heavily and we drive past an old man sitting on the pavement surrounded by a crowd. We radio base to tell them our plans and spin the car around to see if he needs help. Neither the driver or myself are medics, but I’m guessing the crowd aren’t either. As we cut across the road to approach, the crowd assume we are trying to entre the house they are outside and bundle the old man out of our way. I jump out and ask if he is OK. A lady threw a rock at the man and he can’t walk. I ask him if he wants transport to the hospital but he doesn’t. The crowd are clearly stunned at this turn of events. Ambulances in Lae only seem to be used for transporting dead bodies. I can see the crowd reading “Médecins Sans Frontiers” on the vehicle and staring at us. A man asks us if we would take the old man to the bus stop and we do that. David the driver is very excited that logistics are using our vehicles as quasi-ambulances for 2 times in 1 day. “This is why we are here”, I tell him, “to treat the survivors of violence”. I know that David and I are proud of being able to help, logistics don’t typically get to deliver front line assistance. He is also happy that the public saw that we stopped and went back to help.

The shipment arrives and I trick the boss and mental health supervisor into a “warehouse tour” which result in 2 extra pairs of hands for unloading the truck when it arrives. We all go home and decide it’s time to have night out and treat ourselves to pizza and drinks we cannot afford in the hotel before coming home and dancing in the back garden, barefoot in the mud.

Doctors advise that Robin’s nose will heal in 3 to 6 weeks and that he will be back to his handsome self within a week or so. The robbers took his phone, wallet and pocket contents.

The nurse bought a little weather station when she was in Australia.  Last month (June) we had over a metre of rain – on average 35mm every day.  But it doesn’t rain every day.  Just now it rains about 2 days a week, but when it rains it rains heavy.  And when it rains crime happens – because the security companies and police are slower to respond.  I can’t tell if it is less hot in the past few months or if I’ve just acclimatized.  I could not imagine wearing long trousers in the first few months, but I wear my jeans every day now.  The nurse says the temperature has been between 29 and 39 in June.  Until I went on holiday I only had 1 pair of long trousers and when I arrived I only had 1 pair of shorts.  I don’t think I’ll take any of my current clothes home.  They get worn out so quickly here.  I’m not sure what the pattern of the seasons is here.  None of the expats stay long enough to work it out and when I ask any of the local staff they tell me it is
currently wet seasons (if it is raining) or dry season (if it is not).

The current team has 4 girls (project coordinator, nurse, doctor, mental health supervisor) and me.  Everyone I speak to seems to think that working with 4 women must either be heaven or hell.  Most people assume the later. Actually they are cool and we get on really well most of the time.  Most evenings we sit under the canopy at the back of the house and talk about our day or what direction the project should be taking.

We have a cook, which surprised me when I arrived.  It turns out that when projects have a cook the team will eat well, when they don’t the team eat badly and are more likely to be sick.  Our cook is a wonderful old man called Adam who calls me “pikinini” (the Tok Pisin word for child – like I am his son).

The clinic is open 6 days a week and we stay open on public holidays (people don’t stop bashing/chopping/burning/biting their wives for public holidays) and so we can take a Sunday off when we want.  But for me it never works out like that.  Much of our operation is at the house – it’s the location of the medical store, where the vehicles are based, the guard’s base and the house itself needs things fixed.  So Sunday tends to be fixing things at home, making up medical orders and counting stock day.  Last Sunday was an exception however and we were given permission to go to a nearby peninsula by boat.  It was great – we went snorkeling, hiking and even got to see a WWII Japanese tunnel that foreigners are normally preventing from seeing (the land-owner’s sister works in the hospital, so he liked our work!).

I had to decide last week if I wanted to extend my contract until the end of December.  It was really tough decision.  Reasons to leave include the possibility that my former job in London is being kept open for me to return, but they are not sure – but it would be nice to go back to earning some money!  There are friends that I am missing.  I could really do with a rest.  Reasons to stay are the wonderful people I work with and my love of the job.  I get more effective all the time as I learn about how things work in Lae and in MSF.  In the end I decided to leave, as planned, knowing that
I will do it all again sometime.  Maybe sometime soon.

So today is Sunday.  I’m writing this on my laptop under the mozzy net I put up this week.  I was sick during the week and the doc thought I had malaria but the blood test said otherwise.  I had planned to sleep late here, but it never happens.  The guards are too noisy and it is too light.  I’m going to the shops to stock up on a cola bean based carbonated soft drink and then to the clinic to see if any friends have emailed me.  I’m feeling quite pleased with myself as my assistants did their first full stock count yesterday and we don’t have a massive list of things to do at the moment (just find a warehouse, fix the air conditioning, replace the battery in the landcruiser and input the stock count into the computer – what a breeze!)

The project coordinator and I share a prefabricated building.  The buildings
we use are actually fantastic.  I’m very grateful to the team who set up
this project for the nice buildings they handed over.  It’s good to share a
building with the PC as things run smoothly when the PC and the log* work as
a close team.  One of the few downsides of being so close are overhearing
conversations like I did last week.  The Medical Coordinator, visiting from
the capital city, and the PC were talking out the database we record
information on and the categories that we have to put our clients into:

“……with a finger, penis or object….”

“……knife, gun or other weapon……..”

“……imprisoned for 1 to 2 days, 2 to 4 days or more than 4 days…….”

It’s enough to give you nightmares.  Fortunately, it doesn’t although, I did
have a crazy dream last night about our VHF radios not working and being
unable to contact our security guards.
____________________________________________________________________________
__

On Monday I saw the police pull up outside.  I went to meet them – we always
emphasize to people that we are doctors, not lawyers.  Doctors not
prosecutors.  Doctors not moral judges.  We keep a distance from all these
things.  We are neutral.  So we keep a distance from the police, but also
try to encourage a good working relationship.  So it’s complex and best for
a supervisor to meet them when they arrive.  They came to deliver a patient
to us.  He apologizes that they ran out of official forms so he hands me a
piece of scrap paper with the patient referral written on it.  I fold it
without reading it, the logistician doesn’t need to know her story and I’m
sure she is tired of telling people, but he starts to tells me – “she has
been raped by 6 men”.  We don’t need to talk about these details in the
clinic entrance and I’m not sure how to handle hearing her story like this,
so I try to interrupt his story to get her to the medics as quickly as
possible.
____________________________________________________________________________
___

*Log is the MSF standard abbreviation of “logistician”.  Not only do I have
the misfortunate to be known as a log, but because I’m in the city of Lae,
I’m the “Lae Log”.  For anyone reading this who speaks English as a
second/third language – in English “lay” means “not important” and “log” can
mean a variety of things, some nicer examples being a lump of wood, some of
the more informal interpretations I would not be allowed to write about on
an MSF website.